Adult braces. Mid 20s. Do I need extractions? (Photo)

Hi there. Ive been looking at getting braces. Went to a recommended orthodontist clinic. At my 2nd apointment after photos and xrays ,i have crossbites and crowding . I have 1 missing tooth alreadly ( bottom left 2nd molar tooth) see in xray Was told I would need my top 2 2nd premolar teeth removed + 2nd bottom premolar tooth right side. Do i need teeth to be removed to improve my teeth?. Im concerned and worried,about facial profile etc..as i was told my facial symmetry and lip exposure is all good.

No doctor answers yet