Perlane: Did not fill up my lips at all. It only improved my cheek folds about 40-50%, but lasted only about 4 months, so I don't recommend it.
Fat grafts: I had it done twice. The second time, lips got nicely enlarged for about 1-2 weeks, then, they went back exactly as they were, which was very frustrating. I consider both things a waste of money and time; my conclusion is:
FILLERS don't work for patients, only for doctors, because they help make them richer and richer, and most doctors are so mercenary and dishonest that they don't tell you the truth (that any filler will COMPLETELY DISAPPEAR from the 3d week on) before you waste your money.
Only lip lifts work and are permanent (I had it done by an expert and it really changes the shape of your lips). Most doctors don't do them, because they require and advanced level of knowledge and expertise, and they prefer to keep sucking the patient's wallet forever, by applying useless super-short-lived fillers, like Perlane and one's fat.