I've seen some before and after photos were it looked like more could have been done, especially when it comes to noses. I realize that large noses can only be made so small, but some surgeons seem to be too conservative, and the results, to me anyway, are not all that convincing. I'd clock them right away. Maybe they didn't want to look very different? I don't know.
I'd sure hate to spend all that money only to have been made slightly more feminine. I think it's important to tell your doctor what your expectation are.