http://www.youtube.com/watch?v=kZblHW4cO74
When dealing with a bulbous tip usually a combination of surgical maneuvers are indicated. One must debulk the soft tissue calle defattening, trim the lower lateral cartilage, remove interalar tissue, suture the lower lateral cartilages together to refine and define the tip. Removing tissue from the tip of the nose for a bulbous tip is actually a risky maneuver. This can devascularize the tip and lead to skin death at the tip of the nose.
