This young woman's nose appeared to sit too close to her face. She had
inadequate projection. The goal of her operation was to bring the tip
of her nose farther out from her face.
Her nose has some of the appearance of a cleft lip nose, but her lip is
perfect: she was injured in a jungle gym accident. The nose is reminiscent
of a cleft lip nose because persons with that congenital deformity often have an
associated deformity of the nasal tip cartilages that causes the tip of the nose
to sit too close to the face.
The rhinoplasty surgery tutorial contains a chapter
that discusses the importance of tip projection and how it is maintained or
created surgically (the surgery tutorials contain explicit photographs taken during surgery).
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How Do You Fix a Nose with a Bulbous Tip?
How exactly is excess tissue removed from the tip of the nose?
(Questioner submitted photos)
Dr. Denenberg's answer: By modifying the cartilages in the tip, not so much by removing them!
The tip cartilages are very thin, but they are arched, and if the arches are wider, then then the tip will look wider. There are various ways to change the position and shape of the cartilages to narrow the tip.
The Web reference link below goes to the first page of an essay I wrote on narrowing the tip of the nose. Careful, though, because there are photos taken during surgery, although not on the very first page of the essay.
Link to this question on RealSelf.com