Hi, I was looking at him too. I'm having a really hard time finding a rhinoplasty surgeon in San Diego. Have you checked into Paul Chasan? I was going to go for a consult but had to cancel. Do you know if Dr Karam charges a consult fee? Dr Chasan charges $100. Ugh. I was also looking into Dr Steven Cohen- He supposedly was in the Connely book of top doctors, but I've seen some nasty reviews of him. I do recall someone saying they'd seen a bad review someone else had posted, but they didn't say where they saw that. Let me know if you find anyone in our area!