This term refers to surgery of the nasal tip. This region is comprised of the lower nasal cartilages, skin and the septal support. The precise surgery performed will vary with the goals and the specific patient anatomy. 

Surgery of the nasal tip can be performed under local anesthetic and intravenous sedation.  However, the tip has a profound effect on the appearance of the nose and the final result of a rhinoplasty.  My personal preference is to perform tip surgery under a general anesthetic in most cases to ensure placement of tissues in the precise position for optimal results.

Frequently surgery of the nasal tip is performed as part of a full reshaping of the nose: a septorhinoplasty. This may also include breaking of the bones around the nose to complete the reshaping process. It is best to contact an experienced rhinoplasty surgeon to determine if surgery on the nasal tip is all that is required or if another procedure may be of benefit.