Ugly mouth - help? (Photo)

Thanks for your question and photos.  It appears you would benefit from fillers and a a corner lip lift. There are three types of corner lip lifts , each of which provide their own idiosyncratic  benefits.The noninvasive route would be fillers plus or minus a neuromodulator such as Botox® into the depressor anguli oris muscle. This treatment route is good for mild cases. However, corner lip ptosis progresses with age.  A traditional corner lip lift will elevate the drooping corners of your mouth while at the same time, help eradicate the small fold (marionette fold) that originates from the corner. The surgery can be performed under local  anesthesia  and results are subtle yet dramatic.  The DAO release is performed within the mouth but is a less effective treatment option than a traditional corner lift (the effects of which can be predicted by injecting Botox ®  into the aforementioned muscle). It does nothing for any marionette folds  A medial used corner lip lift is one which elevates the corners of the mouth, lessens the marionette folded and also can directly reshape the lateral vermillion. It is essentially a "magic trick". Results are permanent, subtle and yet, as mentioned, very dramatic.

I would advise strongly against any kind of surgery on your lips; I have seen too many botched jobs. The lips are delicate structures that are best augmented with hyaluronic-acid based fillers such as Juvederm and Restylane. One of my favorite fillers these days is Juvederm's Volbella, as it has a very smooth consistency, looks natural and beautiful, and can last for up to 18 months. In your case, I would also recommend a lip lift with Botox, which will relax the muscles that are pulling your lips downward. Botox lasts from three to four months. 
As for waiting until you've lost weight, there is no medical reason to do so. Psychologically, giving yourself something you've wanted for a long time may actually give you a boost and help inspire you to further improvements. Please be sure to consult a board-certified dermatologist with expertise in lip augmentation using cannulas and the hyaluronic-acid based fillers.

From the photo, it would appear that your lip asymmetry (the right side of your lower lip is considerably more full than the left) and your lack of volume  ("pencil thin lips" ) and lack of proportionality (the upper lip should ideally be one third of the total volume of both lips together) could all be easily dealt with, without the need for surgery, by the use of filler, such as Juvederm Ultra Plus XC (which would be my choice in my Upper East Side Manhattan practice) or Princess Volume (my go-to in my Israel satellite facility, where a far greater number of regulatory agency approved fillers are availalble). Treatment should typically take no more than about five minutes in experienced hands and engender little downtime. In this case, both the so-called "white roll" borders above and below the lips can be reestablished, the volume restored, and quite likely, simply by addressing the foregoing, the slight down-turning  of the angles of the mouth corrected secondarily, without the need for directly injecting them. You would do well to seek consultation and treatment by a board certified aesthetic physician with expertise and skill in nonsurgical lip augmentation and make certain to ask to see his/her before and after photos before agreeing to proceed. Good luck to you and Happy New Year.