It would be difficult to comfortably perform those procedures in the office. The alar retraction is very difficult to correct, and is likely best treated by decreasing the hanging/ projecting nasal septum instead. However, this risks further shortening the nose and deepening your nasolabial angle (angle between nose and lip). If contemplating a third rhinoplasty procedure, it is never a bad idea to get a second opinion. All good surgeons welcome second opinions. As always, it is important to consult with a board-certified Plastic Surgeon who has a particular interest in rhinoplasty.