27F, if you want to maintain any form of respect from others, then re-read your post and remind yourself that is one way not to do it.
I'm simply referring to his nasal breathing issues. First, they might not be related to the extractions at all. Many people have nasal congestion, just like many have had extractions. Second, advancement alone does not guarantee there will be any form of improvement to this (may I remind you this was listed as his only functional issue). Seeing a picture and saying he "has to have surgery" is dramatic.
If you take this kind of black and white aggressive approach in a consultation with a surgeon, then good luck to you. Nobody wants to work with a know-it-all patient.