Does having thick skin mean I can NEVER have a refined nose tip?

I have patients from many ethnic backgrounds who see me for rhinoplasty.  Thick skinned individuals is common in my practice.  You can certainly thin the skin by conservatively removing fat beneath the skin in the nasal tip.  You can also place grafts that will help define the nasal tip as thick skinned individuals frequently have weaker tip cartilage and the grafts help to define and support the tip. With all of that said, it is also important for your rhinoplasty surgeon to set realistic expectations with you.  Attempting to thin and define a tip more than nature will allow can result in significant complications and deformity of your nose.  

Naturally thick skin tissue covering the nasal framework can play a frustrating role in limiting the more subtle refinements possible. But some very nice changes can still be achieved, and there are some special techniques (eg. cartilage grafts) that are often used to help with this situation. Unfortunately, the skin cannot be thinned - a layer of scar tissue would result that could be as thick (or even thicker!) than was originally present.

Thank you for your question. I suggest that you move forward and consult with a board certified facial plastic surgeon. The in-person consultation is the only way to address your needs and concerns through the physical examination.
Best wishes,