Bulbous nose rhinoplasty?

I think that you can have some refinement without creating a pinched or pointy look and without compromising your breathing, which is critical.  Kenneth Hughes, MDLos Angeles, CA

Yes, a closed rhinoplasty procedure can reduce the bulbous tip, although the tip will still widen when smiling. Suture techniques and a conservative cartilage removal applied to the lower lateral cartilages are required to refine the nasal tip.It is important to make sure the new tip balances with the remainder of the nose

Dear AnnemarieI think you have a realistic sense of what kind of result can be achieved with a rhinoplasty. You have thin skin across your nasal dorsum and medium thickness skin around the tip. From the pictures, you have good cartilage support of your ala. This combination is a great foundation for getting a natural, refined and long lasting result with rhinoplasty. Look for experienced surgeons who are well trained and certified by the American Board of Plastic (or facial plactic) surgery. See more than one consult so you can make a well informed decision.