Perioral mounds or buccal fat? (photo)

It does not appear that reduction of buccal fat would make much of a difference in your profile. However, liposuction of the neck and jowls with skin tightening (ultrasound, radiofrequency, J plasma) would create desired improvement. Good luck.

Assuming you are talking the slightly softer mound/bulge that is just above your lip but under your nasolabial fold, I wouldn't be 100% sure that that is NOT filler because that blueish/grayish hue and soft appearance is classic for filler and also one does not naturally have fat in this...

You may be a candidate for buccal fat pad reduction and/or lower facial liposuction to improve contour and definition. This can only affect your non-smiling face and will not change the amount of fullness when you smile. Surgery has minimal effect on dynamic changes of the face when people animate.