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Perioral Mound Reduction

Perioral Mound Reduction services offered in the greater Newport Beach, CA area

Perioral Mound Reduction

Perioral Mound Reduction services offered in the greater Newport Beach, CA area

Have you noticed an unattractive fatty bulge running from the sides of your mouth down to your jaw? If so, you should consult Jonathan Zelken, MD, in Newport Beach, California, to learn if a perioral mound reduction can eliminate the problem. As one of the few experts in perioral mound reduction, Dr. Zelken identifies the underlying cause and recommends the best procedure for each person. Call the office right away or book an appointment online to discover how to safely revitalize your appearance.

Learn more about perioral mound reduction at Dr. Zelken's office »

Many of Dr. Zelken's perioral mounds patients have a noticeable convexity outside or above the corner of the mouth. This fullness seems to emerge at the lower border of the smile line fat and the upper edge of the jowl. As the lower facial fat compartments are understood to be the last to deflate, this area may be problematic across age groups. Additional contributors to the bulk may be aponeurotic connections or overlap of the orbicularis oris, buccinator, risorius, platysma, and lip depressor muscles.

Perioral Mound Reduction Q&A

What are perioral mounds, and why would I need reduction surgery?

Perioral mounds are pockets of fat running from the edges of your mouth toward your jaw. If you develop jowls, the perioral mounds form the top part of each jowl.

The perioral fat cells enlarge if you gain weight. But even if you maintain a healthy weight, you can end up with excessive fat in the perioral mounds because of aging. As you get older, fat under your skin gives in to gravity and accumulates in areas like the perioral mounds.

The reason people seek perioral mound reduction is to eliminate the excess fat and improve their appearance.

What happens during perioral mound reduction?

Dr. Zelken has years of experience performing procedures to reduce the perioral mound. He can combine procedures when needed to achieve better results than you’ll get through one alone.

He could recommend any of the following:

Radiofrequency procedures

FaceTite® and AccuTite® are two devices manufactured by InMode. Both use radiofrequency energy to safely heat and destroy fat cells under your skin. As an expert in both procedures and an InMode trainer, Dr. Zelken chooses the most appropriate one to remove your perioral fat.


Dr. Zelken might use a tiny tube and gentle suction to safely and precisely remove fat cells from the targeted area. You can depend on his skill and artistic approach to evenly remove the right amount of fat, avoiding lumps, bumps, and unattractive results.

Buccal mucosal myectomy (buccinator myectomy)

Instead of excess fat, the perioral mound can appear too large because of the muscles below the fat (buccinator muscles) and tissues above the fat (mucosal lining). To restore your appearance, Dr. Zelken recommends a buccal mucosal myectomy to carefully remove some of the muscle and mucosa.

Can I have other procedures together with perioral mound reduction?

Perioral mound reduction slims and contours the lower part of your face. Improving one part of your face can shine a spotlight on other areas that are also showing signs of aging.

Dr. Zelken offers comprehensive facial rejuvenation, ensuring you’re happy with your total appearance. That means he often performs several cosmetic procedures at the same time.

Call Jonathan Zelken, MD, today or request an appointment online to learn how to eliminate your perioral mounds.



From a volumetric perspective, perioral mounds may be thought of as the upper jowl, but these mounds are composed of fat, muscle, and thickened mucosa, not just skin and fat like the jowl.


Dr. Zelken offers various treatment options to reduce perioral mounds, including FaceTiteAccuTite, microliposuction, and buccal or buccinator-mucosal myectomy.

Buccal Mucosal Myectomy

Also known as buccinator myectomy, buccinator mucosal myectomy, BMM, and perioral mound reduction.

The buccinator muscle is a thin muscle on the inside of your mouth. It spans the length of the oral lining, converges, and decussates along the corner of the mouth. Also, it overlaps with the orbicularis oris muscle, a sphincter that closes your mouth when activated.


Activation of the buccinator muscle lengthens the mouth by pulling the corners of the mouth toward the ear and pulling the cheek inward towards the teeth. It is like a loose trampoline that can be tightened. It is a major muscle of the mouth and oral lining that serves an important purpose in suckling as a neonate, facial expression, speech, mastication, and digestion.

Therefore, this muscle is important to preserve, but unfortunately, it can contribute to bulk along the corner of the mouth and results in the appearance of perioral mounds. Fortunately, conservative partial resection of this muscle has not been shown to impact oral function but can have a meaningful effect on perioral mounds.






Individual results may vary

Blepharoplasty Expectations: The First 6 Days

Blepharoplasty before and after images

Day 0

Preoperative. Avoid ibuprofen and alcohol, and any other blood thinners
Blepharoplasty before and after images

Day 01

Night of surgery. The patient has marked swelling and is able to open her eyes part-way. She does not have visual complaints and has no need for pain medication
Blepharoplasty before and after images

day 02

The next day, she reports a slight improvement of swelling, attributable to wearing off of the fluids used to numb the eye.
Blepharoplasty before and after images

day 03

Postoperative day 2 and 3 are usually the worst in Asian eyelids as the fluid swelling is replaced by the body’s natural inflammatory responses.
Blepharoplasty before and after images

day 04

The next day is more of the same, but avoidance of strenuous activity and use of the ointment prescribed facilitates quicker recovery. Bruising begins to fade
Blepharoplasty before and after images

day 05

As swelling resolves the result begins to show, although we are months away from the final outcome. There are still bruises and asymmetries.
Blepharoplasty before and after images

day 06

Stitches generally come out on postoperative day 6 or 7. The act of stitch removal usually stirs up a small amount of swelling, and can be somewhat uncomfortable, but without stitches there, the healing process speeds up and you can be red carpet ready within 2-3 weeks.