You can have a double mastectomy sure, but the trick will be finding a doctor who is prepared to do it. Some women struggle to find doctors who will do it for psychological reasons. If there is no medical cause they are reluctant.
The plastic surgeons are very adept. Being so large in the chesticles you may have an argument that the imbalance will be too much of a strain on your back, neck and shoulders.
If you are considering reconstruction you need to have a conversation early with your breast surgeon and get a referral to a plastic surgeon to discuss your options. If you choose to be smaller in your recon I understand that they will seek to reduce the other to match.
You also need to ascertain the waiting list in your area if you are going public, and check your savings if you are going private. This is an expensive business...
I had a double mastectomy (cancer in one breast but I was the third woman in my immediate family to have BC so it was on the cards from the start. It turned out I have a genetic mutation) and DIEP reconstruction. I'm sad that it had to happen but no regrets. I am happy with the outcome, having my own warm flesh on my chest. You have to have some belly fat though!
You might like to join the Choosing Breast Reconstruction group here. You'll find the link in one of the menus.
Big hug @jamavon. You're in the worst bit now, it does get easier once you have a treatment plan. Hang in there, K xox
PS HELL YEAH you get to think about perky breasts! No apologies on that front. Your body, your right to feel good about it!