Would a tip refinement surgery help my droopy bulbous nose? (Photo)

Thank you for your question. You are an excellent candidate for rhinoplasty. I agree with your assessment and think it is one of the most beautifying surgeries that we do as plastic surgeons. In your case, I would use alar contour grafting as well as alar base excisions to reduce the flare and prominence of your nostrils. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Hello and thank you for your question. Just to clarify, if you're interested in improving your nasal tip, this is a common complaint and something that can definitely be addressed with surgery. Many people complain that their nasal tip is too "bulbous" or "boxy" and that they would like it to be smaller, cuter, more defined, or more feminine. An open septorhinoplasty can best address the entire nose, and is particularly effective for addressing a bulbous, boxy, or asymmetric nasal tip- especially in the secondary/revision context, as in your case. It is also very effective for performing complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look.
Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery- and secondary/revision procedures are even more difficult. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Regarding the anesthesia, my personal preference is similar to most- full general anesthesia to assure the most controlled environment and facilitate the best possible aesthetic results for such a complex procedure. Everything ultimately comes down to surgeon and patient preference, so always have the conversation with your surgeon so you both know exactly what to expect, and so you both feel comfortable with how the procedure will be performed prior to proceeding.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos provided. I recommend for you to come see me or another plastic surgeon comfortable with revision/secondary rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Your questions would be best addressed during an in-person consultation with a surgeon who specializes in rhinoplasty or particularly "revision rhinoplasty". An experienced surgeon will be able to address your questions after a physical examination of the nasal anatomy and a conversation of what your ultimate goals and expectations are.

Undergoing any surgical procedure requires careful attention to detail and consideration for different options. Consider obtaining several opinions before moving forward with any given procedure. Always trust your face to a board-certified facial plastic surgeon or a board-certified plastic surgeon with very extensive rhinoplasty or "revision rhinoplasty" experience.