Perioral mounds are a common aesthetic concern, appearing as fatty deposits or sagging skin around the corners of the mouth. These localized bulges are typically situated below the mouth’s corners, extending subtly towards the jawline. They influence overall facial aesthetics. These mounds are essentially superficial fat pads and skin that have changed over time.
Understanding Lower Face Anatomy
The lower face is comprised of several interconnected structures that contribute to its overall form and function. The outermost layer is the skin, which consists of the epidermis and dermis, providing protection and elasticity. Within the dermis, structural proteins like collagen and elastin form a network that gives skin its firmness and ability to recoil.
Beneath the skin lies the subcutaneous fat, organized into distinct fat pads that provide volume and contour to the face. These fat pads cushion the underlying muscles and bone.
Deeper still, a complex network of perioral muscles, such as the orbicularis oris and depressor anguli oris, surrounds the mouth. These muscles are important for facial expressions, speech, and eating, with some inserting directly into the skin or other muscles.
The underlying jawbone, or mandible, provides the foundational support for these soft tissues, influencing the shape of the lower face.
Inherent Age-Related Factors
As individuals age, several natural biological changes contribute to the formation of perioral mounds. Skin laxity is a primary factor, stemming from a reduction in the production of collagen and elastin proteins. This loss compromises the skin’s structural integrity, leading to decreased elasticity and a noticeable sagging effect.
Fat pad redistribution and atrophy also play a role in altering facial contours. While some fat pads in the mid-face may diminish or descend, fat around the jawline can accumulate or shift, accentuating the appearance of mounds. This dynamic change in fat volume and position contributes to a heavier appearance in the lower face.
Changes in muscle activity further influence the development of perioral mounds. Some facial muscles may weaken, losing their supportive function, while others, like the depressor anguli oris, can become overactive. This overactivity can pull down the corners of the mouth, which in turn deepens the folds around the mouth and makes the mounds more prominent.
Age-related bone resorption, particularly in the jawbone, reduces the underlying skeletal support of the face. This loss of bone density and volume can lead to a less defined jawline and contribute to the descent of overlying soft tissues, including the fat and skin that form perioral mounds.
External and Lifestyle Contributors
Beyond the natural aging process, various external and lifestyle factors can accelerate or worsen the appearance of perioral mounds. Excessive sun exposure is a contributor, as ultraviolet (UV) radiation damages collagen and elastin fibers within the skin. This damage disrupts the skin’s support structure, leading to premature aging and increased laxity.
Smoking also impairs skin health by constricting blood vessels, which reduces oxygen and nutrient delivery to skin cells. This habit can decrease collagen production, further contributing to skin sagging and the formation of lines and folds around the mouth. Repeated facial expressions, such as frequent frowning or pursing of the lips, can also deepen existing lines and contribute to muscle imbalances over time. These repetitive movements can reinforce the downward pull that emphasizes perioral mounds.
Weight fluctuations, particularly cycles of weight gain and loss, can cause the skin and fat pads to stretch and then lose their natural elasticity. This stretching and shrinking can lead to a less taut appearance in the lower face. Additionally, genetic predisposition plays a role in determining the timing and severity of perioral mound development. Some individuals may naturally have more prominent fat pockets in the perioral area from a younger age, making them more susceptible to developing these mounds.