Can rhinoplasty give the refinement & tip projection I want?

The amount of tip refinement and projection that can be achieved depends on many factors, i.e., the original shape of the tip, the thickness of the skin, any previous tip surgery, the age of the patient, the desires of the patient and the experience of the surgeon.  Tip refinement and projection can be achieved on a youthful patient, with average skin thickness and no previous surgery or congenital nasal deformities, i.e., cleft lip nose, etc.  However, both can usually be achieved to some degree in just about all noses except those that have a lot of scarring in the tip from trauma or previous surgery.

As other have said, great job with photoshop - it makes your desired result very apparent. You demonstrate 2 basic things with your desired post-op photo; augmentation of the dorsum (bridge) and increased projection of the nasal tip.  It's very possible to do this with an open rhinoplasty and utilization of cartilage grafts.

Your best bet is consultation with a board certified plastic surgeon or facial plastic surgeon.  Best of luck.

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