Lines around mouth. Lower facelift or any other recommendation? (photo)

You are too young and look good. No facelift needed. Filler in the cheeks will not help. You need precise filler in the marionette lines and also the corner of the lips (oral commissures).
Regards
Dr. J

Lines around the mouth can be quite distressing, especially at a younger age, and fillers don’t always provide sufficient improvement in this area. In your case, considering the overall sagging and volume loss in the face, a total facelift can be a more effective and long-lasting solution. This procedure repositions the tissues in both the mid and lower face, removes excess skin, and rejuvenates the facial contour.Fat grafting (fat transfer) can be performed under local or general anesthesia after the surgical recovery period; it helps restore volume to areas such as around the mouth, the nasolabial folds, and under the cheeks, resulting in a more natural and softer appearance.Since the patient’s own fat is used, the results tend to be long-lasting and well integrated with the tissues. That said, every face is unique, so a physical examination is absolutely necessary to create the best individualized treatment plan for you.

I recommend 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. This will take 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Prominent lines around the mouth are often initially addressed with cheek or direct filler. Fat grafting is another option in the checks and perioral region. Nonsurgical skin tightening devices like Sofwave help treat wrinkles and lift neck/chin/eyebrows and more.
A lower facelift helps to reposition lax cheek tissue improving the cheeks, jawline and perioral regions.

A profile view would have been helpful here to determine whether the use of a robust HA contouring filler could be used at the angles of the jaw and a long the jawline, which might secondarily improve the area the marionette lines area. However, at least from the front face view, it would appear that the use of a robust HA lifting filler could help to elevate the angles of the mouth and thus directly address the marionette lines. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. Best of luck.