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Thank you for your question and sharing your photograph.The asymmetry that you are concerned about is partly driven by the characteristics of the support from the teeth which are always slightly different between right and left sides and activity of the facial expression muscles.Although some of these elements of asymmetry can be improved through facelift surgery, you seem too young to contemplate this option.Alternatives to improve the contours for the labio-mandibular lines and position of the corner of the mouth include nonsurgical treatments like fillers, minimal interventions like threads which can be used to lift the corner of the mouth slightly and smaller surgical interventions like fat transfer.Surgery can be used to put tension to the area and improve the smoothness of the contours while adjusting slightly differently the corners of the mouth. However, you need to consider the scars are related to surgery carefully and perhaps discuss your worries and options with more than one choose 1.
I would recommend approaching you board certified plastic surgeon and looking at potentially some fillers to augment the area of the cheek and also lift tissues. The range of fillers available are powerful in doing this for you.
Based on one picture posted, I would not pay any attention to the analysis of some one at work, they are not experts.Your line around the mouth is hardly anything to do something about and spend lots of money on surgical or non surgical (does not work) procedures.
You should be able to get a facelift with no problems. Just make sure you get medical clearance ahead of time. The medications you are on will not affect the healing to any significant, if any, degree.
Your photo shows extra skin, fat, and probably loose muscles in the front of your neck. You also have lower jowl bulges near the jawline. Either a full facelift, or a lower cheek and necklift would smooth out and better define your neck, jawline, and lower cheeks, creating a more youthful look...
Those are probably not fat pads. They are probably branches of the facial artery. The artery is rather curvy in that area and can poke up from the fat below.