2nd revision needed? Asymmetrical with deviated septum (Photo)

This absolutely should be revised. There is severe asymmetry of the tip and over-rotation, which should be addressed.
Rhinoplasty techniques have advanced more in the past 20 years than any other cosmetic procedure. I do recommend you have your revision with a facial plastic surgeon who specializes in revision rhinoplasty. This is absolutely not a procedure just any plastic surgeon can do, it requires finesse and expertise.
Your surgeon will likely require cadaveric cartilage or your own rib to re-build your nose and create lasting definition, which is standard for revision cases. Hope this is helpful!

Feasibility for determining whether or not revision surgery is appropriate is largely dependent upon someone's examination. You appear to have thin nasal skin and your columella appears to veer to the left. This could be associated with the deviated nasal septum to the right. I think it's worth Consulting with several reputable rhinoplasty specialists since the extent of surgery necessary would need an in-person evaluation. Wishing you well. Sincerely, Dr Joseph