Late 30s - can I have a third or will my nose be even worse? (Photos)

Hello and thank you for your question. I am sorry to hear you are so unhappy after your prior revision surgery, I truly empathize with you, as no one should feel uncomfortable in their own skin. A revision (tertiary) open septorhinoplasty can best address the entire nose, and is particularly effective for addressing all the issues and asymmetries you are concerned with- there is no guarantee things will be perfect, but surgery can definitely make things better.
The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision/secondary procedures are even more complicated. Therefore I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from pictures and descriptions. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Your nose is inclined towards your right side in your photograph. You will need a revision rhinoplasty and possible cartilage grafts as well. Your medial cruras need to be narrowed more towards the midline as they are flaring out too much.

Best Wishes,

Gary Horndeski, M.D.

In our practice, we do offer tertiary revision rhinoplasty surgery, however, the feasibility of this depends on somebody's examination. You appear to have somewhat of a wide nasal appearance with asymmetry at the base of your nose and nostril asymmetry as well. Lastly, the feasibility of a third nasal operation depends on what you are looking to achieve. If you are looking to achieve millimeters of correction in certain areas, perhaps you may consider a permanent non-surgical nose job with microdroplet silicone 1000. If you are looking to achieve a narrower and more symmetrical nasal appearance and Improvement of your nasal Airway, surgery may be considered depending on your examination. I hope this helps! Sincerely, Dr Joseph