How can the shadowing at the corners of my mouth be best addressed? (photos)

The reason you are noticing this puckering is due to a variety of changes that occur with aging.  First is loss of volume, which is typically from loss of fat and downward decent of fat in the mid and lower face areas.  This can be address by adding volume, in the right amount and in the right vectors to get you lift.  Specifically to lift the corners of your mouth.  The second thing you are seeing is recession of your chin and jaw, and this is typically a bony change that occurs over time or something you have always had but never has been so apparent.  I have great success using fillers along the jawline and chin on the bone area to lift the underlying tissues and give more prominence.  This interns makes the lip corners and mouth appear more lifted and happy rather than droopy.  However, a proper assessment is needed as some people benefit more from a chin implant or jaw surgery.  I am not saying you are a candidate for this, filler may be all that is needed, but a proper formal evaluation with a cosmetic dermatologist or plastic surgeon experienced in facial contouring and volumization is what is needed.  I treat many patients like this daily and have excellent success using fillers alone.  I wish you the best of luck, Dr. Emer.

Hi Kflow.  Yes, dermal fillers are a good option for you.  In the area around the sides of the mouth and below the mouth where you see shadows, Restylane or Perlane would both be good options to add a little more volume making the area convex (sloping outward) rather than concave and this would hopefully give you the effect you are looking for.  Take a look at the pictures below for an example.

In my practice every cosmetic patient is addressed separately as there are no "cookbook" approaches even after almost 20 years of filler experience.We use many different fillers in the same patient to achieve a optimal correction in the corners of the mouth. I would recommend you discuss with a dermatologist board certified and experienced in fillers in your area.

The problem area you mention (corners of mouth and below) is an extremely common problem area.  As we age, the face begins to fall vertically leaving us with "marionette lines" and deep nasolabial folds.  A hyaluronic acid filler like Juvederm or Restylane is an excellent choice to smooth out the contours around your mouth.  Typically I also recommend having some filler placed in the cheeks as well as this can help rebuild that youthful cheekbone - giving you back the youthful facial shape we all desire.Find an injector who is experienced with all of these areas and best of luck!