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Steven M. Denenberg, M.D.
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Along the dorsum, you can see parallel vertical white lines that are the reflections of the flashes.  The linear reflections are prominent, and a bit crooked; they softened and straightened after the hump was removed.

Look at the tip of her nose.  In the after picture, there are two white dots, also reflections from the flashes.  The white dots are small and symmetric, closer together than in the before picture, more distinct than in the before picture, and positioned higher above the nostrils than in the before picture.  Those findings are our indications that the tip of the nose was narrowed and elevated during the operation.  Also, we get to see just a little bit more of her nostrils after surgery, another indication that the tip of the nose was elevated.


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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: Rhinoplasty for bulbous very round nose?
I am a 20 year old white female. My nose is very very round/boulbous. The bridge is fairly straight, but the tip throws it off. I think my skin is pretty thick, (i know that can be an issue with rhinoplasty) but how do I know if it is thick? Would I just need a tip rhinoplasty or a full one? What should I expect? I am also haveing a hard time finding a before and after of a white female with a nose as boulbous as mine, so if you could send me one that would help.
(Questioner submitted photos)

Dr. Denenberg's answer: Perhaps work on more than just the width of the tip
Hi,
I see the width of the tip, and indeed it's possible to improve your nasal tip (see the Web link below). My suggestion would be to make a couple other changes at the same time, such as elevating the tip a small amount and taking down the small bump along the bridge of your nose. The video link below shows a simulation of those changes.

Be careful to see the before and after photos of any doctor you are considering for this operation. Work on a tip like yours is extremely difficult, and most plastic surgeons wouldn't be able to handle it expertly. Before and after profile pictures where a hump was removed don't tell you if the surgeon can work on the tip of the nose.

Link to this question on RealSelf.com