Rhinoplasty (Nose Job) Surgery in NYC
As a New York City rhinoplasty specialist, Dr. Philip Miller, M.D., F.A.C.S. is a renowned facial plastic surgeon attracting local patients throughout the greater NYC area to his practice. He appeared on the Discovery Channel, NBC’s The Today Show and has been featured in Marie Claire, The Wall Street Journal, The New York Times, Elle and has been consistently voted as the Best Doctors in America and Top Doctor of New York since 2007.
If you are considering nose surgery (“rhinoplasty”) in NYC, Dr. Miller has the surgical skills to help you achieve a more aesthetically pleasing appearance of your nose. He is an established expert in facial rejuvenation procedures as well as Rhinoplasty, Dr. Miller is an Assistant Professor in the Department of Otolaryngology, New York University School of Medicine, he is a Diplomate of the American Board of Facial Plastic & Reconstructive Surgery, a Fellow of the American Academy of Facial Plastic & Reconstructive Surgery, a Fellow of the American Academy of Otolaryngology/Head & Neck Surgery, a Diplomate of the American Board of Otolaryngology, and a Fellow of the American College of Surgeons.
View Dr. Philip J. Miller’s curriculum vitae.
What is Rhinoplaty
Rhinoplasty, commonly referred to as a “nose job”, is one of the most popular cosmetic surgery procedures performed in the United States each year. Whether it is to reshape what nature provided, repair damage from an accident or injury, or alleviate structural issues that impede breathing, thousands of patients turn to rhinoplasty for relief every year.
Types Of Rhinoplasty
There are two general methods of performing Rhinoplasty surgery; closed and open. All rhinoplasty procedures follow a basic concept. Excess bone and cartilage is removed from the interior nasal structure, and, when needed, a cartilage graft may be added to improve or strengthen the shape of the nose. Once the underlying structure is modified, the outer skin is repositioned over the nose and gradually adheres to the new shape resulting in the “new and improved” nose.
There are two main nose job techniques:
- Open Rhinoplasty
Also referred to as an external rhinoplasty, the open rhinoplasty technique connects the incisions which are hidden inside the nostrils to an external skin incision across the columella – the strip of skin located between the nostrils. Open rhinoplasty allows a surgeon better access to the interior structures. This is important when major reshaping must be done. It gives the surgeon more latitude to manipulate the nasal shape. Open rhinoplasty is especially helpful in situations where extensive correction is required and in more complex revision rhinoplasty procedures.
- Closed Rhinoplasty
With closed rhinoplasty, the surgeon conducts all nasal reshaping through incisions hidden within the nostrils. While it is a less invasive procedure, it requires more surgeon skill to perform, since the entire operation is conducted with limited visibility and through only a narrow incision inside the nostril.
In addition to the two methods of surgery, there are a number of different types of rhinoplasty techniques that are performed.
The first type of rhinoplasty is called reduction surgery. This is performed on noses that are large, making them smaller in proportion to the face.
Refinement rhinoplasty often refers to tip refinement techniques designed to to specifically refine the appearance of the nasal tip. Refinement rhinoplasty may also refer to other techniques designed to achieve a smaller, more refined looking nose, including hump reduction.
Revision rhinoplasty occurs when a patient must undergo a subsequent nose job to repair undesirable results following a previous rhinoplasty procedure. Because of the potential for existing structural damage from the previous procedure (or procedures), revision rhinoplasty is one of the most difficult plastic surgery procedures to perform and should only be performed by those specifically trained, highly skilled and experienced in revision rhinoplasty procedures.
Augmentation Rhinoplasty is usually performed on ethnic groups whose noses have less supportive and softer cartilage. The type of surgery is usually done to lengthen the tip and the bridge after the patient has either suffered an accident or has undergone numerous previous operations.
Rhinoplasty has many benefits depend on the type of surgery you chose and your desired outcome. Patients undergoing a nose job surgery should have realistic expectations and can expect to have an improved physical appearance as well as improve the function of their nose to help with any nasal discomfort. The procedure can also be used to shorten or lengthen the nose, refine the tip and improve the overall shape. Other benefits patients experience from rhinoplasty includes:
- Improve Self-Esteem
Your nose is the focal point of your face. If you are self-conscious about it, your overall confidence suffers. Getting a nose job can be the easiest way to boost your self-confidence and put your best face forward.
- Sleep Well
Your body needs 6-8 hours of restful sleep each night to maintain good health. Unfortunately, structural irregularities in your nasal cavity can cause excessive snoring, sleep apnea or other breathing difficulties, making a good night’s sleep just a dream. A nose job, combined with other procedures to reshape the inner nasal passageway, can help eliminate these common sleep problems.
- Breathe Easier
For some people, the simple act of taking a deep breath through the nose is difficult or even impossible due to blockage in the nose, caused by a misshapen septum – the structure that separates the two nasal cavities. A qualified and skilled plastic surgeon can reshape the inner nose and correct these issues, allowing the patient to finally breathe normally.
Ideal candidates for rhinoplasty are healthy, have finished growing, non-smokers, and have realistic expectations about the final outcome. You may be an ideal candidate for nose job surgery if you meet one or more of the following criteria:
- You are at least 13 years of age
- You are dissatisfied with the size or shape of your nose
- Your are having breathing problems associated with structural deformities within the nose
For people who have undergone a rhinoplasty procedure, but are unsatisfied or unhappy with their results, revision rhinoplasty may be the solution to repair previously failed nose job. Revision rhinoplasty also known as secondary rhinoplasty can often provide dramatic improvement for individuals who are unhappy with the results of their prior nose surgery. When revision rhinoplasty is required, it is imperative that a patient select a facial plastic surgeon highly experienced in revision rhinoplasty. Performing a revision rhinoplasty surgery is not the same as doing a primary or first time operation. View before and after gallery of revision rhinoplasty.
The term ethnic rhinoplasty refers to cosmetic nasal surgery in people of different ethnic groups such as African-Americans, Asian, Hispanics, Middle Eastern and other non-Caucasians. Dr. Miller can help to achieve results that harmonize beautifully with the facial features of virtually any patient and performs rhinoplasty on individuals of all ethnic backgrounds.
During a nose job procedure, nasal bones and cartilage are modified or removed and tissue is sometimes added, to reshape the structure of the nose. The skin of the nose remains unaltered. However, once the underlying bone structure is revised, the skin conforms to the new shape, resulting in an impressive final result.
Every nose job starts with an initial office consultation with Dr. Miller. During this important first meeting, the patient’s concerns and expectations are fully discussed. Dr. Miller examines the patient’s nose and facial structure, and makes recommendations suitable for that patient. He will also carefully explains any potential limitations suggested by the patient’s existing nasal structure and skin condition. Pre-operative photographs may also be taken at this time.
Depending on the shape and contours of the patient’s existing nose, either an open or closed rhinoplasty will be performed to access the interior nasal structure. In both open and closed nose jobs, incisions are hidden within the nostrils. In an open rhinoplasty, a small incision is also placed in the columella, the column between the nostrils.
Once the procedure is complete, the inside incisions are closed with dissolvable stitches, any outside incisions are closed with stitches finer than a strand of hair, nasal packing may be used to control bleeding, and a cast is placed on the nose to control swelling and provide support.
Since a nose job is an outpatient procedure, patients can go home shortly after surgery. As moderate sedation or general anesthesia was administered, the patient cannot drive and must be accompanied by someone for the trip home and in the hours immediately following the procedure.
The outpatient procedure usually lasts one to two hours in our office in NYC and after the nose job is complete patients can return home. The goal for all nose job patients is to allow for rest and recovery in comfortable surroundings.
When general anesthesia is used during the procedure, patients cannot drive or travel alone and must be accompanied by someone for at least the first day following the procedure. You will wear a nose splint for the first week and will experience slight bruising and swelling around the nose and eyes. This will gradually dissipate over the course of a few days or weeks.
While recovery is different for every patient, you can usually expect the following:
- Slight headache and minor pain
- Sleep interference
Besides following doctor’s orders, there are a few additional things you can do to help maximize recovery process.
- Avoid vigorous exercise
- Avoid heavy chewing
- Don’t laugh or smile too hard
- Avoid pulling clothing over your head
- Keep your new nose out of the sun
Patients can actually get a preview of what the results of their rhinoplasty surgery might look like. Virtual Rhinoplasty utilizes the latest in computer imaging and technology to provide nose job patients with the ability to see what finished results will look like before ever stepping foot in the surgical suite. The goal of rhinoplasty is a nose that looks natural and blends with your other facial features. You can expect to wait up to one year to see the final results of your nose job surgery. Some patients begin enjoying their new look within weeks of their surgery. Dr. Miller’s patients are generally extremely happy with the results of their procedure and feel more confident. The most important step to ensure your desired results after rhinoplasty is to follow all of Dr. Miller’s post-operative instructions.
All surgeries carry some risks. Here are some possible risks to be aware of after rhinoplasty:
- Trouble Breathing
- Pain and Swelling
- Numbness Around the Nose
The average cost for rhinoplasty in NYC ranges from $10,000 to $20,000. You should never let low cost be the sole factor in selecting the surgeon to perform your nose job. Insurance does not typically cover the cost of nose job surgery. It is a good idea to contact your insurance company and find out their exact policies.
Before and After Photos
View before and after photos of NYC rhinoplasty patients. Below are some of the procedures that were performed by Dr. Miller.
30 year old would like the tip of her nose raised and the bridge narrowed and made more smooth. An external approach allowed me to perform lateral crural steals and an onlay of a soft tip graft to rotate and smooth the tip.
This 45-year-old male requested a stronger more masculine nose. This was achieved with a multilayered dorsal implant, extensive narrowing of his alar base and nostrils, and tip support, refinement and narrowing. An extended tip graft was harvested from his septum and used to project and define his tip.
This 30 year old female requested tip definition, projection and increased contour. She did not like the way the tip pointed down. A double layered tip extension graft and osteotomies were performed.
For more rhinoplasty before and after pictures, please visit the gallery.
When you are considering a nose job, everything begins with your initial consultation. During your consultation, you will personally meet with Dr. Miller in his office located at 60 E. 56th & Park, New York, NY 10022 to discuss your goals and objectives. He will examine you and evaluate all relevant conditions that are present.
He will discuss specific aspects of the rhinoplasty procedure, including the surgical techniques he will use, information on the anesthesia that will be administered, where the surgery will occur, a step-by-step explanation of post-operative care, and an overview of what to expect during the recovery phase. To setup your rhinoplasty consultation in NYC, please call (646) 791-3112 or fill out the contact form to receive more information.