Just wanted to chime in on this old thread for anyone who stumbles upon it. The aesthetics of the nose is not necessarily a function of the surgeon but of the surgical plan. Alar cinch and shaving of ANS are standard surgical techniques that all oral surgeons are trained with. I've consulted with a few patients from all the major practices and flaring of the nostrils is a common side effect of the surgery. With CCW rotation, the effect should be minimal but it's unavailable as there's simply going to be more support on the outside of the nostrils. Typically the advancement at the nasal base is only about 4mm in an CCW-MMA so the effect is minimal. There are undoubtedly some cases where CCW rotation can't be used or where the surgeon didn't know or want to use it. I don't know if Dr Li wasn't doing the CCW rotation at that time maybe. In those cases, surgeons often want to push the maxilla forward as much as possible and that's when you get into real trouble. In my unqualified aesthetic opinion, in general men tend to tolerate wide noses better and women upturned noses. Most of the time people have sleep apnea there's going to be deformities affecting support behind the nose anyway so you can expect an aesthetic improvement. All volume providers advance the mandible 10-13mm. Only one I met didn't propose being at the upper end of the spectrum.
