Efficacy of a Modified Lip Repositioning Surgery Technique With Tie Levator Labii Superioris and Without Frenectomy and Myotomy for Treatment of Excessive Gingival Display: A Retrospective Study

Excessive gingival display, commonly referred to as a "gummy smile," is an esthetic concern that may reduce patient satisfaction with their smile and overall facial appearance. Several treatment modalities have been suggested to address this condition, including orthodontic treatment, botulinum toxin injection, and various surgical techniques. Among surgical approaches, lip repositioning surgery has gained popularity due to its minimally invasive nature and ability to provide predictable esthetic outcomes.

A modified lip repositioning technique, performed without frenectomy and without myotomy, has been introduced to reduce morbidity and simplify the procedure while maintaining effectiveness. However, published evidence has largely come from prospective interventional series.

To further evaluate the clinical performance of this modified technique, we conducted a retrospective observational cohort study. Data were obtained from the medical records and clinical photographs of patients who had previously undergone the modified lip repositioning surgery at the study site. No new patients were enrolled and no interventions were prospectively carried out.

Inclusion criteria

• Patients treated with the modified lip repositioning surgery without frenectomy and without myotomy.
• Complete medical records including pre- and post-operative documentation.
• Clinical photographs available before and after surgery.
• Minimum follow-up period documented (≥ 3 months).

Exclusion criteria

• The patient has trauma and facial deformities
• Incomplete medical records or missing photographs.
• Patients lost to follow-up before minimum period.
• Patients who had undergone other concurrent surgical/orthodontic procedures affecting gingival display.