Lip lift or fat transfer? (Photo)

You have nice lips. I would be cautious doing any type of lift though in expert hands the results can be dramatic. Give some thought to Permalip implant (silicone) which is a simple, safe and an easily reversible procedure, often done in an office setting. Find an experienced PS.

I personally do not like the scars of the lip lift whether it is done under the nose or at the corners of the mouth.  

Hello tinygreekfox,There are several options for lip rejuvenation.  You've clearly read up on them if you are mentioning the bullhorn.  This is a good technique for someone with a very thin lip.  You have a great shape to your cupid's bow and good volume in the middle.  I would not recommend the lip lift for you based on that.  Your lips do disappear laterally.  For this, a lip advancement where the incision is made right at the junction of the white and red part of the lip to advance it may be a great option.  It is important to realize with this that it does heal with a scar which for most people is aesthetically acceptable.  As a female, you can also camouflage the line with lip liner.  Your lower lip would benefit from this as well.  As far as increasing the size of the bottom if you think it would need more volume (I personally think it has a nice volume in the middle but again disappears laterally) there are some options.  You've tried the fillers which are temporary and do add up.  Permanent implants are rarely used these days because of long term problems that developed.  Fat grafting is an option to add bulk.  Another option is using your own collagen or SMAS (superficial musculoaponeurotic system) which is the material frequently removed during a facelift.  It can be harvested from a small incision behind your ears.  Since both fat and SMAS are a part of you, the risks of these augmentation procedures is very minimal.  I hope this helps and good luck.