Objective:The anatomic stigmata of aging in the perioral area is a complex expression of soft tissue changes, particularly adjacent to the nasolabial folds. Patients identify this perioral fullness as a dissatisfying product of aging. To understand the elements impacting on this structural framework, we undertook an investigation of the perioral region. A surgical approach is justified through this anatomic appreciation. Methods:Eight cadavers with perioral fullness were identified. Histologic sectioning was performed at multiple levels and subsequently stained. Surgically, the perioral mound is marked preoperatively and subsequently aproached from two directions with a 1.5 mm liposuction canula during facial rejuvenation.Results:Histologic sections of the perioral region were remarkable for a lipomatous area without defined ligamentous attachments. There were chambers of adipocytes separated by thin fibroseptations in the hypodermis. The connective tissue septa serves as a scaffold of structural support in this region.A musculoaponeurotic layer is deep to this area, becoming more organized caudally and medially within the specimens.Conclusions:The characterization of the histologic components of the perioral region will enable the plastic surgeon to more thoroughly manage this area during facial rejuvenation. The lipodystrophy demonstrated in this area is amenable to conservative liposculpturing during rhytidectomy procedures.