Can You Shorten a Nose 4mm by Infra Tip? Too Much?

I consider it a bit a red flag when patients come in describing what they want done to specific parts of their nose down to the half-millimeter.  I agree with Dr. Schuster that nobody can produce results that precise.  I can take exactly 2.5mm of cartilage off a certain area during surgery, but I cannot predict with that precision how the final result will be.  Unless you are a plastic surgeon, the fact that you are using terms like "infratip", "alar crease/sidewall", etc. makes me think you have been on Google too much.  You should find a good surgeon, tell him/her what you don't like about your nose, maybe even have them use computer imaging to discuss surgical options, and then let him do the work.  Rhinoplasty is just as much (if not more) of an art as it is a science.
 

The infratip region is comprised of the medial crura of the lower lateral cartilages. Rarely, this can be unusually thick and seems to be in your case. Refinement is achieved by directly thinning the cartilage and also by suturing it up to the edge of your septum in a "tongue and groove" technique.

However, I also agree that worrying about your surgeons goal to the millimeter is obsessive and may indicate you will be difficult to please. When you focus on minute and uncontrollable assymetries and differences from expectations, you will lose satisfaction for the expected overall improvement from your surgery.  Overall your nose is long and bulbous at the tip, as well as overprojected. This will required extensive sculpting and reshaping to achieve the aesthetic goals that you and the surgeon agree upon. It is important to realize your surgeon is making dozens of complex, interrelated critical adjustments in millimeters to carry out the rhinoplasty. Don't make the mistake of focusing on one area in the final result.