Another refinement is possible?

Invisalign now provides unlimited refinements to allow you to complete your treatment.  This policy has changed over the years when they used to limit it to 3 of them

To my knowledge, you are entitled to a total of 3 refinements with your Invisalign treatments, when you do what is called Invisalign Full.  I think that is what you had.  After the 3 refinements, you can still do more, you just have to pay an additional fee.  Hope that answers your question.

You have to have a right expectation of what Invisalign can and cannot do.  If after so many refinements and you're still not satisfied with the result, you might want to look at traditional braces as a final refinement.  Talked to your dentist about it.