This is a question that I answered for someone who had a procedure by another physician.
Crooked nose after Rhinoplasty can sometimes be due to swelling.
Asymmetry with Asian implant rhinoplasty in Seattle is one of the most common complications with this type of surgery. I believe that it has to do with the approach and the fixation that is used to keep the implant in the middle and not asymmetric. Because it was your second time, there was likely a lot of scarring in your nose from the previous procedure. This can leave scar tissue that can serve as an impediment for a straight result.
Another reason for the asymmetry can be due to inherent asymmetry in the nose. An asymmetric nose will like remain asymmetric unless additional procedures are done to straighten the nose along with the implantation of your nasal implant. The crooked nose is one of the most difficult rhinoplasty cases out there. Although unconventional, I prefer to do all implants through an open approach. This allows me to clear scar tissue, open the nose and assure that the plane is correct, ensure that the implant is in the middle and lastly I can fix the implant in the middle with sutures.
Typically I fix the nose to the septum near the bone and septum junction and a point lower than that and then I secure the implant to the lower part of the nose and tip at a total of 4 different locations. This helps cut down on variables that can lead to asymmetry after rhinoplasty. Learn more about Asian Cosmetic Surgery from a Board Certified Facial plastic surgeon in Bellevue.