Help with perioral mound fat? Kybella?

For a double chin, InMode FaceTite with VASERlipo would give you the best result.With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, or Erbium) and microneedling RF (Fractora, Morpheus8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:
1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite 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 formal evaluation and to develop a personalized treatment plan based on your individual situation and goals.
Best, Dr. Emer

Hi, thank you for the question. Its difficult to give advise in your case because of no photographs. I would recommend you to have in person consult with a reputable injector for evaluation and further discussion about different treatment options available. Usually Energy based radio frequency devices like Mini fx can be very helpful. 
Best Regards,
Dr. Neel Bector

It's hard to comment on your case without seeing a photo or evaluating you in person. In many cases, hyaluronic acid based fillers like Restylane Refyne/Defyne can be used to improve the appearance of this part of the face by camouflaging the bulge.