A bulbous nasal tip can be caused by a combination of things: too much tip cartilage, tip cartilage that is in the wrong position, and tip cartilage that is too splayed apart.Additionally, excess tissue at the tip may be due to extra fat in the skin of the nasal tip. Defattening of the tip is often necessary to bring out more contour and precision in the shape of the tip.
The cartilages are reduced and sutured to refine the structure but most importantly the skin needs to be aggressively thinned to achieve adequate drapping over the refined cartilagenous structure.
The video clip above shows the pre operative planning and the pictures below shows pre and post op after removal of sutures.The final results cannot not be judged untill 6 months after surgery.There is lot of edema to settle down.