Micro-Autologous Fat Transplantation Shows Durable Correction for Gummy Smile in Long-Term Study

Micro-autologous fat transplantation (MAFT) may offer a durable, minimally invasive option for correcting gummy smile, according to a long-term retrospective study published online ahead of print in Plastic and Reconstructive Surgery.

Investigators analyzed outcomes in 52 patients with excessive gingival display treated with MAFT between 2014 and 2023. The cohort had a mean age of 43.4 years and was predominantly female (92.3%). The procedure involved harvesting and purifying autologous fat, followed by micro-injection using the MAFT-GUN® device into the nasolabial groove, ergotrid, and upper lip to increase soft-tissue volume and alter perioral biomechanics.

Gingival exposure was measured at four maxillary incisor regions before and after treatment. Mean preoperative gingival display of 3.31 mm decreased to –0.82 mm postoperatively, representing a mean reduction of 4.13 mm (P < .00001). The greatest improvement was observed at the right central incisor. Mean injected fat volume was 16.1 mL (SD, 3.4 mL), corresponding to a calculated graft weight of 14.8 g. No significant correlation was found between injected volume and clinical outcome (P > .40), suggesting that regional anatomy and tissue responsiveness may play a larger role than volume alone.

Patient-reported satisfaction improved markedly, with mean Likert scores increasing from 1.40 preoperatively to 4.90 postoperatively. The mean follow-up duration was 56.4 months, supporting the durability of results. Only 2 patients (4%) required minor secondary touch-ups, and no major complications were reported.

The authors concluded that MAFT provides a reproducible alternative to existing approaches such as orthognathic surgery, botulinum toxin injections, or lip repositioning procedures. 

“MAFT is a safe, effective, and durable treatment for gummy smile,” the authors wrote, noting that the technique preserves dynamic lip movement while offering long-term aesthetic and functional benefits.