What can I do to minimize the appearance of mounds in the mouth area? (photos)

Question

Hi! I'm a 40 y/o female, 5'4", 195lbs. I have mounds on either side of my face that are more pronounced at my current weight, but are definitely still present at my usual weight of 140lbs. These seem to be genetic as both my mother and maternal grandmother have them - and they are present in photos throughout their lives. I hate them. What are my options??

Randal Haworth, MD, FACS · Answer

Hello !

One treatment for small fat collections located at the sides of the mouth involves performing microliposuction.

FaceTite which works which radiofrequency could also be - and may be the best - option. It provides dramatic improvement in skin laxity on the face and neck, which was previously only attainable through a surgical procedure such as a facelift. FaceTite utilizes minimally invasive radio-frequency energy to melt fat and tighten skin.

Another alternative would be filler injections to even it out.

Of course, an “in person” exam is necessary.
It is best to consult with a skilled board certified plastic surgeon.

I hope this helps,
Good luck !

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the minimization of soft tissue mounds near your mouth area. Based on your query and the provided images, surgical removal could be a solution. This can be approached either through a facelift incision (placed in front of the ear) or an incision inside the corner of your mouth.
Aside from surgery, another potential treatment is the injection of Kybella into the affected area. This non-surgical option can also effectively treat excess soft tissue.
Remember, it's important to consult with your surgeon to determine the most appropriate treatment option for you.

Anuj Purbey, MBBS · Answer

Thank you for sharing your concerns. It sounds like you're dealing with mounds on either side of your face that have been a source of frustration for you. Given that you've noticed them at both your current weight and your usual weight, it's understandable that you're seeking solutions.

Here are some options you may consider:

Consult with a Dermatologist or Plastic Surgeon: Schedule a consultation with a dermatologist or aesthetic surgeon who specializes in facial aesthetics. They can assess your specific concerns and provide personalized recommendations based on your facial anatomy and desired outcomes.
Non-Surgical Treatments: Depending on the nature of the mounds and your aesthetic goals, non-surgical treatments such as dermal fillers or injectables may be an option. These treatments can help add volume to certain areas of the face, improving contour and symmetry.
Surgical Options: In some cases, surgical procedures such as liposuction or facial sculpting surgery may be recommended to address excess fat deposits or reshape the facial contours. A qualified surgeon can discuss these options with you in detail and help determine if you're a suitable candidate.
Lifestyle Changes: While lifestyle changes may not directly impact the appearance of genetic facial features, maintaining a healthy weight and following a balanced diet can contribute to overall well-being and may help improve self-confidence.
Cosmetic Camouflage: In the meantime, you may explore makeup techniques or hairstyles that can help minimize the appearance of the mounds and enhance your facial features.
It's essential to have a thorough discussion with a qualified healthcare professional to explore your options fully and make an informed decision that aligns with your goals and preferences. Remember that everyone's anatomy and aesthetic goals are unique, so what works for one person may not be suitable for another.

Mats Hagstrom, MD (license on probation) · Answer

The Peri, oral mound is not easily understood or treated. It is in my opinion most likely more related to facial skeletal structure then issues related to soft tissues. Soft tissue coverage of the face tends to be fairly consistent from person to person and variables to determine desirable aesthetic, facial traits, can often be Explained by bone structure. Oral surgeons tend to take a more facial, skeletal approach to facial aesthetics while plastic surgeons tend to take a more soft tissue approach. The area is adjacent to the corner of the mouth where a myriad of muscles come together to move the mouth, and the entire cheek for functional and emotional causes , it is the muscles of facial expression and the functional lip muscles that all come together. The muscles themselves, including their tendons, give some volume, but the pull of these muscles also create certain contours by the forces that they put on their overlying skin. While there is subcutaneous fat in almost every layer of the body, there’s no particular thick fat pad in this area. There are providers who claim to have successful treatments, including the ability to differentiate if this is more related to subcutaneous, fat or bulkiness of muscles. I question if the procedures deliver a consistent quality results, though they may have some subtle benefit. Recognize that all surgical intervention has risks and uncertainty especially when the treatment and problem are not clearly understood.
There is no one simple great solution to your problem.
If you move forward and consider surgical intervention, then I would be extremely selective and move forward with a great degree of caution. Asked to see enough before and after pictures to get a clear confirmation that the provider has enough skill and experience to deliver consistent results. Ask them specifically about how many of these procedures they performed And asked to see a variety of results including excellent outcomes, average outcomes, and outcomes that did not turn out as well as they had hoped for. 
Somethings we just don’t have a great treatment for and this is one of them.
Best,
Mats Hagstrom, MD

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