Rhinoplasty, Bulbous tip, Thick Skin, Will there be any improvement after Rhinoplasty? (photos)

I have thick, round skin at the tip of my nose like a joker. I wanted to know if there will be any improvement after Rhinoplasty? What procedures should be done on my nose?

Doctor Answers 8

Nasal Tip Rhinoplasty: Bulbous Tip and Thick Skin

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Thank you for your question. First, I would like to assure you that you most certainly do not look like a joker. What I gather from your photos is that I can see the tip of your nose might benefit from rhinoplasty (nasal tip surgery). The front view of your photo appears to show that an adjusted tip that is more feminine in appearance would better suit the other features of your nasal anatomy. This is not an uncommon request and is one of the most requested procedures that fall under the family of rhinoplasty surgery. 

Regarding your dissatisfaction with thick skin and whether nose surgery can correct that. Let me start by saying that the first thing you should do is research plastic surgeons that are board certified in facial plastic surgery. Specifically, facial plastic surgeons that are skilled in ethnic rhinoplasty. One pitfall you want to avoid is reducing the tip and actual size of your nose too much. My reason for stating this is that you do not want to create a space between your nasal skeleton and skin which can fill in with scar tissue over time.

With over 20 years of experience in the field of facial plastic surgery, specifically ethnic rhinoplasty, I can tell you that I would highly recommend researching your surgeons and examine their before and after photos of ethnic patients. 

I am including a website link about ethnic rhinoplasty as well as video that discusses decreasing your nose size and skin thickness. If you would like more information, please feel free to contact our New York City office if you feel we might be of assistance in helping answer your questions along your journey.


Philip J. Miller, MD, FACS

Double Board Certified Facial Plastic Surgeon

New York Facial Plastic Surgeon
4.7 out of 5 stars 100 reviews

Rhinoplasty: Bulbous tip

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Hi Srishti,

Yes there can be improvement after a rhinoplasty procedure. Depending on the reason for your bulbous tip- surgery may require defatting the tip, cartilage grafting, and/or reshaping. Make sure the surgeon has experience in ethnic rhinoplasty.  In good hands, you should get a great result. Feel free to email me your pictures for computer imaging. 

Dr. S

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews


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Thanks for your question. You will absolute get a better nose shape after Rhinoplasty. There are various techniques to fix Bulbous nose tip such as silicone implant technique, artificial cartilage insertion technique, or revised nasal cartilage technique. 

Open rhinoplasty, some advices:

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Thank you very much for the questions. The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us. In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping. With this procedure you get a delicate nose, better harmonize with your other facial features.

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 368 reviews

Tip refinement

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A full evaluation in person is necessary. Certainly tip refinement can be performed. There might be some limitations because of thick tissues.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews


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Thank you for your question and photographs.

It is important when looking for a plastic surgeon for Rhinoplasty to find one who is board certified and specializes in Rhinoplasty to obtain the best results possible.  To fully evaluate your nose, I would recommend you schedule a consultation with a board certified plastic surgeon and have a full facial and nasal examination performed.  However, from what I can tell, it appears your tip is enlarged and bulbous. You would benefit from a tip rhinoplasty which includes trimming the lower lateral cartilages and placing precision sutures to refine the tip and make it look more pleasing and smaller in size and give you that sharper appearing nose. Best of luck in your endeavors!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 reviews


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Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 173 reviews

Tip refinement

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Dear Srishti,

You are quite correct that thick skin can obscure the details and underlying cartilage shape of the nose, but from the images that you have sent it is apparent that refinement of bulky tip cartilages along with careful tip grafting could be used to better define your nasal tip and bring it into proportion with the remainder of your nose.

With best wishes,

Waseem Saeed

Waseem Saeed, BSc, MBChB, FRCS(Plast)
Manchester Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.