The nose is a prominent feature and its shape, symmetry, and appearance significantly affect our facial profile, facial aesthetics, and self-confidence. Nasal enhancement, or rhinoplasty, is a popular choice in New York among men and women from every ethnicity and background for its ability to improve facial balance and symmetry.
Leading New York rhinoplasty surgeon, Dr. Philip J. Miller, M.D., F.A.C.S., performs surgical and non-surgical nose job procedures for men and women who are dissatisfied with the appearance of their nose or are experiencing related health issues, such as problems breathing.
What is Rhinoplasty?
Rhinoplasty, often known as a “nose job,” is a popular plastic surgery that improves the appearance and/or function of the nose. Dr. Miller performs cosmetic rhinoplasty to reshape, reduce, or augment the nose by removing a hump, narrowing wide nostrils, or changing the angle of a crooked nose. Functional rhinoplasty addresses medical conditions, injuries, and birth defects to improve breathing and reduce snoring.
There are two main rhinoplasty techniques: open rhinoplasty and closed rhinoplasty. Both approaches allow the surgeon to access the interior of the nose and make any necessary modifications, but the placement of the incisions is different based on the technique. Dr. Miller chooses an open or closed method depending on the amount of work required and on the size and structure of the patient’s nasal passages.
All rhinoplasty surgical procedures follow the same basic steps and often include the removal of excess bone and cartilage from the interior nasal structures. Many procedures also include the addition of a cartilage graft to strengthen or improve the shape of the nose.
During surgery, Dr. Miller modifies the underlying nasal structures and repositions the skin over the nose, which gradually adheres to the new form. Previous plastic surgery results from Dr. Miller’s patients are available in the photo gallery.
Types of Rhinoplasty
Dr. Miller performs several different types of custom rhinoplasty surgery at his New York office, depending on the individual patient’s needs. In addition to the standard cosmetic nose job, Dr. Miller offers the following nose surgery options:
Septoplasty
A deviated septum can cause issues like sinusitis, snoring, sleep apnea, breathing problems, and respiratory complaints. Septoplasty is a nasal surgery that straightens a twisted or deviated nasal septum, the structure that divides the left and right nasal passages.
Nasal Fracture
A broken nose or nasal fractures resulting from facial injuries can significantly alter the appearance of the nose and create difficulty breathing. Dr. Miller specializes in the repair of broken noses and may perform one or more procedures to repair the fracture.
There is a 7-14 day window when a fractured nasal bone can be put back into its original position without breaking the bone again or using advanced techniques. After 14 days, the displaced nasal bones have begun to heal into a new position. An in-depth procedure is then required to align the bones, which involves making incisions inside the nose. The bones must be rebroken and set in the desired position.
Ethnic Rhinoplasty
Dr. Miller specializes in ethnic rhinoplasty, which takes specific nasal characteristics and facial features from ethnic groups into consideration. For instance, Middle Eastern rhinoplasty patients often have extensive nasal profiles with round, hanging nasal tips. East Asian rhinoplasty patients typically present a flat nasal profile, full nasal tip, flared nostrils, and a slight nasal bridge.
The doctor’s nose job techniques allow him to maintain a balance between the eyes, nose, chin, and lips that reflects the beauty and heritage of each ethnic group. Of course, the doctor can also adjust the treatment for a patient who prefers a less ethnic appearance. The procedure is customized to meet the patient’s specific wishes.
Revision Rhinoplasty
Dr. Miller is skilled in revision rhinoplasty, which is a secondary surgery used to correct structural issues and provide cosmetic improvements after an unsatisfactory rhinoplasty. This is an extremely challenging procedure that requires extensive experience and skill.
Liquid Rhinoplasty
Dr. Miller can change the shape and position of the nasal tip, straighten the nose, and hide bumps using injectable fillers. Liquid rhinoplasty is a convenient, pain-free alternative to surgery that utilizes moldable, hyaluronic acid fillers, such as Restylane® and Juvederm®.
The doctor is an injectables expert who provides outstanding, natural-looking nasal and facial improvements. Injectables offer temporary changes and do not prevent future surgical nose job procedures.
Benefits of Rhinoplasty
There are many benefits
associated with rhinoplasty at our New York City practice, including increased
self-confidence. Men and women choose rhinoplasty surgery with Dr. Miller to
accomplish one or more of the following:
- Improve sleep
- Shorten an overly large nose
- Taper wide nostrils
- Lengthen a short nose
- Remove blockages to improve breathing
- Improve facial harmony
- Restore facial balance
- Straighten a nasal hump
- Achieve natural-looking results
- Fix poor results from a previous rhinoplasty
- Reduce snoring
- Repair a previously broken nose
Candidates
Dr. Miller determines the candidacy of each prospective patient during a private rhinoplasty consultation in New York City. The ideal rhinoplasty patient is a healthy, non-smoker who feels that their nose is too large, flat, pointed, crooked, small, or causing breathing problems. All patients must have realistic expectations.
Most rhinoplasty patients are adults. Younger candidates are typically over the age of 14 and have completed facial growth. Patients under the age of 18 must also have parental consent.
Your Rhinoplasty Consultation in New York City
Dr. Miller provides private consultations for prospective patients to assess their candidacy and discuss their overall nasal enhancement goals. He first examines the nasal passages and structure of the nose and reviews the patient’s medical history to determine if nose surgery is the best option.
Dr. Miller then discusses the procedure and explains what it can and cannot accomplish. The doctor takes preoperative photographs and creates a customized surgical plan based on the patient’s anatomy and personal goals. This open patient-doctor discussion ultimately leads to high levels of postoperative satisfaction.
The Nose Job Procedure
Dr. Miller performs rhinoplasty surgery as an outpatient procedure at an accredited surgical facility. The operation typically takes 1 to 2.5 hours and is performed using general anesthesia or local anesthesia with IV sedation, depending on the extent of the surgery.
The doctor creates incisions inside of the nose during a “closed” rhinoplasty. But in some cases, he may also create a small incision externally in the columella between the nostrils in what is known as an “open” rhinoplasty.
Dr. Miller artfully manipulates and sculpts the nasal bones and cartilage to achieve the patient’s desired shape. He may further augment the bony area on the bridge of the nose or the tip using cartilage from the ear or nasal septum. If any significant deviation in the septum is present, Dr. Miller will perform septoplasty.
The skin naturally adapts to the new shape of the nose during the healing process. Dr. Miller closes the incisions with dissolvable sutures that are finer than a strand of hair. A splint is placed on the nose to provide support and control swelling, and nasal packing may be used in some cases to control bleeding.
Recovery
Patients return home shortly after the surgery. Because moderate sedation or general anesthesia is administered, the patient will need someone to escort them home and remain with them during the immediate hours after the procedure. When nasal packing is used to control bleeding, it is removed the next morning. The sutures dissolve naturally and Dr. Miller removes the cast in approximately one week.
Nasal breathing may be uncomfortable during the first few days, due to swelling. Most patients experience very little pain during the recovery, but pain medication is provided just in case. Swelling, bruising, and stiffness are common and fade gradually.
Patients typically return to work and regular activities within one week but must refrain from vigorous exercise for 3 to 4 weeks after the procedure to allow for complete recovery. Patients who wear glasses should avoid resting them on the bridge of their nose during the recovery. Dr. Miller provides each patient with detailed aftercare instructions that should be followed closely.
Why Choose Dr. Miller?
Philip J. Miller, M.D., F.A.C.S. is a highly-respected facial plastic surgeon who takes pride in providing beautiful, natural-looking results. He has a keen eye for aesthetic detail and offers outstanding results for men and women of all ages, facial types, and ethnicities. Dr. Miller has many years of experience and his qualifications include:
- Board-certified in both Facial Plastic & Reconstructive Surgery and Otolaryngology/Head & Neck Surgery
- Associate Professor, New York University School of Medicine, NY, NY
- Director, Facial Plastic Surgery Fellowship Program at New York University School of Medicine.
- Specializes in minimally invasive and surgical procedures
- Selected as one of the Best Doctors in America and Top Doctor of New York on a consistent basis for over 10 years
- 2019 winner of the Castle Connolly Top Doctors Award
- Fellowship trained in all aspects of cosmetic surgery, including rhinoplasty, facelift, and eyelid surgery techniques
- Uses accredited surgical facilities that uphold the highest safety standards
- Trains other surgeons and lectures worldwide extensively
- Holds memberships in many prestigious facial plastic surgery organizations
- Adds beauty and brings harmony to other facial features during rhinoplasty
Frequently Asked Questions About Rhinoplasty
Most rhinoplasties are problem-free. Some potential risks include bleeding, infection, adverse reactions to anesthesia, bruising, swelling, hematoma, and poor aesthetic results. Rhinoplasty is a complex surgery that should only be performed by a highly experienced plastic surgeon like Dr. Miller to minimize risks.
You will receive a complete list of pre-surgical instructions during your consultation with Dr. Miller. Avoid medications, supplements, and vitamins that may thin your blood and increase the risk of bleeding or bruising, including aspirin, ibuprofen, Aleve, and NSAIDs. Stop smoking at least several weeks before the surgery to ensure that you heal properly and achieve the best results.
For the first week or two after surgery, you will need to refrain from lifting, bending, and participating in strenuous activities. Rest is a priority, so stock the freezer and fridge with meals that don’t require cooking, and complete household cleaning and other tasks before your surgery. If possible, have a friend or family member stay at your home during the first few days of your recovery.
Our anesthesiologist will discuss the anesthesia options during your consultation. General anesthesia is typically used because rhinoplasty is a complex and invasive procedure.
The tip of the nose is a very delicate area of the body that is made up of cartilage and prone to swelling. Because of this, final rhinoplasty results may take six to 12 months to fully emerge. However, surgery benefits will begin to appear within two months, and the nasal function and cosmetic improvements will continue to advance until the swelling completely fades.
Rhinoplasty improvements typically take up to a year to fully emerge. However, profile improvements are the first to appear. The appearance of a small bump may remain until the nasal swelling subsides, which could take several months.
It is safe to perform rhinoplasty along with other plastic surgery procedures. Dr. Miller may combine a chin implant with rhinoplasty to allow for the proportionate profile projection of the nose and chin. Eyelid surgery may also be performed along with rhinoplasty to enhance the eyes or to reduce signs of aging.
How much does rhinoplasty cost?
Rhinoplasty costs vary because it is a customized procedure based on the patient’s unique needs. Dr. Miller’s office staff will discuss the price with you before scheduling the surgery. There are affordable financing options available.
When a cartilage graft is removed from the ear during rhinoplasty, are the changes to the ear noticeable?
The harvested cartilage for use during a rhinoplasty procedure does not affect the structure or shape of the ear. The ear will not distort or collapse due to the removal of cartilage.
Are age-related improvements possible with rhinoplasty?
Age may cause the tip of the nose to fall towards the upper lip as it elongates. The rhinoplasty procedure will raise and shorten the nose, narrow, and rotate the tip for a more youthful appearance. Dr. Miller will discuss age-related improvements during your rhinoplasty consultation. Rhinoplasty surgery may be combined with another cosmetic procedure to reduce signs of aging further.
When can I return to work and resume my normal activities?
A splint will protect the delicate nasal structures and help your nose heal after rhinoplasty surgery. Dr. Miller removes the cast in approximately one week. Patients can typically resume their regular schedule of low-key activities at this time. Strenuous activity must be avoided for 6 to 8 weeks to ensure proper healing.
Will my health insurance cover rhinoplasty?
Medical insurance typically considers rhinoplasty surgery to be optional or cosmetic. However, your health insurance may cover rhinoplasty surgery if it is deemed necessary due to a birth defect, injury, deviated septum, or a medical condition causing problems with breathing. The office staff will provide you with medical paperwork you can go over with your insurance provider before functional rhinoplasty.
Schedule Your Rhinoplasty in New York City Today
To learn more about your options for rhinoplasty in New York, NY, call 646.791.3025 or visit drphilipmiller.com to schedule your consultation with leading rhinoplasty surgeon Dr. Philip J. Miller, M.D., F.A.C.S.