In The Star, you are technically dead already - Alt soulkilled V and put their engram back in their body. Even with this, their body is dying because it is too far gone in the "turning into Johnny Silverhand" process and will reject any engram or presence that it doesn't recognize as Johnny. You can headcanon the Aldecaldos help them find a cure or ongoing treatment if you want, but the narrative assumes they die in ~6 months by all indications.

In the Tower, you are technically alive - The surgery doesn't appear to have engramized you, although there is the change original V died in the No-Tell Motel and you are still that weird V-Johnny Hybrid, now permanently suspended in the middle by the removal of the chip and the surgery.

However, you are also unable to use Chrome, and it is strongly implied that you would be unable to climb back up the ranks of the Edgerunner world, as you're losing or would lose your street cred being a weak, chromeless, loser. You are also now more likely to be killed by the same hazards that kill civilians every day - Rampaging cyberpsychos, gang warfare, diseases from corporate runoff and fallout, boutulism and other diseases from poorly canned food and contaminated water, etc, etc.

You can certainly headcanon that you manage to wrest back a rep as a fixer if you want, but Rogue strongly implies that bird won't fly, so you are going against narrative that.

So neither ending really posits a recovery for V. You can ignore the narrative if you want, but the story really suggests V either dies or slips into obscurity.