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Wide or Bulbous Tip The most common reason why the tip of the nose looks wide is because the cartilages called the lower lateral cartilages have a shape under the skin that is excessively wide. This situation can be greatly improved by narrowing the orientation of the cartilages, sometimes removing part of the cartilage. We must pay particular attention to the thickness of the tip skin. If the skin is normal or thin, then the underlying changes to the cartilage will be nicely revealed to the overall shape of the nose. If the skin is very thick, it becomes more difficult for the final result to show the underlying changes. Sometimes other or extra techniques are necessary to force thicker skin into appearing narrower to the tip area. Overall techniques for changing the shape of the tip involve sutures and grafts. Sutures grasp two or more sites of purchase and pull them together to a degree that depends on tension placed on the suture. Grafts are the patient's own tissues most often taken from the septum, but sometimes taken from other areas such as the ear. They are sculpting material carved into certain shapes and sizes and sometimes weakened to become softer and more pliant.