Without a consultation or photos it is difficult to access your nasal contour issues. It is possible that your tip contains a lot of cartilage or is bulbous and your plastic surgeon mentioned an "open" approach where he would "peel back the skin from the tip" of your nose. Topical or injectable steroids would not correct this issue and would probably make the skin thinner. An open rhinoplasty, in my hands, is the best way to correct a bulbous nasal tip with excision, grafting and suture contouring techniques. Some surgeons claim they can correct the bulbous tip with a closed technique, however, I'm happier with my results with the open approach. Hope that helps. Dr. Shaw