Answer: If the dome cartilages under the nasal tip skin are large and rounded, then you are in luck in that these cartilages can be trimmed and then reshaped with sutures, giving you better tip definition. If on the other hand, the roundness to your tip is all due to thick skin and the cartilage underneath is weak, then there is less that can be done. Sometimes with thick skin, the tissue underneath can be thinned out, but this must be done conservatively and carefully. Some individuals with thick tip skin benefit from a tip graft that increases tip definition. Some lasers can thin overlying nasal tip skin and some medications can decrease pore accumulations and size. If you are going to have a rhinoplasty and you also have a dorsal hump, it would make most sense to have that addressed at the same time.
Dr. Russell Kridel, Houston, Texas