How can I fix this sagging skin around my mouth area? (Photo)

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, Microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

I think you would see the best result with a combination treatment using fillers such as Sculptra Aesthetic to address volume loss and a skin tightening procedure like Thermage FLX to lift and tighten the skin. 

Hi,There are a pair of "depressor" muscles that are attached to the corner of the mouth that pull them down - carefully placed botox can relax these muscles and allow the corners of the mouth to assume a more neutral position. Additionally, you can have the round mounds adjacent to the corners of the mouth resuspended with dissolvable sutures that lasts 2-3 years (Silhouette InstaLift). I do not love using fillers around the mouth in thin patients because it can create an unattractive roundness to the lower face. I recommend a consultation with a provider that performs the InstaLift procedure to understand the procedure a little better and go from there.Best,Mehdi Sina, MD

Hi. Thanks for your message and for uploading photos. It would be best to start with a combination of fillers and collagen building. The dermal filler I would recommend is Voluma which will enhance the cheek bone and help tack up the face which is important as the sagging around your mouth is due to a loss of volume and the fat falling from the upper to the lower face. In addition to the Voluma, Thermagesculpt (a technique where we combine Thermage RF heat with a liquid stimulant called Sculptra) will stimulate your body to produce it's own collagen. Collagen is the architectural support of the face and the Thermagesculpt will build collagen and lift up the entire face and neck in a very natural way. Between the two approaches you should feel rejuvenated and lifted in a natural way. Best of luck with your treatments!