Options for Correcting Nasal Bossa Deformities?

Bossa correction requires a complex reconstruction.  Often times bossa occur as the cartilage is weakened and then subsequently curls.  Seek a consultation with a revision rhinoplasty expert.  (Patient below had bossa on right nasal tip corrected)

The bossa can be corrected sometimes through a simple excision technique through a closed rhinoplasty underneath the nostrils of the tip. If they are recurrent and are problematic, occasionally a dome suturing technique can be performed, but it all depends on the shape and structure of the nose. You should wait at least a year from the previous rhinoplasty before embarking on a revision tip plasty.

Bossae is the medical term referring to prominent paired bumps on the nasal tip.
The nasal tip is made up of paired cartilages that are shaped like horseshoes. The apex of that horseshoe is referred to as the dome. The part that makes up the side wall of the nostril is called the lateral crus, and the part that makes up the columella (the area that separates the 2 nostrils) is called the medial crus. The paired tip cartilages are often attached to each other with fibrous connective tissue. Different people may have tightly bound domes or loosely bound domes, depending on the amount of connective tissue they have.
Bossae formation occurs in individuals with loosely bound domes that have volume/cartilage excision from the lateral crurae. During healing and scar contracture, the tip cartilages are pulled apart from one another, creating the 2 visible bumps.
The usual fix for this problem is to use a suture to tie the domes together, taking away the possibility of them separating. This stitch also can narrow the tip, if that outcome is desired. Alternatively, cartilage can be placed over the domes in order to camouflage the bossae. This is usually done when the tip requires significantly increased projection or height away from the face.
I am not sure what was done in the second surgery. If sutures were used, then they likely loosened during healing. If a graft was used, then it may have absorbed.
I would recommend a suture technique if that was not done previously, as this is a more definitive solution.