Revision - are my expectations realistic? (Photo)

Thanks TaianaDuncan for your question! Based on your description, you're aiming to refine the nasal tip, shave down the nasal bridge and address internal nasal issues to Resolve the bump and potential swelling.
To refine the nasal tip, a qualified surgeon can carefully sculpt the nasal tip's cartilage to give it the proper definition and shape. In some situations, particularly when structural integrity is lacking, cartilage grafts may be utilized to strengthen or enhance the nasal tip.
A section of the bone on the bridge of your nose can be carefully removed to create a smoother profile in order to shave down the nasal bridge via bone contouring.
To address Internal Nasal Issues your surgeon can do septoplasty to correct any underlying septal deviations that may be contributing to breathing difficulties or persistent swelling. Morever, The internal bump, likely scar tissue, can be surgically removed to improve airflow and reduce discomfort. Sometimes the lower turbinates need to be pushed out to improve airway.
Although thicker skin might occasionally make surgical outcomes less predictable, a talented surgeon can take this into consideration and still provide outstanding results. Methods such as meticulous dissection and accurate suturing can maximize healing and reduce scarring. Occasionally cartilage need to be removed and internal splinting placed to help with proper healing.
As a triple Board-Certified Plastic Surgeon and experienced rhinoplasty surgeon, I specialize in revision rhinoplasty. This complex procedure requires meticulous attention to detail and a deep understanding of facial and nasal anatomy. I am committed to correcting imperfections and restoring both the form and function of the nose. My philospphy is to listen carefully to the goals and desirers of my patients with a focus on patient satisfaction, I utilize advanced techniques to achieve natural-looking and long-lasting results.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian
TRIPLE Board Certified Plastic Surgeon

Unfortunately, revision rhinoplasty surgery is exponentially more difficult than primary rhinoplasty surgery. And I agree with what you've been told: You appear to have thick nasal tip skin. When someone has thick skin in the nasal tip area, significant narrowing and refinements may not be feasible. Please consider meeting with several reputable rhinoplasty specialists who offer computer Imaging so you can see what to expect moving forward. I hope this helps. Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining revision 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. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon