Rhinoplasty to narrow nose, refine tip, build up bridge, and possibly turn tip down a bit. Is this possible? (photos)

I think that the goals for your nose could definitely be accomplished with rhinoplasty. Refining the tip, narrowing the nose, derotation of the nose, and building up the bridge would be the main goals, in your case. Look for an experienced rhinoplasty surgeon.

Your goals are achievable but you will need rib cartilage grafts to augment the dorsum of the nose with a satisfactory amount of material. This is best achieved using a technique where the rib cartilage is diced and placed inside a tube of fascia. As you say, the lengthening of the nose would also improve the aesthetics and is achieved by using pieces of cartilage from the septum as extension grafts. The tip refinement is a standard technique. Be sure that you seek the opinion of an experienced plastic surgeon who has experience of using rib grafts. Rib grafts are commonly used in revision techniques and so a surgeon who regularly performs revision rhinoplasty would have the necessary experience .Good Luck

Hello,Your bridge is low and it's take off from your forehead (the radix) is low too. Rib is the only donor site with sufficient cartilage to use for diced cartilage grafts, as well as sufficiently long and strong caudal septal extension grafts. Best of luck!