I had a rhinoplasty 19 years ago. I have a nasal bossa. Is it a hugely complicated and expensive procedure based on my pictures?

Hi,
More Photos are needed for better advise. However based on them cartilage grafts can be use to support tip of your nose.
After in-person detaled examination work, A Revision Rhinoplasty can achieve better, well proportioned nose.
Regards,

Dear berlidders77,
Thank you for your question. It is difficult to make an accurate assessment and recommendations based on photographs alone. I recommend you seek an in-person consultation with a facial plastic surgeon or plastic surgeon who is a rhinoplasty specialist who can perform a thorough evaluation and discuss with you the best surgical treatment options to meet your goals. Revision rhinoplasty is always a more challenging procedure and requires a surgeon who is a true rhinoplasty specialist. If you have thin skin, you may need additional soft tissue coverage for the cartilage grafts to address the bossae appearance to your nasal tip. Depending on how much cartilage is left in your nose (your septum) from your first surgery, you may require cartilage from another source such as your ear or rib. 

Thank you so much for submitting your question. 
Late nasal tip bossa are often due to fibrosis or scar contracture acting on weakened or unsupported cartilaginous framework. Treatment of this issue is individualized so it is difficult to assess you without seeing you in person and honestly may not know until you are in surgery. 
The price point varies by region and surgeon so it is impossible for me to say how much this will cost. I wish you luck and hop this was helpful.  

Nasal tip bossae deformity is frequently result of over-resection of nose tip cartilages. Correction would depend of the nature of deformity and most frequently involve placement of  cartilage grafts in the area of nasal dome. In person evaluation by a plastic surgeon with outstanding reputation in nose surgery is recommended. Good luck. 

I agree that you will likely require the use of cartilage graft to support the cartilages of the tip of your nose.  If the septum was not used at the time of your initial procedure then it may be available.  Otherwise the use of some ear cartilage or rib graft may be required.