The 90 inside the wall will need to be replaced with a 45, so you will definitely have to open up the back of the cabinet and the wall. You have some flexibility on the height of the 45 inside the wall, but once that is chosen, it will determine the exact location of the 45 you'll need within the cabinet, so that the diagonal entries on the two 45s line up.
Your san-tee can go below the cabinet 45 which is conceptually simplest, but would require dropping the trap as you suggest. Or your san-tee can go between the two 45s, as long as the inlet is perpendicular to the plane defined by either 45. The latter would move the inlet towards the back of the cabinet, but assuming you can rotate the garbage disposal, that's fine. Given the horizontal distance between the trap u-bend outlet and the garbage disposal vertical center line, you could move the trap arm pretty far back by just rotating the garbage disposal. Of course you need to avoid conflicting with the water supply riser -- looks like the trap arm is currently just in front of it, but maybe just behind it would work.
Anyway, those are the constraints, so based on that you can determine what elevation to use for the 45 within the wall, and where to put the san-tee, in order to get the best result with the least troublesome rework. One piece of advice is that if you are going to be cutting a hole in the cabinet back, while it would be good to leave 1" to 2" of the back intact next to the any of the edges, it's just as easy to cover a large hole in the back of the cabinet with an overlaid piece of similar material as it is to cover a small hole. Likewise for drywall repair. So I'd suggest cutting out a big hole to make the rework easier.
Cheers, Wayne