Hello and thank you for your question. From the pictures you have provided, you have some striae (stretchmarks) present on the upper poles of both breasts, mild ptosis (drooping) on the right breast with more significant ptosis on the left, as you mentioned. From just the one picture and without a side view it is difficult to determine much more here. Ultimately though, you would definitely benefit from a mastopexy (breast lift) to help improve the symmetry of your breasts. There is not a significant amount of skin redundancy on the right, so you could likely get away with a vertical incision pattern ("lollipop" scar) on the right, and would likely need an inverted T incision pattern on the left to take out the additional skin ("anchor" scar). If you are happy with the size of your breasts in a bra, then the volume is not an issue, and the primary focus of surgery would be on resecting skin and symmetrizing the breasts- so you're aware, it would be considered a cosmetic procedure, so insurance would not cover the surgery. With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the single photo you have provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps! Best wishes, Dr. Donald Groves Plastic Surgeon