I've been refused treatment because I questioned whether it was sensible to also do a revision rhinoplasty at the same time as bimax.
How dare I question a surgeons abilities, my mistake 
No offence but the doctor might expect you to know the relationship surgery to the maxilla has to a nose that has been prior altered directly THROUGH the maxilla, especially so if there was anything in your questioning him that came off as your assuming you were knowledgeable enough to 'question' this.
From his perspective, he knows that the prior 'septo rhino' you got (that you think is more 'sensible' to revise at a later time) was a direct surgery to and through the roof of the maxilla because the act of lowering the 'floor' of the nose (to alter the septum) is basically the SAME thing as lowering the roof of the maxilla. Look at a ceph diagram where there is an outline of the part of the maxilla that's displaced during bi max. ANS-PNS is anterior to posterior nasal spine as in 'floor' of the nose. The curve below it is the roof of the maxilla at the palate. So the act of lowering the floor of the nose through prior cutting through the maxilla to do it is basically the same thing as lowering the roof of the maxilla.
So, your question probably came off as you thinking it was more sensible to cut through the maxilla a 3rd time in a different operation to revise your prior septo rhino than revising it during the same surgery where they would be making a cut to the maxilla to do the bi max.
Seriously. If someone got the 'floor' of their nose lowered via direct access through the maxilla and then later wants bi max where the maxilla needs to be cut through again and a rev rhino is contingent on having similar acess to the maxilla as was the case with the septo rhino wanting to be revised, what kind of patient would think it was more 'sensible' to go through the maxilla again, a 3rd time to revise at a later time after bi-max.
He probably doesn't want a patient who thinks that's more sensible. It isn't.
