Bulbous nose tip surgery at 58 years of age with thick skin - Any advice?

Seems to me you're a great candidate for a rhinoplasty. On the frontal view, that shadow just above the big tip cartilages indicates that the skin is thin enough that the tip cartilages show themselves distinctly under the skin. On your photo number four, the way that the tip stands out abruptly from the bridge of the nose also indicates that the skin isn't terribly thick.
The woman in the short video that I posted with this answer had very strong tip cartilages like yours.
Besides the wide tip, your tip is very strong in its forward projection away from your face, so it should be brought back closer. Then, the tip is low, making the nose look droopy, so the tip should be elevated upwards.
Rhinoplasty, though, is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes I described in the paragraph above require advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon.
Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! 
But remember, you're not the surgeon for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands how to narrow, elevate, and deproject the tip cartilages, and how much change is needed for an attractive nose for your face.

In looking at the supplied images, it is my opinion that what is revealed is hypertrophied lower lateral cartilages and medium to thin skin.I believe you are an excellent candidate to make significant and beautiful changes to your nose.See a practitioner with extensive rhinoplasty experiance and you will achieve a great result.Be well and best regards,Fred G. Fedok, MD FACS 

Hello and thank you for your question. You appear to have a bulbous nasal tip with prominent lower lateral cartilage.  Based on your photograph, you may benefit from a tip refining rhinoplasty which can be performed by trimming, suturing, and reshaping the cartilage in your lower nose. You age is not a contraindication at all for this surgery.  It is very safe and common to perform at your age, as long as you obtain medical clearance from your primary physician.  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.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon. 

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon