My nose tip is uneven. What are my options? (photos)

Tip refinement and modification may be perhaps the most challenging part of any rhinoplasty and is quite difficult to get just right. There are a number of critical factors which must be considered. Overlying soft tissue thickness (thick or thin), integrity and location of the caudal septum (deviation? instability?), and overall balance with the rest of the face should all be evaluated. Add in the scar tissue and altered anatomy after having undergone previous rhinoplasties, and this increases the difficulty level even further. These challenges can certainly be overcome in the right hands, but there is always going to be some inherent risk in revision surgery that things could potentially end up looking worse instead of better.
I would strongly consider your level of trust with your current surgeon who will hopefully give you an honest evaluation of what could be causing this residual deformity and what can potentially be done to correct this. If you are unhappy with these answers, finding another reputable surgeon in your area for a second opinion is always an option. Personally my goal is to always be honest and realistic with my patients and I would never be upset if they wanted to get a second opinion. After all, it is your face to do what you wish and if you're unhappy, you are free to seek answers with someone else. I hope this helps, best of luck!

Hello! Thank you for your question. As far as I can understand from your question 3 surgeries the fourth surgery will be too risky for you. Maybe that is why your surgeon would not recommend. It would be more convenient to decide with face-to-face consultation. Best Regards!