Dr Z usually advocates fat transfer for the cheeks, and I have seen it done on a person and myself and I know they are not "overdone". He is very easy to talk to, and if you do not want alot put in, he wont. I do not know where you are getting this "piggish look" for the nose, as it is just not the case. Not many have the endoscopic experience of Dr Z even in the world, let alone the USA. He is a very good surgeon with FFS and aggressive. I have had him also do my BA and imo, he is the best at doing MTF BA in the US, because he takes into account the rib cage and frame of a MTF is different than in a genetic females and most of the surgeon's in the USA do not know how to do them appropriately. which will make you end up with a huge gap between your breasts. Dr Z was the only surgeon that got it right and with mine you can barely put one finger between them, even without a bra on..I went with the Mentor Brand medium profile smooth round 600cc implants, but i am 5'6".. If you are taller and broader than that is perhaps the reason for larger ones, unless you are just wanting them larger. Dr Toby Mayer did revision on my nose, as I initially had Dr. Ousterhaut in San Francisco do it and it was not what I wanted. Dr. Toby Mayer of Beverly Hills, CA in my opinion is the very best at rhinoplasty and in doing anything with the eyes. The very main thing to think about before doing anything is if your wife is really conducive to you doing this, or is she just appeasing you, because she knows you want this.? If she is doing it only because she loves you and wants you to be happy, please consider her. I know you may think you are, but as all pre ops know..after you transition, there is no going back, and your wife's feelings for you may very well change, even if she says she is ok with it. After, she might likely switch completely. I am not saying you have not thought this out, but transition is a very selfish thing and many overlook the potential ramifications that could happen after. Take heed in what I am saying, because unless your wife is bi, she will most likely not want intimacy later or even consider separation or divorce later after you have transitioned. You have to ask yourself "Is this all worth it"?? Is the potential for loosing everything you had with her worth it? I do not, nor would I ever judge anyone's relationship, as I do not know, but speaking from experience, even if your wife seems agreeable now, later she can and may very well change her feelings, especially if she is hetro. Think about what you had as man and wife and about her true feelings inside and not just the me part..Other than that, Dr. Z is about the best FFS surgeon in the US. The only other FFS surgeon is Dr. Di Maggio in Buenos Aries. My face is a product mostly of Dr. Z and Dr Mayer for the rhinoplasty. If you would like to see profile and other pics of my face, just pm me.