What do you recommend to get rid of these fat pouches - Perioral mound Liposuction, Filler, or thread? (photos)

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Barbed PDO threads could be used to pull the skin back. This may help and would be the simplest solution, however it is temporary and will need to be repeated once or twice a year to maintain. A very small amount of Kybella could be injected to reduce the fat in the area. This is completely off label and should only be performed after careful evaluation and by an experienced practitioner. The other option is a mini liposuction, again, after careful evaluation and by someone who has lots of experience performing Lipo in the face combined with a subdermal skin tightening treatment such as Thermi, facetite, or Renuvion. The other option, of course, is to just leave it alone.

Hi there, I have a few ideas on how to reduce the appearance you are unhappy with, however a full face assessment would really be needed to come up with a treatment plan.If there is volume loss in the face, strategic placement of filler can help lessen the appearance of that area. Fat reduction either surgically or non-surgically (Agnes RF or Kybella) may help reduce the appearance however often when dissolving fat you must then tighten.Skin tightening such as Microneedling RF, Ultherapy or Agnes RF may further reduce the appearance or may be needed in conjunction with skin tightening.