Move your mag pouches further forward, at the very least the pistol pouch on the left side. There is some wasted space there. You could put your knife in the space you opened up then. I liked my M16 mag pouches in the front with everything else behind them. I'm a bit bigger, but I used to carry two of them on each side, but starting them just behind the buckle. The knife went just in front of the buttpack, and a holster would fit on my left behind the m16 mag pouches. Pistol mags would have gone on my right in front of the knife. Also for smaller things look at the SpecOps small pouches that fit onto the shoulder straps. Get a couple of the first aid/bandage pouches and you can fit them onto those little straps on your shoulder. Just tie them down so they don't flap around.
For comfort you might want the pad that attaches to the pistol belt. Some people like them, some don't.