Procedure to Subtly Refine Nose Tip?

It’s not unusual for patients to be concerned about the aesthetics of their nasal tip.  When this scenario arises, an isolated tip rhinoplasty procedure is often the solution to the problem.  This procedure is indicated when the patients deformity is confined to the lower third of the nose.  In this area, the structures involved consist entirely of soft tissue and cartilage.  The nasal bones are not involved and because of this there’s no need to fracture them. 
            Tip rhinoplasty corrects a variety of deformities that involve the nasal tip.  Examples include bulbous tips, wide tips, tips that lack projection, and tips that have too much projection.

            Typical deformities are addressed by suturing techniques, removal of excess cartilage, and augmentation of cartilage with cartilage grafts.  These maneuvers can significantly impact the appearance of the nasal tips.

            Careful analysis of the nose is essential before proceeding with this procedure.  It’s important to make sure that the upper portion of the nose doesn’t require intervention before proceeding.  Harmony, proportion and balance with the surrounding facial structures are necessary for an optimal result. 

            Since fracture of the nasal bones isn’t necessary with tip rhinoplasty, there’s less bruising and swelling.  For these reasons, recovery is less eventful and takes shorter periods of time.  There’s also less pain following surgery.  Tip rhinoplasty is associated with high satisfaction rates.

According to the description and picture you have provided,
it does seem as if a rhinoplasty can improve the appearance of your nasal tip.
A qualified, experienced surgeon will know how to conduct the nose job in a way
that will give you the most natural looking results. I understand that my
patients are concerned with having a nose that looks too overdone or “fake” and
am always sure to avoid such results. For a more accurate depiction of what
your new nose will likely look like, ask each of the surgeons you are
consulting for real life before-after-photos. These are the best indications of
the surgeon’s work and can help you work together to construct a nose that
suits your face and needs.

 The most important decision is the surgeon. Choose an experienced rhinoplasty surgeon who does natural noses that you like. See real patients or long term photos of his results.

It is a reasonable option and can be achieved by scoring the catilages and then stitching them together. There are several other techniques that address the problem, such as removing a sliver of the cartilage, morselizing (crushing) the cartilage.
The techniques can vary for each surgeon as we all have our own preferences. Its the result at the end that matters more than the technique used. Remember there many ways to skin a cat.
Regards

Hi Betty Lou,
Subtle changes to the tip of your nose ("change the offending party please) can achieve the goals that you desire. You may need additional subtle changes depending upon the structure of the remainder of your nose.
Choose your subtle rhinoplasty surgeon carefully and make sure that she/he understands your wishes and can carry out the steps to attain the result your want.
Good luck and be well.
Dr. P