One of the lines of the face that plastic surgeons pay attention to is the
line that is parallel to the bottom of the nose, along the columella. In her before picture,
that line is about parallel with the ground, and in the after picture it is
pointing up a bit.
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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