Cheek Implants (Revision), Buccal Fat Removal, ThermiRF (2nd Procedure) - Saint Louis, MO

I am scheduled for removal and replacement of cheek implants, buccal fat removal, and a second ThermiRF procedure to my lower face and neck. My current cheek implants (size large) are being replaced with Terino Malar Shell small 6mm implants in hopes of achieving a higher, more pronounced, chiseled look. I had acceptable results from the first ThermiRF procedure but need more tightening especially around my jawline, neck, and jowl area. Dr. Ridenour has been very understanding and fair in working with me. The price is discounted since this is a revision of my cheek implants and second ThermiRF procedure.

The left cheek implant was placed too low and there was gross asymmetry between my cheeks. Immediately post-op I noticed the pre-op markings were at completely different levels on each side. I asked Dr. Ridenour about this at my post-op appt, he noticed the asymmetry, and scheduled another surgery to reposition the left implant. The repositioning was done with local anesthesia under oral sedation (or so it's called) with Xanax, phenergan, and Norco. It was absolutely miserable and very painful. I had to go back the next day because the swelling and pain were so bad. I have a post-op appt tomorrow to have the left cheek bolster removed. I'm losing faith. I'm not sure how it wasn't plaved correctly the first time. I have been so worried and stressed thinking about the possibility of having to go through another "oral sedation" surgery if it isn't in the correct position again and avoid public for another week. I am still very sore to even light touch around my left cheek, eye area, temple, and still having to take pain medication. This has not been fun.

After having revision of my L cheek implant a little over one week after having my implants replaced, there is still gross asymmetry. The right implant has a huge area of projection (bordering on the line of too much) and the left is still a little lower. Dr. Ridenour said he made some manual adjustments during surgery to the right implant because of bone structure (?--but this wasn't done with my first implants). I'm wondering if this is part of the problem. Something isn't right with my implants. They don't match and its very obvious.
At my follow up I have now very obvious tear troughs, and a step-off under my eyes from the implant that he says needs filler. He also says I have some "soft tissue changes" that need fillers. None of this was present before surgery. According to what I've reaf, he should have automatically performed a subperiosteal lift so this wouldn't happen. He didn't even address this possibility or complication with me. It seems like a way to keep me coming back for more filler, to get more money out of me since implants are a one time thing (or supposed to be). He didn't even offer to do the filler at cost or substantial discount since it was caused from his surgery.
I feel like I look like a monster. I feel like he doesn't care anymore, like he is brushing me off and doesn't want to be bothered with me or fix his mistake. I look in the mirror and I cry because things were supposed to be improved this time. I went with his recommendations, trusted him, and now feel so, so incredibly alone in this. I don't know what to do. Filler IS NOT the answer. I just want my face fixed and to look symmetric. He keeps saying "oh perfection!" Perfection?? I don't think so. I've never asked for that. When I look in the mirror and it's quite obvious and other people ask me what happened and I am left with an aged face because something wasn't done properly, something is wrong.
Feeling so disappointed, letdown, alone in this, and not sure what to do. It hurts so much when you put your trust in someone and am left like this. I have spent probably $15k in the last year with his office. I would think I'd be treated a little better.