Dear SaraIn general, your nose can be made to look more narrow and your tip can have increased definition. The degree of definition is limited primarily by the thickness of your soft tissue envelope. A natural result is not the same to any two patients. Your job is to communicate the result that you want with good description and pictures so you and your surgeon are on the same page. Most surgeons will go over a series of before and after pictures and you can discuss the results and your preferences at that time. Consult with more than one surgeon.
The areas of your nose that concern you and would like improved can be refined with a rhinoplasty, in spite of having thicker skin. Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on a limited two dimensional photo without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.Robert Singer, MD FACSLa Jolla, California