Revision - Nipples misaligned and lower poles are different. Options? (photo)

Hello. I had a lift w implants Oct 22. They were perfect in shape but huge. In Oct 23 I went down to 220cc from 305. I'd addressed concerns about laxity and large pockets and was assured nothing additional was needed. While one breast looks tight and sculpted the other is loose, flat and unshapely. The nipples also look misaligned and the lower poles are different lengths. My Dr wants to simply lower the dropping one saying that will fix it but I think the pocket/skin needs correct too.