My nose has changed a lot ever since it was hit by a book . Can it be helped? (photos)

Hello. It looks like the caudal portion of your nasal septum is slightly deviated towards the left side. You may also have some flaring of the medial foot plate of the alar cartilage on this side. I would recommend to have a full evaluation by a rhinoplasty surgeon, they will be able to tell you if something needs to be done. Good luck.

What you can see on the basal view of your nose ("hanging out of your nostrils") are the footplates of your medial crura - this is a relatively simple problem to manage.  Otherwise, the bridge of your nose is not a smooth line and this may be a cartilage fracture or movement of a graft.  A 4th revision is a significant challenge and not to be taken lightly.  You may want to consider nonsurgical options such as filler to smooth out the dorsum.

Recommend you go see a few boarded surgeons to examine the nose to determine if the injury is severe enough top need surgical correction.....