What Exactly is Tip Refinement?

Some basics. The shape of the nose is the shape of the underlying architecture. In the nasal tip, the architecture is cartilage. If the cartilages are rounded and weakly supported, then the tip will have poor contour and definition. You need thinner width and strongly supported tip cartilages in order to have tip definition. If you cover this with a piece of silk or thin skin you will see great definition. If you cover the architecture with a thick mattress or thick skin, then you won't see much definition. Support is key in thick skin noses, not reducing architecture.

Tip refinement refers to reshaping and in most cases narrowing the dimensions of the nasal tip. Various techniques are used to achieve this depending on the patient, including dome division, cephalic margin trim and dome binding. Sometimes the cartilage is reshaped by removing small sections of it, but more commonly with modern rhinoplasty techniques, the cartilages are repositioned and reshaped rather than reduced. Tip refinement techniques are often used in conjunction with tip rotation (elevation).

In rhinoplasty jargon, the term "Tip Refinement" simply means reshaping the nasal tip to improve its appearance. This can involve making the tip narrower, smaller, less bulbous, less boxy, more/less upturned -- depending on the goals of the surgery.
The techniques used to achieve these goals depend on the type and shape of the patient's nose. Also, skin thikness can impact the result of "tip refinement". Changes to the tip may be less appearant in thick skin patients compared to thin skin patients.