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.
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.
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