Perioral mound - filler or lipo? (Photos)

I have a dimpled/sagging area below my bottom lip that makes my face look haggard, and I'm not sure how this would be treated. Would it be best to use a filler like Juvederm, or would it require mini lipo to get a smooth, undimpled appearance?

Doctor Answers 9

Perioral Mounds Treatment

Unfortunately these are actually fat pads and muscles and are more prominent when people have a weak chin/jawline.  This typically needs chin implantation or fillers to this area. I suggest seeing an expert.  Best, Dr. Emer.


Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Lower Periorial Depressions & Dimpling May Be Helped By Volumizing Filler & Nonsurgical Chin Augmentation

Unfortunately, a profile view is lacking among the photos provided. However, the right face, three-quarter view suggests that there may be insufficient projection of the chin. Should this truly be the case, it is likely that improvement in the lower jaw/perioral region can be achieved by combining a nonsurgical chin augmentation, performed first, followed by actual volumization of the depressions that you dislike. 

My volumizing filler of choice for the chin, in my Upper East Side Manhattan practice, would be Voluma XC, and for the sides of the jaw, Restylane Lyft. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available, I would opt for Emervel Volume for the chin and Hyaluronica 2 for the sides.)

Treating these areas is not for novice injectors accustomed to injecting simple smile lines with ordinary fillers. So you would be wise to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in advanced injection techniques. And of course, be sure to ask to see his/her before and after photos. 

Before proceeding, you would be wise to also consider a dental consult to check to see if some bite irregularities are in any way contributing to your problem.

Good luck to you.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Mationette lines?

Thank you for sharing your questions and photos. The area you complain about would probably look better following injection of dermal fillers. If this does not give a satisfactory result, more invasive treatment options can be considered.
Good luck,

Lips and filler

A small amount of botox to relax the muscular pull of the mouth and filler underneath.  However, the muscle of the lips is circular and only small amount of botox, done properly, can be used to reduce the pull in this area, while the filler may also be used to enhance the region under your lips.  The type of filler is variable and you should see a derm or plastic surgeon familiar with these anatomic areas.

Rodney E. Schmelzer, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 4 reviews

Consultation to Determine Treatment for Peri-Oral Mound

Dear yt2345, An in office examination would determine the best course of action to treat your current concerns. The photographs do not show a profile view however often times when we see this complaint the patient has a weak chin and addressing the chin with augmentation helps bring better balance to this portion of the face. Liposuction would not be an advised treatment in this area. Most surgeons offer complimentary consultations so this is an easy way to start that will have no expense and you will then be fully informed of your options. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Filler or Lipo?

To decide how to approach this problem area the it would benefit you to consult with a board certified plastic surgeon.  They will be able to tell you the cause behind the protruding area and whether injectibles, braces or surgery would be able to help you achieve the result you are looking for.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Lower face question

I think there is volume loss in the marionette area. Placing filler there will help in my opinion. Don't need lipo and I can't comment on braces as the others have.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Lips and Aging

From the photo that you described it appears that you might benefit from fillers and/or braces to correct this problem area.  Please consult an expert to assess the area.  Best, Dr. Green

Dimpled area below lip

Thank you for asking about your lips.

  • This fullness is often from muscle -
  • A trial of Botox would be my first suggestion.
  • If the lower face has muscle imbalance - that can be times be corrected with braces, oral surgery or chin surgery.
  • Neither liposuction nor filler is likely to be a good choice.
  • I suggest you start with a consultation with a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.