The nasal tip can certainly be defined. The round appearance is from the large cartilage underneath the skin. The cartilage can be shaved and that reduces the round appearance to more defined tip.
You should take your photo and draw with a marker on it to show the surgeon exactly what you want. You can also bring some photos from magazines of noses you like.
Rhinoplasty Surgeon in New Jersey
Hi Jersey Girl,
Don't dismay, you will find a rhinoplasty surgeon who hears what you are saying. It is possible to define your nose without making it narrower. A very conservative trim of your lower lateral nasal cartilages, possible subtle suture sculpting of the LLC domal area, and possibly a columellar struct graft can achieve your desired results without narrowing your nose.
You are doing well by consulting with many rhinoplasty surgeons, and not settling until you are confident that your surgeon can understand your nasal cosmetic desires, and most importantly be able to achieve your goals.
Keep up the good work choosing your rhinoplasty surgeon most carefully. I know a pretty good rocker nicknamed the Boss in NJ, but unfortunately do not know the work of a rhinoplasty surgeon there whom I could recommend.
Good luck and be well.
The ideal nasal tip has a slightly triangular shape with rounded contours
If you look at the most attractive nasal tips, they aren't round or narrow. They have a soft contour that is slightly narrower above than below, creating almost a triangular shape. This shape was actually achievable with techniques that removed cartilage in the past. However for weak cartilages these tips sometimes got too narrow. So instead surgeons started removing less cartilage and using sutures to narrow the tip. When done symmetrically above and below you got a narrow straight tip, called a uni-tip. These sutures are very helpful but should be tighter above and allow some flare lower down. There are a number of good rhinoplasty surgeons in the New York Metropolitan area who are adept at this procedure.
The bulbosity in your tip is a result of large overprojected lower lateral cartilages. For improved tip definition the cartilages can be resculpted to give you more of a contoured look. You may also require some cartilage tip grafting. Overall the idea is to reshape the lower lateral cartilages rather than just remove cartilage.
Jersey Girl, you are right - a defined tip is not necessarily smaller. Definition is determined by shape and contour. You will find a surgeon whose results are consistent with your aesthetics. It is always enjoyable to work with patients who have clear, appropriate goals in their expections of nasal surgery.
Treatment of a round or bulbous tip is fairly straighforward. The tips would be narrowed a bit to remove the bulbosity in a controlled fashion under direct vision. It is fairly routine.
What you want may not always be possible
You can't always get what you want - what you get depends on the anatomy present and the skill of the surgeon. Don't just limit yourself to NJ, come into the city.