I have shadows and excess skin on the outside of my lips!..

You may want to consider fillers or laser skin treatments to address the problem. Fillers will add volume to lift sagging contours and the laser treatments can rejuvenate your skin to boost collagen production.

Thanks for sharing. Buccal fat pad removal is not an option here as the location is further away. Injections like Botox or Dysport may help camouflage the area depending on how the other side looks and how the corners of your mouth move. In addition to some of the other comments, it is possible that you have a small benign fatty tissue that simply may necessitate removal alone. An in person exam is needed to diagnose and treat you best. 

This is called the marionette or pre-jowl area and is starting to droop in your case.  Filler in this area isnt the best as it can make the area look more "hound dog" like.  My suggestion is to get radiofrequency tightening, laser treatments for texture and superficial tightening, and sculptra to the lateral face to lift and contour the area.  Direct filler to this area, which most people will suggest isnt the best first option.  This should be done after you have done all the filling and lifting elsewhere.  I suggest a formal consultation with a facial contouring expert to give you the best long term solution.  Best, Dr. Emer.

You have an excess of tissue in an area that tends to lose tissue with aging.   I expect it will improve with time as your face matures.  I would avoid buccal fat pad removal, which removes a pad which is not in the immediate area and may accentuate the problem you have.  Botox and neuromodulators like it are not used in this area by most injectors, as the smile can be impaired.
Best,
Dr. Kennedy

As has
been mentioned, buccal fat pad removal is not your best choice here. A combination of chin augmentation and skin
tightening would probably be your best option.

Hi Paige, My approach to this issue would be a combination of fillers injected in the depressed or hollowed areas of teh skin and the use of radiofrequency for tightening of the skin .      

You are quite young to have aging changes in the face but the hollows in your chin and lower face mimic those that we would usually see in someone older.  I would recommend treatment with hyaluronic acid filler to both your chin to softly augment.   Such fillers are reversible if you do not like and can last as long as two years, without the risks of surgery.  Less filler may be needed after follow up treatments due to lasting newly formed skin collagen.

Hello paigemobley,Part of the issue that you have identified may be a small chin.  I cannot tell for certain since there is not a side profile photo but I suspect that that may be the case.  Botox below the corners of the mouth may be a good place to start since there is little cost and downtime associated with it.  A chin implant or some fillers in the chin and under the corners of the mouth may also be helpful.  If you are happy with that change you can then go with a chin implant at a later date, fat grafting, or continue getting the filler placed periodically.  I don't think the your buccal fat would extend all the way to the area you are concerned so buccal fat pad removal may not be a good option for you.All the best,Dr. Remus Repta

Dear Paigemobley, what you refers to is not caused by buccal fat or a true excess skin, but not uncommonly seen in such a young age group. It is the combination of premature sliding down of the skin and subcutaneous fat which cause the appearrance of marionette line. This aggravated by the deep hollowness on both sides of the chin below the mouth corner and the prominent nasolabial  folds. I would begin with filler to correct the nasolabial folds, chin hollowness and marionette lines plus Mesotherapy to flatten the fat mound. Thread lift may be an alternative.

You have a small chin.  Having a chin implant will project the chin forward to better balance the lower half of your face.   If you place your finger from your lips straight down, your chin should almost touch your finger.  Yours is behind.  You may also try Botox or filler to the 'marionette' lines.  I would suggest staying away from buccal fat removal.  As you age, your face will thin and removing that fat will only make you appear drawn.