Thing is, you stand to get more facial balance 'relief' from having the ANS cut down than you would with jaw surgery alone without that. The jaw to jaw balance brought about by maxfax whether you get the single BSSO or the BIMAX with CCW stands to NOT look like good facial balance (soft tissue contour) if the ANS is not cut down.
The ANS cut down is a 'deprojection rhino' and they just can't lop it off without doing other rhino adjustments along with it which are best done by a nose guy who demonstrates they are familiar with managing protrusive ANS and doing so to also improve overall aesthetics of nose.
For those of you on here who are familiar with Gunson's TVL line for the CCW, you would know that the Gunson TVL passes through WHERE the BASE of nose MEETS the UPPER LIP. I've drawn one in GREEN on his ceph. (His S-N line/plane is actually parallel with plane of photo. So looks like he's close to the type of head rotation they want.) NOTE how the line suggests ALOT of maxilla advancement and of course mandible advancement with that for the lips to 'kiss' a bit past the line and the chin point to line up with it. Now, WITH THAT, try to VISUALIZE how his nose to lip angle would look with the maxilla brought forward so the lips are close to that line. If you can't visualize what that could look like, I can tell you it would look BAD. THAT'S WHY I called the GREEN TVL a FALSE one. It's because his protrusive ANS gives a FALSE reading of where the TVL should be placed as guideline to displace both maxilla and mandible.
The BLUE TVL is adusted to (approximately) WHERE that line should pass through the BASE of the nose where it meets the upper lip. So, the BLUE adjusted TVL is a better aesthetic guideline with reference to a Gunson type CCW posterior downgraft rotation BIMAX. However, for the TVL to pass through where the base of then nose meets the lip, the ANS would need to be cut down.
So, it's not a thing where he needs a rhino just for nose aesthetics. But rather he needs one because the ANS would need to be cut down for good JAW SURGERY aesthetics where the situation is one where cutting ANS down will require other alterations of nose best done by a rhino guy.