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Perioral mounds or marionette lines - how can I fix this area? (Photos)

skit10010Feb 7, 2026

What would it take to remedy these puffy bumps/ lines/sagging in my lower face. I’m not sure if they’re perioral mounds or marionette lines. I already had Botox injections that did nothing for them. If I pull the skin by my jaw (near ear) back, it remedies it-—is it just skin laxity? It seems like there is excess skin-—would a mini lower facelift fix it? If so, is that the only option or is there a skin tightening that would work or mini lipo?

Answers (1)

From board-certified doctors and trusted medical professionals
Dr. Gary M. Horndeski, MD
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Dr. Gary M. Horndeski, MD
Board Certified Plastic Surgeon
4.6 | 319 Reviews
Answered on Feb 12, 2026
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