What can be done to reduce the lines and the pouchy sags just to the outside and below my mouth corners? (Photos)

Hi @DESIGNKAT. Thank you for sharing your photos. I recommend a combination treatment of Morpheus 8, dermal fillers, and PDO threads.

Best of luck,

Dr. Nima

A combination approach will give the most improvement. I recommend fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

From your photo, you are very lean so volume replacement, which is what is lost as we age, is the perfect solution for correction.  Sculptra injection (usually a series of 2 or 3 several months apart) would increase the volume in a natural way and add stiffness to the skin as well.  Sculptra is also the longest lasting of the fillers and can be maintained with follow up treatments every 12 to 18 months.