Best surgical approach to make my nose smaller around the bottom?

Your nose is beautiful. I would not recommend any surgery at all although that is only based on one view you showed

Hello and thank you for your question. Just to clarify, if you're talking about your nasal tip, this is a common complaint and something that can definitely be addressed with surgery. Many people complain that their nasal tip is too "bulbous" or "boxy" and that they would like it to be smaller, cuter, more defined, or more feminine. An open rhinoplasty can best address the entire nose, and is particularly effective for addressing a bulbous or boxy nasal tip and performing complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. If this is a significant area of concern, I would definitely say it is worth it- I have seen so many patients who comment on how much happier they are with their appearance and how much more confident they feel in all aspects of daily life!
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from just photos. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Hello,
Thank you for your question. There are many effective maneuvers to narrow the tip (cephalic trim, tip suturing, etc) and the actual nostril width can be adjusted as well. This can be done using the closed / scarless approach. I wish you all the best.
Mark G. Albert, M.D., F.A.C.S.New York, NY