Virtually anything can be changed but sometimes at a price. If the nose is made too small breathing problems can develop.  The smaller the nose, the harder it may be to breath.  This is particularly the case if the base is reduced. Thick skin can limit the appearance of definition in the nose.  Very thick skin can be thinned but mildly thick skin may not be worth the risk. Perfect is the enemy of good.  So often patients tell me they don't need it to be perfect, then describe the perfect result that they want! Results from revision surgery may be less beneficial than the first surgery, but not always.  Sometimes at the first surgery key changes were not made at all. Scarring can occur at the bottom of the nose if the nostrils are reduced by external incisions. The more skin removed, the more tension on the tissue, and the worse the scarring.  Otherwise, all of the surgery can be done from inside the nose. The breathing can always be improved by increasing the size back to the original conditions.  It amazes me how many patients would rather suffer with a blocked nose than have it widened again. A perfectly straight nose can be achieved 95% of the time. Proper tip height as well.  Tip definition and other features can all be improved 95% of the time as well.  A lot depends on what you start with.