I am 28 now. When I started college, I gained 15 pounds, and I noticed the mounds for the first time shortly after I lost the weight a few years later. They have become more noticeable over time, and though my weight tends to fluctuate within a ten pound range, it does not seem to impact the appearance of the mounds. I think that they may be due to asymmetrical facial sagging, as I have noticed that at rest the left half of my mouth is closed while the right side is slightly open.
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