Dear Chopra82; The photos are very helpful. Whether or not it is appropriate to have a “sharp nose through grafts” is something to consider. Your nose can be improved with standard techniques. Without feeling the cartilage and evaluating the skin, it would be unwise to make a specific recommendation if you need grafts or not. However, the most important thing is to have consultations with surgeons who specialize in nasal cosmetic surgery. You should have computer imaging.Computer imaging, uploads an existing picture of the patient into a computer. Then, the surgeon and an artist sit down and work up a predicted picture of what you most likely will look like after surgery and healing. (The technology is also known as computer morphing.) The final, healed patient picture is included so the three-picture panel is known as a triptych. In many cases, the actual after surgery, healed results look better than the predicted picture. Look for a practice that offers that service; it’s the best way to get a glimpse into the surgeon’s mind of what he or she is thinking about the changes that can be made to your appearance. From the profile, and this may be an inaccurate observation because of the pose, but it looks like you have a significantly receding chin. Remember, the chin is an important part of the profile, right up there with the nose, so when you go for consultation, you may want to raise that issue, if that is something that interests you. Regarding general reconfiguration of the nose: the surgeon must take into account the strength and shape of the cartilage and thickness of the skin. It is important that all elements be taken into account because they all have a bearing on the outcome. Not every operation requires tip grafts. As a matter of fact, often it is a combination of both surgical and non-surgical techniques that wins the day for patients.There is a value to fillers.Remember that one nice thing about fillers is that they represent the “extra tool in the toolbox” such that after the surgical result has become pretty well settled in at six months or so, then you make a decision whether or not you wish to consider fillers to help put the “frosting on the cake,” and then, of course, you would be wise to have that saline demo so you can see the results of the outcome. Finding a good cosmetic plastic surgeon starts with a computer search of surgeons in your (or distant) areas. Best results come from super-specialists (a medical, not an advertising term) who do the procedure you want at least weekly and have done it for at least a decade. Once you narrow in on the website of a surgeon who looks good to you, focus on the before and after pictures, looking for patients who have had the procedure you want. There should be dozens and dozens of such photos. Many good, plain language booksabout cosmetic plastic surgery are on Amazon.com or Barnes&Noble.com. As you read, write down questions that can be asked later in consultation with a surgeon. My two books (listed below) are designed to help with all the nuts and bolts of cosmetic plastic surgery consultations and questions about before and after surgery matters.Best regards, Robert Kotler, MD, FACS