Is it more risky to perform a septoplasty on a nose that had a previous septorhinoplasty done?

I have performed revision septoplasties and revision rhinoplasties many times over the past decade. They are always more challenging due to scarring (tissue planes are distorted), potentially less blood-flow to regions, and, as you commented, missing pieces. Some septoplasty surgeries can result in a significantly less cartilage and bone with which to work. These tissues are often helpful in rebuilding and straightening a septum. When they are not present, and are required, we surgeons need to look elsewhere for structural support. Occasionally, ear cartilage can be used, but the septum usually needs more support and rib grafts are often necessary.
If your airflow is disrupted and your septum is crooked, you may need to undertake a revision. Just consult with an experienced nasal surgeon with whom you feel comfortable to ensure you feel good about your decision moving forward as there may be some bumps in the road (hopefully not).

Hello! Great questions. You sound like you have a complex history regarding your nose. You'd want to meet with a surgeon who performs structure repair to the nose as your septum likely can't be fixed in the traditional way without potentially creating instability. An open structure, septorhinoplasty can be used to straighten any remaining septum and create stability to your nose. Seek consultation with a number of surgeons to determine which approach may be best. Hope this helps!