What is causing this bulge below my lips and what treatment would help? (Photo)

That’s your Depressor Anguli Oris (DAO) and it’s not fat. Kybella there would be risky in my opinion. Botox by an expert injector can lead to nice results!
Good luck. Dr. Aldo

I have seen this before in several young patients, and I believe it is more a part of aging and tends to be genetic. I definitely believe this is due to fat and skin laxity, not muscle hypertrophy. I would first address volume loss in the mid face, high on your cheeks- if you inject filler this will lift your lower face and can help with that area that is lumpy. I would also consider a tightening treatment such as Ultherapy to help with skin laxity. After these are done then I would think about using filler strategically to improve your facial contours in that area. Kybella would be off label to use in this area, and can help reduce fat, but won't address the cause---which is volume loss and skin laxity.Best of luck, Dr. Papantoniou.

The best opinion will be after the examination but usually this area looks like that becasue of volume loss most likley in upper face and also excessive laxity. Muscle action can pull the angle of mouth down a bit so will need combination therapy. 

This can be camouflaged with fillers.  Please see an expert for a full facial sculpting consultation.  Best, Dr. Emer.

Based on the appearance in the pictures I think this is most likely due to volume loss around the chin and would be best improved with some filler to restore the volume.  All the best.

I would attempt to see two, perhaps 3 plastic surgeons and get their opinion on this matter. I would definitely not inject kybella in that area as it's me cause harm to the nerves which go to the lip. Good luck from New York City

This is not due to muscle contraction. It is likely related to underlying volume loss and the appearance of this area could be improved using a filler. 

Your problem is complex although quite easy to solve. It appears you have a significant volume loss in deep fat compartments including, most likely, your upper face. The "bulges", in reality, are due to lack of soft tissue support so the superficial volume is more visibly a subject to gravity. In my opinion, it has nothing to do with muscles so there is no need for Botox. It is also unreasonable to think of Kyabella. I would suggest to seek a third, forth, and beyond, opinion. Also, please read as much as you can about the soft tissue and fat distribution on face. Good luck!

Muscles do not appear like this so it is unlikely that it is muscle and fat deposition in this area is very unusual and should not occur with 10 pound change so it is very difficult to tell what is going on here/. a consultation with a board certified facial plastic surgeon is in order

Hi Anonymous1982, You case is complicated in a way because you have significant weight loss on the face, yet a weight gain of 10 pounds over 3 years. The fat would have descended and your doctor can palpate whether this is fat or muscle. You may consider filler on the midface area but if that is not enough to lift the bulging area, this might not be treatable with non-surgical options. Theoretically, Kybella can dissolve fat but the area below the lips is not ideal. It will also produce a lot of swelling, making it look worse before it can look better.All the best,Justin Harper, M.D.