Many of my Houston rhinoplasty patients are concerned about their bulbous tip and would like a more refined nasal tip. Bulbous tip causes are most frequently due to misshaped cartilages that form and support the tip of the nose. The cartilages can be too wide, have too much “spring” to them, too much convexity, or simply be too widely spread apart. Another cause of a bulbous nasal tip could be the thickness of the overlying skin. This is especially true with my Houston ethnic rhinoplasty patients. Reshaping the cartilages and debulking of the skin are two methods to create a more refined nasal tip. Lastly, small cartilage grafts from a corrected deviated septum can also be used to refine the tip.