Revison Saddle Nose
One cm of dorsal and caudal septum left intact after septoplasty is borderline but would usually be adequate unless there is a fracture of the integrity of that “L” strut support. If you have not had the cup cartilage from your ears used for grafting already, it can be harvested without misshaping the ears and used to bolster the nasal support and to enhance the beauty. A sophisticated surgeon can protect you from collapse of your bridge “Saddle Nose” and it might require a bone graft or rib graft. But I prefer [if there is not enough of your own cartilage left] to use safe bone bank allograft because there is no morbidity due to harvesting a graft from a rib or bone donor site. Yet this is all too much in the abstract unless you at least provide some pictures with a true profile and oblique and frontal views. If you send pictures to my email at clarkplasticsurgery@yahoo.com I can better assess your nose and give better advice. Of course, a responsible true final opinion requires an examination in person yet the quality of that “in person” opinion depends totally on the quality of the person giving the opinion. There are well qualified doctors in your area and at this point of considering a third revision it requires spending time to seek out that surgeon, who may not have a flashy office, but has multiple results to show you of similar cases well solved. Use your intuition and make a sober choice. Peace be with you.