Poor outcome - my main concerns were unaddressed

I wish I could make this a positive review. My journey with Dr. Karter has been marked with unexpected outcome. Initially I had high hopes, I expressed my concerns and aesthetic goals through meeting with Dr. Karter (consult/pre-op), along with submitting a detailed email with attached pictures. I entered this surgery on March 2024 with realistic expectations, understanding that 100% perfection wasn’t attainable but hoping for significant improvement, the 70-80% that Dr. Karter stated he would aim for. Post-surgery I was disappointed to find my main concerns (aesthetics) unaddressed. The dent on top of my RT nostril, a RT retracted nostril, asymmetrical nostrils-one pointing up and the other pointing sideways, and old scars that I had expressed the need to have them revised during surgery. Dr Karter informed me that the old scars were not visible during surgery, therefore he didn’t revise them. When I looked at the table pictures, the old scars were visible. Perhaps he didn’t realize that the scars were less visible to him due to the amount of swelling. Unfortunately, once the swelling subsides, things become noticeable. Prior to surgery I was not informed that there would be a possibility that not all my concerns would be addressed during surgery and further in office procedures would be needed to fully resolve the issues. Had I been made aware of this possibility I would not have made the decision of having this surgery. On days with minimal swelling and stiffness, my concerns become more noticeable. During my follow up appointment, I expressed my dissatisfaction, only to be told by Dr. Karter that my nose was in very bad shape and there was nothing more he could have done to correct it. He stated he shaved down my bridge, removes old scar tissue, placed graft on my tip for support and corrected incision on the side of my nostrils. But left my main concerns unaddressed. My nose does not reflect the investment I made; my nose looks like I am in need of a revision. After hearing Dr. Karter say that there was nothing else, he could have done to fix the retraction and dent, I asked him of the possibility of cutting the inside of my nose along the right alar and pull the alar skin down to prevent it from fully retracting. Previously he stated he did every he could have, but when I asked him about the alar he stated he could take a small piece of cartilage from my ear and place it along my alar rim and dent on top of my nostril to correct them to the best of his ability. Left me wondering why didn’t he take this measure during surgery. I am aware that I am only a few weeks post op, but having gone through this same procedure before, I know how my nose will heal. There isn’t significant amount of swelling left-not enough to make a huge difference on the aesthetics of my nose. My concerns will continue to be there. I stated to Dr. Karter that I continued to be self-conscious about the appearance of my nose and it has kept me from being socially active. Dr. Karter responded “You have to go on with your life.” After being told by Dr. Karter that I have been unrealistic in regards to this surgery and the need to go on with my life, I realized that I could no longer continue under his care. I didn’t find the need to further discuss the trouble that I have been experiencing after the surgery. My breathing is not good, I have a developed a bump on the bridge of my nose, shooting pain on the RT side, pressure to the tip of my nose radiating to my front teeth, talking causes a lot of discomfort/pulling on the tip, occasional headaches, unable to wear my glasses, very sensitive to touch, and pain when it’s cold outside. I have invested in this procedure only to not have my main concerns (aesthetics) addressed. I would have been happy if attempts were made with slight improvement, slight improvement is better than no improvement. Dr. Karter felt my nose looked good enough to go out in public"people don't look at the nose." Lip lift also needs revision. Looks worse in person