To get rid of perineal mounds around the corners of mouth. What can I do besides surgery to help with this? (Photo)

that's tough and there is no clear cut solution.the cause is not obvious and thus nor is the "cure"here are some out of the box thoughts though based on the photo shown, you have vertical maxillary excess (the middle part of your face is to "long" or "tall")  and you likely have clockwise rotation of our mandible (meaning your lower jaw is being "pushed down" by the upper jaw).  Furthermore, you have microgenia (a small chin) and retrognathia/retrogenia (a "retruded chin,"  possibly related to the clockwise rotation of the lower jaw).so the things listed above make it harder for you to close your lips, you try harder and the fullness you see especially in the lower lips is due to your orbicularis oris muscles working over time.  a thought - hard to prove.any how there are two ways to address the situation I listed above that might improve your condition, I stress might1) the short cut way - a chin implant or osteoplastic genioplasty.  doesn't solve all the issues, but will likely help some2) the full deal - lefort 1 upper jaw surgery. possible lower jaw surgery and a genioplastynumber one is less expensive, also does not address everything.  neither is inexpensive hope that helps

It is common for patients to notice increasing fullness ('mound') of the skin in the lower face, jowl, or nasal labial cheek, especially as gravity and even aging changes the contour of the face. Sometimes this is attributed to 'fatty tissue'. Sometimes it is just loose skin. Sometimes it may be genetic anatomy.    When excess fat is actually present, micro-liposuction may help. When there is a 'low area' near a 'high area', the lower area may be improved with use of an injectable filler (Restylane, Radiesse, etc) to disguise the high area ('mound').  Your facial surgeon can help you diagnose the reason for the unevenness and help you plan the best strategy to improve it!