9 months post op - can a second revision help me achieve more length without the addition of more cartilage? (photo)

I would say to always wait at least 12 months before considering touching the nose again. A revision rhinoplasty usually requires harvesting rib cartilage or using cadaver rib cartilage. The nose always needs support whenever there is an incision placed in the nose. I would go discuss with your original surgeon what your concerns are regarding the outcome.

Hello and thank you for your question. It would be helpful to evaluate your nose without your glasses on. Based on your limited photograph, you may benefit from a a revision to derotate your tip. This can be performed by releasing scar tissue and placing extended spreader grafts. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon