I'm definitely favouring the B2BUA+SST approach here.
I really, really don't want to proxy media unless I have to; it makes the bandwidth bill much higher, it lengthens many users' network path to reach the carriers, and for no benefit whatsoever except in the case of far-end NAT traversal, which applies to a minority of users. If anything, the aggregate effect on QoS in my case is probably worse if I relay RTP than if I don't.
The B2BUA+SST approach seems clean, efficient, and at least from a theoretical point of view, rather reliable.