There are surgical and non-surgical approaches to lip augmentation. Non-surgical approaches include botox (slight lift, reducing gum show) and filler (volume restoration). Surgically, you can have two separate incisions under the nose (italian), one incision under the nose (bull horn), one incision at the red/white upper lip junction (gull wing) or two separate incision at the corners, or a combination, depending on your desired look and anatomy. My preferred surgical technique is called the Elelyft, which is a version of the bullhorn approach. In your situation, would start with 1 syringe and evaluate it from there. Consult with an experienced lip surgeon for a complete range of options that are appropriate for your situation. Gary Linkov, MD Lip Specialist / RealSelf Lip Lift Medical Reviewer Manhattan