Is it worth getting a second rhinoplasty to make my nose even smaller? (Photo)

There is a natural limitation to size reduction in rhinoplasty.  This is especially relevant in noses with thicker skin.  If the structure of the nose is reduced beyond the capacity of the skin to contract and drape tightly over the structure, the skin behaves like a garment that is too big on your body.  The nose will lose form and generally gain width on the front.  Thicker skin cannot shrink as much as thinner skin.  While thick skin can be thinned a bit during surgery (removing some of the underlying fat), there is still a limitation on how much in can contract.  Your primary surgeon may be able to counsel you on these issues. 

You have a nice natural shape, which is obviously a big improvement over your preop appearance.  Changing the slope slightly can soften the nose, and make it look smaller, but setting the entire nose back to the face relies on skin contraction to shrink to the smaller framework, and the judgement of how successful that will be would be helped by an in person examination and photos that showed more of your face. Keep in mind that revision rhinoplasty is more complex, and is best undertaken by somebody with experience in revisions.  All that being said, I think a consultation would be worthwhile if you are not happy with your current appearance.

I don't think your nose has to be exactly smaller, but indeed could be narrower, the tip more balanced in shape and derotated (it is a little too high).If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

No one can answer your question for you as how "worth it" a revision rhinoplasty would be.  From a rhinoplasty surgeon's perspective, I feel my job is to inform patients as to what is a reasonable expectation for their postoperative recovery and result (always demonstrated with computer imaging) would be.  That said, although you have had significant improvement from your first surgery, it does appear you could have a small degree of refinement/thinning with revision surgery.  It would require an examination to tell for sure.  Best of luck.

Hello,
Thanks for your question. Looking at your photos, it may not be possible to safely reduce the size of your nose further without compromising something important. Your skin looks like it may be fairly thick, but that could only be confirmed in person. Scar and changes in blood supply may limit how small the nose can go. If you seek revision rhinoplasty, make sure you work with a specialist in revision rhinoplasty to have the best chance of getting close to what you want. Good luck,Dr. Shah

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_anflower12.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.
Generally, if your nose has a basically good shape, it's not worth doing a revision to make a tiny tweak. But if you wanted a bigger change, such as elevating the tip noticeably, and bringing the tip back closer to the face, and lowering the bridge, then those changes together would add up to a difference that you might consider worthwhile.
I tried to make a morph to show some of that, but really, a photo of a nose needs to have the entire face in it, for context. The nose is part of the face and the face helps to show what the nose should look like.Did the morph seem to address your main concerns? I could modify it to your taste if you wish. Some people might want more of a distinct concavity in the bridge, for example.
You should understand that the changes I demonstrated in my morph try require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and read the essay on how to tell whether your previous surgeon should be performing your revision. Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. 
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery. 
Finally, at the *very* bottom of the "Learn more" page is a link to instructions on taking and sending photos that are comprehensive and useful for an online consultation like this, in case you'd like a more complete evaluation.

Your nose looks very natural from the AP view (front) and I would not recommend further reduction of your tip cartilages or bridge width.  You could have slightly more dorsal reduction for a slightly more feminine profile.  Digital imaging can help you decide.  

 Revision rhinoplasty is more difficult than a primary  Rhinoplasty due to the fact that there's thick skin,  scar tissue formation, and previous alterations to the normal anatomy. The healing process can be  less predictable. It's always important to weigh the risk versus reward ratio. It is important to choose your surgeon wisely based on extensive experience performing both rhinoplasty and revision rhinoplasty procedures. Digital computer imaging would also be helpful to understand what can and cannot be accomplished with a  revision procedure. Its possible to undergo some more refinement of the nasal structure, but is important to have realistic expectations about what you are trying to accomplish