Twisted columella, uneven nostrils, deviated septum - do I need a third septorhinoplasty? or frourth surgery? (photos)

Uneven nostrils. Twisted columella. Deviated septum (again!). Want to correct due to self esteem & confidence. Surgery is the only solution. Surgeon reassuring, very experienced. Advises irradiated cartilage for further support. Also place betw nostrils to keep in place/avoid twisting. Open procedure. Skeptical/afraid of any issues as would be 3rd septorhino and 4th op overall. Don’t want to make it worse. Understand there are complications and limitations. Would like objective opinion.