Thank you for the question and picture.
Whether or not to have breast surgery is a very complicated personal decision that should be made after careful consideration of the pros and cons of surgery as well as issues such as timing of surgery in relation to life circumstances. Unfortunately, no degree of exercise will improve the breast shape or position.
Your breast demonstrated breast ptosis ("sagging") which will require breast lifting plus or minus breast implants to improve. Exactly what which operation will be offered to you will depend on your personal goals. These goals will need to be determined during consultation. I prefer the use of goal pictures to help with this communication.
Breast lifting involves some amount of skin excision. The skin excision serves to “tighten up” the breast skin envelope. How much skin needs to be removed will depend on each specific patient's situation. In other words, some patients require more “lifting” and have the need for additional incisions. Generally, these incisions range from around the areola, vertical breast incisions, and transverse incisions (“anchor”).
Most patients (If properly selected and who are doing the operations and the right time of their lives) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.
It may be in your best interests to meet with well experienced board-certified plastic surgeons to discuss options when/if the time is right for you.
I hope this helps.