23 years post op and considering a second breast reduction - should I wait or move forward? (photos)

Hello! I'm a 5'7" 142 lb 52 y/o peri-meno woman, I had a breast reduction at age 29. At the time, my breasts were a very heavy and pendular 36DD/DDD. I was reduced to a large C/small D. The Dr. apparently did largely a lift + a small reduction (more skin than tissue removal). And I was happy! Now, (after proper fittings) I wear a 32/34 F. And I'm back to shoulder pain, neck pain, etc. But I'm also amidst severe hot flashes, fighting meno weight, etc. Should I wait?