The aim of the proposal study is to answer the question of how to manage gummy smiles due to hypermobile upper lip with less invasive and low risk level procedure . This trial will help the practitioners and the patients in taking the convenient decision to correct the gumminess to restore lip-gingival-dental harmony and enhance smile asthetics.

In this randomized clinical trial , two groups will be included to compare the effectiveness of a treatment modality of botulinum toxin-A injection , in the first group , on gingival display during smiling ,patient satisfaction , lower face esthetics ( upper lip length , upper lip vermillion length , interlabial gap , nasolabial angle) and the postoperative side effects . the comparator group will receive treatment by modified lip repositioning surgery ,to compare the results of the intervention group that can possibly obtained without undergoing surgery.

Inclusion Criteria:

• Adults with age range from 18 - 30 years.
• Excessive gingival display more than 3 mm during smiling.
• Patients having hypermobile upper lip with or without (mild / moderate) vertical maxillary excess.
• Patients with normal morphology of clinical crowns.
• Normal lip separation (ILG) at rest
• Medically free subjects.

Exclusion Criteria:

• Patients with systemic diseases or neuromuscular disorders.
• Gummy smile with gingival display more than 8 mm during smiling.
• Severly long face (VME) patients.
• Patients with periodontal disease or gingival hyperplasia .
• Medically compromised patients contraindicated for surgery .
• Pregnant or lactating female patients.
• Patients with inadequate attached gingiva .

single blind