Inclusion Criteria:  Gummy smile because of 2 combined etiologies:  Short clinical crown of teeth due to the altered passive tooth eruption Hyperactivity of upper lip muscles (lip mobility level > 8mm)  Exclusion Criteria:  Pregnant or breastfeeding patients  Gummy smiles due to:  Maxillary bone overgrowth (maxillary hypertrophy) Vertical maxillary excess Neuromuscular disorder Gingival hyperplasia due to medicine, supplements, or neuromuscular transmission inhibiting agents Systematic diseases that can affect the result of surgical treatment (such as diabetes, heart disease taking blood anticoagulant medicament, blood diseases, immunodeficiency disease etc.) Allergy to BTX-A or albumin History of taking BTX-A injection in the head-neck area formerly Patient with any contraindication of surgery