4 months PO, should I wait full year to have fascia removed that's caused irregularities/pain my entire PO? (Photos)

After reviewing your photos, I do not believe that you have a saddle-nose deformity; rather, the irregularity is caused by the fascial graft.  This could be removed via a closed approach and allow to settle.  As far as any twisting or irregularity, I would wait one full year and utilize rib cartilage to fully stabilize the structure of the nose, especially in a tertiary setting.

Sutures that were used to secure the fascia to your nasal bridge may have been temporary, like polydiaxone, and you may be experiencing redness, discomfort, and fullness on your bridge as your body metabolizes and dissolves those sutures. This may be a more common scenario than inflammation to your own temporalis fascia. The majority of dissolvable sutures will be gone within six months, sometimes longer. The visualization of these sutures means they may still be present. If you are not comfortable with the advice of your surgeon, consider getting a second opinion from another reputable rhinoplasty specialist so you could see what might be best for you. Hope this helps. Dr Joseph

It is not uncommon for a surgeon to place fascia or Alloderm along the nasal dorsum in revision rhinoplasty patients with thin skin and soft tissue. If the placement of this fascia is creating a "hump" along the nasal bones, above your spreader grafts I would consider taking it out via a closed approach now. Redness and pain maybe a sign of inflammation to the skin and removal would help. Additionally, if sutures were used in this area and are causing skin irregularities, these can be safely removed at the same time. Your doctor knows exactly what was done at surgery so naturally, he/she may be the best person to do this for you.    Best wishes.