Can you advise on fat pads around my marionette lines? (Photos)

Unfortunately, front face photos as well as profile photos would have allowed a more accurate determination of your problem. However, what you seem to have is far more common than you think. In general, the appropriate use of a volumizing filler placed in the region of the posterior jawline along with volumizing filler to the upper cheeks would likely provide the lift as well as the pull backward needed to elevate and straighten the jowl formation (the "fat pads") around your the mouth. What you need is to consult with an experienced board certified aesthetic physician. And be sure to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

mouth corners do well with fillers, threads, morpheus every 2-3 months and accutite. early in life you can do a neck lift. looks like you need fillers to the chin, jaw and marionette for support.

if you want a dramatic change necklift/facelift, Implants and fillers will give you that. noninvasive will improve the area and facetite, threads, morpheus, and fillers can be used.  start at home dermarolling to tighten you skin, see emeragecismetics.com where we do free skincare consults daily and recommend MTS roller with anteageMD ampules daily (see dermarolling package).

With significant neck sagging you would need a neck/face lift with muscle tightening (platysmaplasty). at the same time lasers (fraxel,  co2 or erbium( or microneedling RF (fractora, intensif) can be . performed to improve the crepe skin or wrinkles.  You need a formal consultation, as the neck can be treated with a combination approach:
1. micro needling and lasers for texture
2. botox, disport or xeomin to help platysmal bands
3. intensif or fractora RF microneedling for crepe skin and lifting
4. fillers like belotero, restylane silk, juvederm volbella to improve lines and folds
5. neck/face lifting if sagging is prominent or early starting +/- platysmaplasty (muscle tightening)
6. J plasma/Renuvion, thermiRF, inmode facetite for internal tightening
7. ultherapy and thermage for external tightening
8. regular Venus legacy, exilis ultra, or inmode forma treatments with facials to maintain tightness
9. PDO novathreads or silhouette instalift cone threads for lifting and long-term collagen production
see an expert for a full evaluation and treatment plan based on your individual situation and goals.
Best, Dr. Emer