I picked Dr Alexander purely based on bedside manner. He was so kind and attentive. When I looked at pictures of his other rhinoplasties I didn't see huge differences but figured maybe these people didn't want a dramatic change. After my cast came off I couldn't tell much of a difference, but I knew that this type of surgery took a while for the swelling to go down. It has now been a little over a year. Does my nose look smaller? Yes. Small enough? No. He didn't take nearly as much off as I had hoped. Maybe if he used digital technology to simulate results we would have been more in the same page? Not sure. I also have a small bump now on the bridge of my nose (probably from scar tissue). It's not super noticeable, but when you spend 3 years saving up for a surgery you've wanted all your life, you don't expect to come away with a bump. I also have a small indent on the left side (not sure why). It's under the surface and not visible but every time I run my fingers over it it annoys me. Also the right nostril has a sore that won't heel and is constantly bloody (was not like that before). I would NEVER say I was botched. Like I said, it is definitely smaller... But the change was so slight it was a little disappointing... Especially for someone who is going to have to spend another few years saving for a 2nd surgery. Sounds like he is great for breast augmentations, but I don't know if I would recommend him for a rhinoplasty.