The bulbous tip is addressed with dissolvable stitches that take many months to dissolve. Since the sutures take a long time to dissolve, scar tissue holds the cartilages in place. When the lower lateral cartilages of the nasal tip are excessively wide, a conservative cartilage removal is performed as well. For many examples and more information, please see the link and video below
Rhinoplasty sutures are typically temporary. Permanent sutures can be used but occasionally can cause problems down the road as they are a "foreign body" and can result in inflammatory reactions or other issues. I prefer to use PDS as it has good staying power but is typically reabsorbed by 6-9 months minimizing the risk of long term suture complications. Once the nose has healed completely, the shape is stable but it is important for any sutures to last through the early healing period to prevent distortion of the newly created nasal shape. I hope this information is helpful for you.
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon