I am assuming that you are showing pre and postop rhinoplasty photos here. The only thing I could add regarding your nose might be some alar base take outs to narrow the base. Otherwise, I would not recommend any of the other measures you suggested.
Rather, I would spend the money on making sure to keep your weight down and have a makeover with a new hairstyle and makeup regimen. That will really do much more for you than any more surgery.
The "best" result is the result you are most pleased with. It is possible to do more, it just depends on what you would like. It is difficult to give advice with only frontal photos. This holds true for the chin implant as well. If you wish, you may send any additional photos to my office and I would be happy to evaluate them for you. Thank you, and best of luck.
Options to improve facial structure
According to the pictures shown, you would have a nice result from the rhinoplasty procedure. A limitation of this rhinoplasty is the thick alar skin, for which nothing can be done about. Cheek implants will only make the cheek structures bigger, which do not appear that it is needed. It is impossible to tell from the front-on view whether a chin implant is needed. This has to be done from the side profile view.
Difficult to assess nose and profile of chin without multiple views and an examination
Rhinoplasty is an extremely difficult and challenging operation . No matter how skilled the surgeon is, there are several factors that can affect the final result.
For example a surgeon can create a delicate structure that has the facets of a diamond but if the skin is thick, you will never see the results. Attempting to thin the skin can result in disasters such as the Michael Jackson Nose.
Facial contouring is difficult to judge without an examination that involves assessing the skeleton and soft tissues in 3 dimensions as well as with x-rays.
In a lot of ways, morphed images are not great. I think they can give the patient a false sense of a result and sometimes not even a great sense either. Without seeing a lateral or worm's eye view, I could not comment on jaw/chin work or even alar base work. However, from your original photo it looks like you could have a significant improvement.
See an experienced revision rhinoplasty surgeon
I think the nose could be refined and requires the expertise of an experienced rhinoplasty surgeon. The tip is still wide as is the base. This type of tip can easily result in a "pinched" look. This requires advanced techniques and you should see before and after revision surgery photos or live patients that the surgeon has revised. You don't need a chin implant. Your question about cheeks can be answered when the surgeon evaluates you.
Improving nose and facial structure
Rather than putting up a single frontal view morphed before/After picture, impatiently crossing your arms across your chest and stating "I do not like the end results, is this the best a Plastic surgeon can be done with my nose?", I would suggest that a more constructive way to approach your nose would be to tell us / your surgeon what you do like and what you do not like about your nose that you wish could be changed.
Without guidance from you, the ultimate beneficiary and sufferer of our work, we would just be guessing at what may make you happy and put you through procedures you may not really need.
- If your tip bothers you - the nose tip can be refined
- If the flaring of the nostrils bothers you - the flaring can be improved.
- If the top (dorsum) of the nose is too high or has a hump, it can be lowered and straightened.
You are in charge. As the leader of the team you need to direct your surgeon.
Narrowing a round face and wide nose
It appears from your photos that you have received some nice narrowing of the tip and the dorsum of your nose. It may narrow further if you are still within a year of your original surgery. Also, your nasal base or nostrils may be slightly widened and they could perhaps be narrowed further.
As far as a chin implant, I would need to see lateral or side views to make an assessment there. You might benefit from some fat removal in the face or cheek implants; however, other facial views would be necessary. You might want to discuss your facial features with your surgeon to see if he has anything else to offer you.
Rhinoplasty and facial slimming.
A single morphed image as you've shown here can only reveal so much. I assume, though, that it's primarily the fullness of the nasal tip that you're bothered by. Depending on skin thickness, a little greater definition of the tip is probably possible than what's shown here. Also, blending the nostrils with the tip a little better (such as with lateral crural struts) might help.
As for the rest of the face and its lack of structure, as you describe it, there are a few options. But first, I would not recommend chin or cheek implants for this face shape. They would likely make a full face seem even fuller. One interesting option would be to consider so-called "facial slimming" with Botox. In this procedure, Botox is injected in moderately high doses to induce atrophy of the masseter muscles at the angles of the jaw. This can help with very square faces, but it requires quite a few sessions early on. It's an uncommon option, but can have really surprising results.
All the best,
Improving facial structure
If this result is secondary to computer imaging, the result may be improved with additional narrowing of the tip and narrowing of the nasal base (where the nose joins the upper lip and cheek). If this is an actual result, wait a year before critiquing your appearance. Although your chin does appear wide, I cannot advise you regarding a chin implant without see a profiile view. Cheek implants would improve the contour of your mid-face.