Would I benefit from a facelift or from liposuction to perioral mounds? (photos)

That is not your natural fat. That is retained filler that migrated out of your lips. You think that you have always had these. That is highly improbable. It is much more likely to related to a past fiiler treatment. One can also see you have retain lip overfill. As these treatments age, they hold more and more water. There is also retained filer along the jaw line. Removing that material will make you look years younger.

With your face in repose, it is clear that the deep soft tissues of your midface have descended, replicating the aging process despite your years. Liposuction is a bad alternative to a proper rejuvenative surgery, and as I said, you don't have excess fatty deposits.

One thing I would recommend is a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.