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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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Two cartilages form the tip of the nose, a left tip cartilage and a right cartilage.  In the before picture, you can see the depression, or dent, between her two tip cartilages.  They are quite prominent, and decreasing their strength was an integral part of obtaining this result.

If you don't mind looking at photos taken during surgery, the first chapter of the rhinoplasty surgery tutorial gives a good introduction to the anatomy of the tip cartilages,


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"I am so happy that I cannot even put it in words ... "
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All views of this rhinoplasty patient:
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current: Right oblique
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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Is my nose tip broken?
As a child I had a bad fall on my nose. Ever since it has gradually got worse over the years. I have trouble breathing from my left nostril and I have a poor sense of smell. I can feel a split at the front of the tip. Also if I squeeze my nose tip it feels springy. I'm not sure if this is related, but I suffer with nose bleeds alot too
(Questioner submitted photos)

Dr. Denenberg's answer: Your nose isn't broken, but you must be very careful in selecting a surgeon.
The split and the springiness and the size of your tip are all related to the fact that the two cartilages that form the tip of your nose are fairly large and asymmetric. Your skin is thin, so it's easy to see, and even feel, the contour of those cartilages under the skin.

This all means that if you decide to have a rhinoplasty, you must be very, very careful about selecting the right surgeon. The vast majority of rhinoplasty surgeons do not have the skill and expertise to handle your tip cartilages, which cartilages pose a significant technical challenge.

When evaluating surgeons, you must insist on seeing before and after photos of their other patients. Look to see whether the doctor has been able to handle large tips like yours. If the photos only show profile views, like shaving off a hump, that's not good enough evidence for your situation. Generally, the three-quarter views show the tip cartilages best.

Link to this question on RealSelf.com