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

I've seen people having even their 7th rhinoplasty. Sometimes you just need the right situation and person to get it settled. If you are clear on what you want done it should be possible to improve.

Hello! Thank you for your question. As far as I can see from your photos you have very asymmetrical nostrils and your nose tip is turn one side like deviated. For get rid of this image and gain more natural, elegant and symmetrical nose I recommend you revision rhinoplasty. In your 30's you are still suitable for nose surgeries. however, you need to be careful about your surgeon choices because after 3rd surgery 4th cannot be an option anymore. Please keep in mind that %100 symmetry is not achievable in any case. Best Regards!

The question is not "can you?" but instead "what are your desires for the final result", and "what is the existing facial anatomy as well as nasal anatomy given previous rhinoplasties including remaining cartilage donor sites?"

I see somewhat thick skin and a curved frontal view with asymmetry including a septal tilt from the worm's eye(bottom of the nose)

Depending on your desires for the eventual result, skin quality and cartilage donor sites your question can be answered; but yes your nose can be straightened and made much more symmetric as well as aesthetically appealing.
Hope this helps

There's definitely some improvement that can be made regarding your nose, but it's imperative to choose a rhinoplasty specialist based on extensive experience. Your nose will never be perfect, just improvements. A full set of facial photographs from all angles would also be helpful to understand your current anatomy. You appear to have alar retraction on your left nostril which requires a composite graft from the ear to improve