What are my options for removing these fat pouches beneath my lower lip permanently? (Photo)

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

These can be camouflaged with fillers. I recommend a combination of fillers, lasers and microneedling/prp. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Dear Tori4176,it is hard to tell for sure without an examination. If you are considering a treatment, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks for yours will not be  question and photos. These are the residual parts of your embryological mouth development. The composition is complex tissue. It will not be a simple matter to remove these but direct excision would improve the appearance. Speak with a board certified maxillofacial/plastic surgeon to learn more. 

the facial skeleton has by far the greatest impact on facial contours or how one looks.  This is especially true for young people.It’s hard to tell for sure but I’m guessing your upper lip projects forward more than your lower lip. This is based on your underlying bony structure. You don’t have unusual fat deposits that need to be removed. Facial assessments should be comprehensive and take many factors into account.When it comes to making a treatment plan it should be done so based on what factors are causing the greatest impact on aesthetics and which are the easiest to correct. In facial aesthetic treatments often the primary cause is not treated because it is invasive or difficult.  As you can tell from the number of different responses your situation is complex.  This should also make you weary of treatment recommendations. Look for thorough indeapth evaluations Best,Mats Hagstrom, MD 

I personally doubt that liposuction or other reduction techniques will prove helpful.  Consider filling the adjacent depressed areas gradually with restylane or juvederm to soften their contour.  Though I don't use it, this may be an area where an attempt at kybella might be considered.  Talk to someone with experience in injections and micro lipo to see if you can find a doctor with expertise in this region.Best wishes,Jon A. Perlman, M.D., FACSDiplomate, American Board of Plastic SurgeryAssociate Clinical Professor of Plastic Surgery Geffen/UCLA Medical CenterExtreme Makeover, ABC TV plastic surgeonBeverly Hills, Ca.