The areas you are concerned about are frequently improved with a tip plasty or a full rhinoplasty. Whether you should have the procedure is a personal decision only you can make. Additional information about the procedure will help you decide which procedure would have the best chance of achieving your cosmetic goals and if it is a procedure that you want to pursue.
Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to dowithout seeing photos and without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
A tip rhinoplasty can sometimes be performed to reduce the bulbous tip, but the remainder of the nose must be in full balance to accept the new tip. A small amount of cartilage can be removed from this tip noted in the photographs, but only anticipate a minimal change.
Your photos do show a bulbous tip which can be addressed with a tipplasty, however, you do need to discuss what your goals are with your surgeon to decide whether the tipplasty or rhinoplasty is what you need. The goal of the tipplasty/rhinoplasty is to reduce and refine the nose.
This is a question that I'm asked every day. The most obvious improvement will be in your tip. It will be necessary to discuss your alternatives during consultation; there are definitely advantages of each approach.
Depending on the results you are looking for, a tipplasty or rhinoplasty could enhance your appearance. The way I think about nose surgery is about what the patient is looking to achieve that is still natural appearing and in balance with the rest of the face. Please consult with a board certified specialist in the face who can assist you with achieving the results you seek. 3-dimensional computer imaging can also assist you with visualizing what you may look like afterwards and with communicating with your surgeon your desired result.
Tip refinement can be performed through a closed approach if this is all you want changed.
Kenneth Hughes, MD
Los Angeles, CA