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What Exactly is Tip Refinement?

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Jewdaism
My doctor said my tip won't be as refined as someone with thin skin. I definitely understand the reasoning of that. I just want to know what exactly is tip refinement. Is it removing cartilage tissue that makes your nose tip what you call bulbous? Upturning your nose tip, or elevating your tip? Or does it mean all of that? I would just like a better understanding from you doctors because you guys actually take the time to help others, which is nice.

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