Can my nose tip be refined without adding projection or a graft if I have thick skin? (photos)

Hello and thank you for your question. Based on your photographs, you may benefit from a revision. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. It really depends on how far out from surgery you are now. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

In person exam is essential as well as review of the operative report. Based on limited photos- it appears that improvements can be achieved with Revision Rhinoplasty performed through a closed technique with possible utilization of new graft. I suggest that you seek an experienced Board Certified PS and review your options at the time of your consultation

Yes the septal extension graft can be trimmed, and your nose rotated up, so this will look less long and projected, which you don't like. Steroid injection will not help.