Thick Skin, Bulbous Tip Repair, What Kinds of Risks are There with this Surgery?

Thicker skin noses in general need plenty of strong cartilage underneath the skin to have a good shape to the nose. Skin thinning is often needed and some noses require grafting of cartilage from other sites (rib or ear)

Refinements made to the nasal tip during rhinoplasty are always blunted by thick skin during the healing process. Postoperative cortisone injections and Blenderm taping can help with this. Surgical refinement of the bulbous tip involves suturing cartilages of the nasal tip and occasionally removing excess cartilage. The biggest risk with a bulbous tip repair and thick skin is a pollybeak deformity, which can be managed through close follow-up with surgeon for cortisone... more

Seems you have foud a n honest and staight forward plastic surgeon. For middle aged rhinoplasty candidates with thick skin and bulbous tip you should reduce your expectations and be as patiend as you are. In the hand of an experienced plastic surgeon therei s minimal risk for this type of surgery. You do not need to worry too much, your nose will continue to improve even up to two years after the operation.