Great question - the answer is yes! There are many techniques a rhinoplasty surgeon can use to change the characteristics of your nasal tip. And these can be done independent of a dorsal augmentation. The key is to be very specific with your surgeon about what you are looking for so they can choose the best techniques for you. If you are looking just for a smaller, more defined tip, this is relatively easily achieved by narrowing the cartilages that make up the tip of the nose. If you want extra projection in addition to definition, cartilage grafts can be added to the tip to achieve this. Typically strut grafts (in my hands) are used more for structural support and not definition. I would probably offer cephalic trimming of the tip cartilage with possible shield or cap graft to add some projection and additional definition. The last note I will say is sometimes bulbous noses are created not by excessively large cartilage, but cartilage that is oriented in a non-ideal fashion. This would require re-orientation of the tip cartilage which would reduce the volume. I would use strut grafts in this situation. Good luck!
Yes! A cheek augmentation can definitely help your face not appear as flat. You have a couple of different options: filler injections can be done during an office visit and produce good results, but are temporary (around 1-2 years depending on the material used). You can repeat the injections as you need to maintain the contour you want. You can also place a cheek implant. This would require a surgery, but it is permanent and the implants can be shaped to the face you are desiring.
There are definitely options you can pursue to achieve the results you are looking for. If all you are wanting to change is the humped appearance, I would recommend a “closed” rhinoplasty. This would allow your surgeon access to the dorsum (top of your nose) to lower it down without placing any external incisions. You have a very nice, slender nose, so you need to be aware that by lowering your dorsum, your nose will look slightly wider due to the contour change. Prior to consultation, you should think about what you want the final appearance to be - you can either have a straight line profile or one that is slightly scooped. Either of these can look natural and it is more of a personal preference for you. Take a look at some photos before you go to a surgeon and get a sense for what these look like to see what you think you would want. Best of luck!
