Buccal fat, perioral mounds, or something else? Treatment options? (Photos)

I have developed troubling fatty deposits or mounds above my upper lip, particularly toward the corners of my mouth. This doesn’t seem to be common, and I haven’t found much information on it. Any idea what this might be? What kinds of treatments or procedures are available, and what type of doctor should I consult? I prefer to start with something minimally invasive, but of course effective. - S context, I have had HA filler a handful of times over the past 15 or so years (no more than 4 attempts total, with the most recent one being about 4 years ago). I am not a fan. I don’t believe this is filler migration, as looking back at older photos, there was a subtle tendency toward this kind of anatomy/look, but it has worsened significantly with age and is now quite noticeable and bothersome, casting a shadow and more obvious when smiling. Any insights or recommendations would be greatly appreciated.