Are These Perioral Mounds? (photo)

    Fillers at the level of the oral commissure are usually a good choice.  I would not recommend liposuction.  Kenneth Hughes, MD Los Angeles, CA

The picture demonstates some contour issues around the mouth that are the product of muscular function.  The muscle can be weakened with Botox or the depressions filled with a filler.

The mounds that you have developed are related to a combination of loss of subcutaneous fat leading to the appearance of loss of volume, or may be secondary to changes in muscle function. I wound initially recommend low dose Botox treatments in an effort to modify the activity of the orbicularis muscle around the mouth

As we age, we lose volume in different areas of the face at different times.  Loss of volume at the corners of the mouth can create the contour irregularities you are referring to.  Temporary fillers (Restylane, Juvederm, etc) can improve the contours.  Fat grafting can give a longer-term result, but the result can sometimes be more unpredictable.  Filling these areas can also improve the downturned appearance of the corners of the mouth.

I would not do micro-lipo in the area of concern. The reason you are noticing these fat/muscle bulges more with age is probably a loss of fat tissue contour in the area. As we age we loose fatty tissue and tend to get sagging of what remains. This can lead to the visible deformity you describe. The better correction is to replace fullness around the area in an even fashion. either with fat itself or a filler like Juvederm or Perlane.