Rhinoplasty for wide nose with bulbous tip?

Thick nasal skin would camouflage the refinement of nasal tip. In some instances the subcutaneous nasal tissue (fat under the skin) can be trimmed in order to create more definition at the tip. This requires experience and expertise of how much of tissue to remove. I do not think you have overly thick skin, an experienced rhinoplasty surgeon can create a beautiful and natural results by performing a tip rhinplasty and reducing of your alar base. Your nasal dorsum  looks wonderful, therefore there is no need for osteotomy (breaking nasal bone). 

You would do well with a rhinoplasty. The thickness of your skin is a limiting factor of how  narrow/refined your tip can be. Having said that you would get a significant change in the appearance of your nose from a rhinoplasty. I believe you would like it. 

An open or closed rhinoplasty with tip modification will improve the shape and definition of your nasal tip. The rest of your nose would harmonize well with improved tip features, as discussed.

Based on your photos, you would be an excellent candidate for rhinoplasty. The areas of your concern are realistic and the result should be obtainable with an experienced rhinoplasty surgeon. Best wishes to you.

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. Cartilage grafts may also be used to help improve tip refinement.
 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. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon