One of the comments posted after that TMZ story you posted about the crazed blonde mentioned that Larry had a nose job after high school (Doss High Scool, Lousiville, Kentucky). It IS a nice nose. Have the "before" photos been posted here before?
I have never seen the pictures but I have ababy picture of Birkhead and his nose looked the same then as it looks now
http://community.webshots.com/user/dannielynnhopebirkhead
Go the link above and click on Birkhead's album and see his baby picture there.
The only thing I can think is that he broke his nose at some point later in life and had it fixed back to the way it was suppose to look originally.