Procedure to get rid of fat pockets on sides of mouth? (Photo)

Thanks for including a photo! The aging you are seeing here is a result of the ligament separating your cheek from your chin. Though the cheek falls with time, the chin tends to move less. This creates a prejowl sulcus that can pull down the corner of the mouth. This area can be addressed with facelift surgery. In the interim before surgery, you may consider using some filler to that area to help with the contour. Restylane Refyne is the filler I use most commonly for this issue. Best of luck!

Based on your photo, I would consider a conservative liposuction performed through a small stab incision at the jawline or even within the mouth, to reduce the fat deposit. The risk is that the overlying skin could be slightly looser, increasing the depth of the groove in front of the fat bulge. That doesn't always happen, but it is a risk. Of course, with a subsequent surgical lift, the skin would be advanced up and backward, tightening and smoothing the area. An alternate approach is to leave the fat, but inject filler into the linear groove to plump that up which would camouflage the bulge by blending it into the side of your chin.

These fat pockets are the jowl and cheek fat that is sagging, which will be fixed with your facelift. The reason they appear more prominent, however, is also because you have volume loss in the prejowl area, right in front of them. I usually fill this area with fat grafting at the time of a facelift, but it can be filled in advance of the facelift as well, either with fillers or fat grafting.

There are several options to lessen fat pockets near the corner of the mouth prior to a facelift. Fillers help restoring volume, improve wrinkles and depressions. Fillers may be placed directly in the depression to soften and camouflage the areas of concern. Cheek fillers or jawline fillers can help the with some "lifting". Nonsurgical skin tightening devices like Sofwave help stimulate collagen gradually and help with wrinkles and lifting.

An examination in person would be required to properly evaluate you and determine how to best help, but the reason the “fat pads” are troublesome for you is that they create a shadow. The depression below the fat pads may be able to be treated with injectable fillers to reduce the optical effect of the shadow and create a more aesthetic and youthful lower face.

Please consult with an experienced board certified plastic surgeon or cosmetic dermatologist skilled and experienced in the use of injectables. Best of luck to you.