How to get rid of perioral mounds? (Photo)

Question

I have extensive perioral mounds due to genetics and aging. Which procedure is the most suitable? I have heard about a face liposuction. I am aware that a combination of treatments is needed. I am happy to do that. I am looking for a long term solution. Thank you in advance for your advice. Photo attached.

Martin Benjamin, MD, FACS · Answer

Hello! It looks like you have some perioral laxity and the beginning of what may be jowling. Nonsurgically, I have found that the Ellacor device of microcoring treatments to be beneficial in removing between 5-8% of skin and tighten this area. You may require 3-4 treatments spaced a month apart but will deliver scarless results and is FDA approved for mid to lower face tightening. Check it out!

Connie Hiers, MD, FACS · Answer

That is not fat and liposuction in that area can cause nerve damage to your mouth. I would suggest micro-needling with radiofrequency to tighten your skin in that area and Sculptra injections for the thin areas of your face for more volume.

Hilton Becker, MD · Answer

I would recommend botox to decrease muscle action and intradermal fat grafting around the mound ,which may need more than one treatment

Mats Hagstrom, MD (license on probation) · Answer

There are some plastic surgeons who claim to have figured out how to do treatment for Perioral mounts.
In my opinion, the problem is primarily related to facial bone structure, and some people are inherently prone to developing this facial contour.
It does not represent an abnormal fat, distribution and liposuction is not the treatment of choice.
The contour is simply a combination of how to soft tissue drapes over certain facial, skeletal structures.
Before undergoing any permanent change to your face, I suggest you try to vet providers who claim to be able to treat this successfully by insisting on seeing multiple before it after pictures.
It is an inherently difficult thing to treat.
Best,
Mats Hagstrom, MD

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