Nasal tip refinement for bulbous/boxy nose?

During a primary ethnic rhinoplasty, the skin and soft tissues are often completely separated from the underlying bone and cartilage framework. The framework is modified and the skin is laid back down. These are big movements that are often intended to create millimeter changes to the shape of the nose once it heals.Each nose is different, however, and so there will be slight variations in the technique. In addition, the thickness of the nose skin can affect the overall result. With skin preconditioning, however, an nice improvement can be obtained for most patients.See the link below for more information. 

A detailed examination will help delineate the best treatment. Consultation with a plastic surgeon certified by the American Board of Plastic Surgery would be the next best step.

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