Questions about breast asymmetry correction (Photo)

Thank you for your question and for providing photographs. Breast asymmetry is a common yet challenging surgical concern and one that can not be treated with shortcuts. I do believe that fat transfer to your left breast is a good option for correcting the volume discrepancy. The fat can be harvested from multiple areas including your abdomen/flanks, thighs, or back. My preference is thighs and abdomen/flanks. About 50% of the fat transferred should take if done correctly. Because this is a moving target one option is to stage these procedures and address the right breast once the final volume of the left breast is reached at around 2-3 months. A periareolar mastopexy for the right breast is a poor option in my opinion because of these reasons, it tends to flatten the breast and it does not hold up well over time. The scar and areola will widen leaving most patients unhappy.
If you are happy with the nipple position on the left my advised plan would be to perform fat transfer to the left breast and a vertical lift (lollipop incision) of the right breast with possible small volume reduction to match. If you are willing to stage these surgeries that would be ideal but I understand most patients would like to accomplish this in one stage which is a fine option as long as you understand the rationale for discussing a staged surgery.

You can do fat transfer to the smaller breasts and fat can be taken from several areas if donor fat is available. You can also consider minimally invasive skin tightening with radiofrequency, like Renuvion, for tightening and lifting your skin with minimal scars.