Rigottomy, Fat and Breast Lift
Thank you for a great question. From your picture, I believe fat and a breast lift will really help. The lift will reduce the areolar and reposition the nipples. Depending on what your surgeon finds when he or she examines your breast folds, you may or may not benefit from rigottomy. Make sure you see a board certified plastic surgeon. Good luck in your search.
Breast lift and fat grafting
YOur pictures show that your breasts are low and separated. The best option in your case is breast lift and fat grafting to enhance the cleavage. There is no indication for rigottomy in your case. Please see the link
Rigottomy might be helpful for correcting a minor tuberous breast, but unfortunately, you also have severe drooping. When your nipples point towards the floor, the only correction is to move them up. Filling with fat or implants will only make them look worse!