why don't you go in for another consult with him and explain that you like his methods but have a very definite vision in mind and you'd like him to work with you on that? I do know that he is very against taking out too much cartiledge because that is the cause of many needs for revision. Perhaps that is why he doesn't want to touch your columnella? I do not think it is because he doesn't know how to handle it, because raising my columnella was something he suggested for me (which, ironically, I do not feel I need so much as tweaking my nostrils and straightening my septum.
Try not to freak out too much about needing a revision. I think if you are looking to do conservative things and go to someone conservative you will hopefully be safe.
If you discover any other great Florida docs keep me posted
I'm missing NYC right about now!!!