The objective of this prospective study was to assess clinical and patient-centred outcomes of aesthetic crown lengthening surgery for the treatment of altered passive eruption. Twenty-two patients were treated and followed up for 6months. The evaluated clinical parameters included, among others, probing depth, clinical attachment level, clinical crown length (CLc ), cemento-enamel junction to alveolar bone crest distance, gingival width (GW) and gingival display (GD). Subjects completed surveys to evaluate satisfaction with smile, gingiva and tooth features and experience with the procedure. Average CLc was 8.5±0.5mm at baseline and significantly increased (9.9±0.5mm; p<0.0001) at 6months. Concomitantly, GW significantly decreased from baseline (5.8±1.2mm) to 6months (4.9±1.1mm; p<0.008), as did GD (from 2.6±2.0mm to 1.1±1.9mm; p<0.0001). In contrast to their pre-operative satisfaction level, the majority (≥73%) of patients were very satisfied post-operatively with gingival and tooth display, when smiling or talking, and with maxillary anterior tooth size and shape. All patients would undergo the procedure again and would recommend it to someone with a similar problem. Aesthetic crown lengthening surgery results in high levels of patient satisfaction and predictable and stable outcomes in the short term.