First of all you can have another revision. I'm not going to suggest techniques. the most important question is not what is done, but who does it . Find a rhinoplasty surgeon who is very experienced in revision work. Ask for multiple before and after pictures of other patients. It might be helpful to get more than one consultation. Do your homework. Good luck!
Revision rhinoplasty for the third time.
Each time a nose is operated on, it becomes more difficult. And therefore the success decreases and the goals of surgery are lowered. The first time is the best time. That isn't to say revision surgery can't be successful. Its just more difficult and takes longer. This is reflected in the cost. A primary nose job usually takes between 1 to 2 hours, while a revision takes between 2 and 5 hours. There are outliers, minor 'touch ups' or complete complex nasal reconstructions using multiple ear, rib or skull grafts.
I have recently set a new personal record of sorts. I operated on a young lady for the eighth time! She had, over the years, had 7 surgeries of one description or another by the same surgeon. I wouldn't recommend this. If a surgeon can't achieve mutually agreed upon goals after 2 surgeries, it time to move on or up. Will your nose fall off? No. Will your nose be straight? Maybe. And you increase your chances by taking the time to find the best, most experienced rhinoplasty surgeon you can find.
Revision rhinoplasty to straighten the crooked nose
In general, I counsel patients who seek me for opinion on revision rhinoplasty as follows: While it may be possible to make your nose straighter, it is unlikely that *any* surgeon can get such a nose perfectly straight. The reasons for a crooked nose are quite complex and may involve a number of issues, from asymmetries of the entire facial skeleton to isolated nasal asymmetries. The treatment for this is highly individualized and would require a personal examination.
Regarding your concern about the safety of a third procedure, it is highly unlikely that your nose would 'fall off' (I know you don't mean this literally). A safe procedure should be feasible. However, the real issue is, will you be happy if it is not 100% straight?
Having a rhinoplasty the second or third time is very complicated and one has to look seriously at this because one can only have so many rhinoplasties before needing significant nasal reconstruction. I would definitely seek a Board Certified Plastic Surgeon that has significant expertise and experience in secondary and tertiary rhinoplasty procedures because these are completely different operative procedures that require additional experience and judgment.
Third Rhinoplasty Surgery
Yes, it is possible for a patient to seek a second revision rhinoplasty should the first two nose jobs not be up to par with his or her expectations. I highly recommend that you wait at least one year after your original revision rhinoplasty to consider this third surgery. If you are still unhappy with the results of your previous nose jobs, you may want to re-visit the same surgeon who performed your initial revision rhinoplasty, or you may want to find a new surgeon altogether. At this point, however, it is important to understand that with each additional surgery comes the possibility of increased complications and unnatural results.
Revision rhinoplasty for the third time
Revision rhinoplasty is always more difficult than a primary rhinoplasty, that's why it's a good idea to find a very experienced rhinoplasty surgeon who has performed thousands of rhinoplasty procedures. Tio straighten the nose, medial and lateral osteotomies of the nasal bones will need to be performed. A cartilaginous spreader graft harvested from inside the nose will also be required to be placed underneath the concave upper lateral cartilage. For many examples of nose is similar to your own we have repaired in our practice, please see the link below to our rhinoplasty photo gallery
Crooked septum after revision rhinoplasty
You may need revision rhinoplasty that addresses the bony and cartilaginous septum of the nose. Simple cartilaginous tip work will not correct the problem.
Revision Rhinoplasty Possibilities
Revision rhinoplasty is definitely more challenging than primary - or for that matter, secondary- procedures, but these are procedures in which I specialize. Given that it has been 2 plus years since your last surgery, this is sufficient time to allow for healing and therefore help to reduce the risk of complications, in particular poor healing and scarring of the skin. I will tell you that you really need to make sure that this procedure gets done correctly, to finally achieve the results you seek.
The risks in multiple revision rhinoplasties
When a patient has had a previous rhinoplasty or several previous rhinoplasties the next rhinoplasty can be exceedingly difficult. This is because the surgeon not only needs to perform techniques to help you meet your aesthetic goals, but must also battle the scar tissue and the deformities from the previous surgeries. Many times your tissue has suffered extensive trauma after all of the surgeries and may not be pliable enough. It is often necessary for surgeon to bring in healthy tissue including cartilage from another area that has not been previously used such as a rib. Before proceeding with yet another revision rhinoplasty, be sure that you receive multiple consultations from a variety of board-certified plastic surgeons who will be able to examine your nose and the quality of your tissue to help determine if you would benefit from even more surgery.
A third rhinoplasty can be done. However,
multiple rhinoplasties increase the complexity of the surgery. The risk of scar
tissue, the possibility of excessive removal cartilage and bone tissue, the
chance of improper healing–all these increase with each subsequent surgery. It
is best consult with a surgeon who is specializes in rhinoplasty and has a
great deal of experience with revision procedures. Before you decide on another
surgery, you should speak realistically about your expectations.