Many patients with a wide tip want it narrower, but you have to be careful. A tip that is too narrow can take on a very “operated” look. When viewed from the side, the tip of the nose should have a well-demarcated tip-defining point, the farthest projection of the tip from the lip. When viewed from the front, the nasal domes, the two prominent and well-defined points in the nasal tip, define this area. What creates these domes is a sharp bend in the same lower lateral cartilages that I discussed in item #3. The “bulbous tip” is usually a combination of thick skin and large, widely spaced nasal domes. The domes are often separated by fat or a thick ligament and can be moved closer together. Thick skin is a harder issue to deal with. The addition of cartilage to the tip in the form of a tip graft will often give the appearance of more tip definition in a thick skinned nose. Tips are also narrowed with and by scoring the cartilage superficially.