Age 60, 4th revision? Can this nose become more refined and shaped? (Photos)

I would recommend seeing another rhinoplasty specialist to evaluate this nose in person. I would find a plastic surgeon certified by the American Board of Plastic Surgery. I always tell prospective patients to look at the plastic surgeon's training (ideally a 6 year integrated plastic surgery residency and a 1 year aesthetic fellowship accredited by The Aesthetic Society). In addition, examine before/after photos on social media platforms. I would also look at Google or RealSelf reviews. This will help you get a comprehensive understanding of your provider.

It's hard to tell from these photos as to the true shadows of your tip but from the mere fact that you've had 3 rhinos before, my suspicion is you should leave your internal nose components alone. Something you could do to get your nose a little smaller is to consider an alarplasty because at the very least that will narrow the lower part of your nose, but it will not change the rest of your nose.