This study investigated patients' perceptions of laser-assisted esthetic crown lengthening (ECL) for treating "gummy smiles" using either an open-flap (OF) or flapless (FL) technique. This study included 36 healthy patients with altered passive eruption who underwent ECL surgery and were randomly divided into two equal groups: OF and FL. Gingivectomy and ostectomy were performed using an Er, Cr:YSGG laser in both groups. Patients' perceptions of postsurgical morbidity were assessed using a 5-point self-administered Likert scale. The participants provided ratings on their experiences with anxiety, pain, swelling, bleeding, discomfort, tooth sensitivity, and use of pain medication after 7 days. Nine months after surgery, another survey was conducted to assess the overall satisfaction. Patients reported less anxiety, postoperative pain, swelling, bleeding, discomfort, sensitivity, and need for pain medication after the FL than the OF surgery procedure. Both groups reported high satisfaction with the final cosmetic outcome after 9 months, although patients who underwent FL surgery tended to report even greater satisfaction. The FL procedure was also significantly faster, taking approximately 15 min less than OF surgery. The FL laser-assisted ECL technique led to a more positive recovery and better patient experiences than the OF technique. This study suggests that laser-assisted FL ECL may be a more patient-friendly and efficient procedure compared to traditional OF surgery with similar esthetic results. This could be important for dentists looking to offer their patients a less invasive and potentially more comfortable option.