Thanks for your question. Small irregularities and asymmetries in the nose can be improved with fillers and one can either use permanent or temporary fillers. Among the permanent fillers are FDA approved, Bellafill ® or fat transfer (which, of course, comes from your own body). Fillers will rarely improve nasal obstruction or make the nose smaller. For a life long result, a rhinoplasty is still generally the gold standard. For refining the tip of the nose, either a closed or open (my preferred method to get maximum control of symmetry) tip rhinoplasty can be performed which refines the bulbous area with minimal scarring. An open technique allows better visualization and control of the paired cartilages which act in conjunction to define your tip shape and symmetry. The ability to see both cartilages simultaneously and work on them together allows the surgeon ultimate control over both the shape and symmetry and beauty of the nose. Recommend an in person consult with a board certified plastic surgeon specializing in rhinoplasty to discuss your options.