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Anatomy of the Nose

Your nose sits front and center of your face and is responsible for a number of daily functions that you usually take for granted. From smelling the flowers, to filling your lungs, your nose plays a vital role in your day-to-day existence.
Unfortunately, unless there is a nasal blockage that prevents easy breathing, you probably ignore your nose for the most part. Your nose may hold your sunglasses upright or warn you of spoiled food, but is otherwise neglected or unnoticed. Unless, of course, your nose has the misfortune of sporting an unattractive hump, bump or other characteristic that draws your ire. In those cases, your nose may be prompting you to consider a nose job.
To better understand how and why rhinoplasty by Dr. Miller in NYC works, you should have a basic understanding of how your nose is built.

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The Anatomy Of The Nose

Your nose is comprised of two obvious areas – the outside and inside. Nuances within each of these areas can cause your nose to possess undesirable characteristics such as humps, bumps, hooks or nasal blockages.

Outside Of The Nose

The outside is made up of a hard bony “roof” that consists of your nasal and cheek bones; both hard and soft cartilage that forms your bridge and shapes your middle and lower nose; and very soft cartilage that forms your nostrils and nose tip.
The entire exterior structure is covered in skin, which adheres closely to the bone and cartilage and forms the shape of your nose.

Nasal Bones

Though the upper third of the nose is made of bone, only the very peak of the bone consists of the separate paired nasal bones. Those bones sit on top of an extension of the upper jaw bone, called the Maxilla, that extend forward away from the face.

Upper Lateral Cartilages

The upper lateral cartilages are wing shaped cartilages extending horizontally across the middle third of the nose and then vertically. They are attached to the bone structure described above.

Lower Lateral Cartilages

The lower lateral cartilages are paired rams horn shaped cartilages that are floating in a skin and soft tissue envelope. The lower lateral cartilages constitute the lower third of the nose, namely the tip of the nose. It is these cartilages that are altered, narrowed, re-positioned, shortened or elongated to modify the nasal tip.

Inside Of The Nose

The main internal structure of your nose is your septum, the structure that separates your two nostrils. The septum is made up of bone and cartilage that is covered by a mucous membrane. While you can’t see your septum, you can feel it by running your finger down your bridge to the middle third of your nose, or by placing your thumb and forefinger inside your nostrils and feel for the bridge of skin that separates your finger tips.
Also inside your nose you will find turbinates – small bony, mucosa-lined outgrowths on the sides of each nostril. Turbinates are the filtering device that the nose uses to clean inhaled air before it reaches the lungs.

How Does My Nose Structure Affect A Rhinoplasty Procedure by Dr. Miller?

When you are considering a nose job, there is undoubtedly some aspect of your existing nose that you don’t like. Perhaps it is aesthetic or maybe it is a structural problem that keeps you from breathing easily.
Regardless of why you seek out rhinoplasty, your nose’s unique structure and characteristics will impact all aspects of your nose job procedure. During your consultation with Dr. Miller in his New York City office, he will thoroughly examine your nose and surrounding bone structure and identify your goals and objectives. He will advise you as to the proper technique and strategies he will use to give you the nose of your dreams. To learn more about the anatomy of your nose, visit rochester.edu or contact our office.
Next, learn about balloon sinuplasty.

Broken Nose Surgery

Nasal fractures, or broken noses, result from facial injuries in contact sports or falls. When a physical fight or car accident results in a broken nose, there is more than just appearance to consider. While many NYC patients may often have to contend with a significant alteration to his or her appearance, they may also experience difficulty breathing. Dr. Philip J. Miller specializes in the cosmetic and structural repair of broken noses in NYC damaged through accident or trauma.

You can call Dr. Miller to set up your broken nose or nasal fracture consultation and surgery. Dr. Miller accepts most POS and PPO insurances for any medical issues related to the nose as an out-of-network provider. Please contact us today to find out.

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How Can A Broken Nose Be Treated?

While some broken noses can be resolved with a basic alignment procedure, in most cases surgery is needed to restore full functionality and appearance to the nose. Depending on the severity of the break, Dr. Miller may choose one or more procedures.

New York Nasal Reconstruction Procedure
Before and after of a broken nose surgery to fix the shape and bone structure of the nose. *Patient results may vary

Closed Reduction of Nasal Fracture

There is a 7 to 14-day window after nasal trauma when the fractured bone can be put back into its original position. This can be done without breaking the bones again, or requiring any advanced techniques. It simply requires the patient to be adequately anesthetize a long the nose such that manipulation does not cause any discomfort or pain.

Open Reduction of Nasal Fracture

After the 14-day window, the displaced nasal bones have already begun to heal and have formed firm attachments to their new position. As such, a more involved procedure is required to realign the bones. An open reduction means that incisions inside the nose have to be made in the bones read broken. An open reduction can be avoided if the patient is seen and treated within the first 7 to 14 days after nasal trauma.

Rhinoplasty

Also commonly called a “nose job,” a rhinoplasty procedure is performed by a skilled facial plastic surgeon that uses a variety of techniques to restore the appearance of the nose. Nasal bones and cartilage are modified or removed and tissue is sometimes added for reshaping 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. While performing a concomitant rhinoplasty with a close reduction of the nasal fracture is typically uncommon, many patients with a long-standing nasal fracture who have elected to undergo an open reduction, as discussed above, will elect to simultaneously get refinement of the nasal contour.

Septoplasty

Septoplasty allows the surgeon to realign the wall between the two nostrils – the septum – to achieve balance and symmetry within the two nasal cavities. In many nose break cases, the septum can become very misshapen. In turn, this causes breathing difficulties, as either one or both of the nasal cavities becomes blocked.

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Whether one or both procedures will be required, depends on the severity of the break. Dr. Miller regularly performs close reduction, open reduction, rhinoplasty, and septoplasty procedures in his NYC office for patients who have suffered broken noses as a result of accidents or trauma.

broken nose treatment nyc
Broken nose surgery to fix the shape and bone structure of the nose. *Patient results may vary

How Is Broken Nose Surgery Performed by Dr. Miller?

Every broken nose patient is unique and so is the approach Dr. Miller takes in treating his broken nose surgery patients in NYC. Whether the patient requires a close reduction, open reduction, rhinoplasty, septoplasty, or any combination thereof, the patient can expect the following:

Initial Consultation

Every broken nose evaluation starts with an initial office consultation with Dr. Miller. Dr. Miller examines the patient’s nose and facial structure, assesses the structural damage and makes recommendations to restore the nose. X-rays will be reviewed or ordered as seen necessary. Dr. Miller also carefully explains any potential limitations suggested by the patient’s existing nasal structure and skin condition. Pre-operative photographs will also be taken at this time.

Day of Surgery

The patient arrives at Dr. Miller’s accredited, office-based surgical suite in NYC, and is prepped for the outpatient procedure. The patient is sedated with either a general anesthesia or intravenous medication to ensure comfort throughout the procedure, and the procedure begins.


Depending on the shape and contours of the patient’s damaged nose, Dr. Miller will perform one or a combination of the listed above to access the interior nasal structure.


Once he has completed his work, the incisions are closed with stitches, nasal packing may be used to control bleeding, and a light cast is placed over the nose to control swelling and provide support. Any nasal packing is removed before the patient is sent home. The cast is removed after one week.

A male surgeon seated on a hospital operating table, wearing dark scrubs. Two round surgical lights glow behind him in a dimly lit operating room.

Post-Operative Care

Since nose break surgery is an outpatient procedure, patients can go home shortly after surgery. If 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.
Pain medication will be prescribed and the patient should expect some swelling, stuffiness and bruising in the first few days after surgery. This will clear up in a few weeks.
Patients can usually return to work and daily activities within one week, but should avoid rigorous physical activity for 3-6 weeks following the nose job surgery. Throughout the recovery period, patients who wear glasses should avoid resting them on the bridge of the nose.

What Are The Benefits Of Nose Job Surgery by Dr. Miller?

A patient who suffers a traumatic nose break can experience many benefits from close reduction, open reduction, rhinoplasty and/or septoplasty, including:

Restored Appearance

Broken nose surgery can restore the nose to it’s pre-accident or original condition. In many cases, a rhinoplasty procedure can result even make improvements, resulting in a new nose that is more symmetrical and streamlined than the nose prior to the break. Patients often comment that they love their “new nose” even more than the old one.

Easier Breathing

When the inner nasal structure is broken, irregular or difficult breathing can result. During broken nose surgery, the inner nose can be reshaped to correct these issues, allowing the patient to finally breathe normally.

Better Health

Obstructed breathing can lead to a host of health issues. By restoring the nasal airflow, nose job surgery can help a patient avoid common health issues related to poor nasal airflow.

Improved Self-Esteem

Nothing can make a patient more self-conscious than the disfigured nose after a nose break. With the right surgical procedures, the patient can once again enjoy a natural looking nose and the boosted self-confidence that comes along with it.

How Can I Learn More About Broken Nose Surgery by Dr. Miller?

If you have suffered a broken nose as the result of traumatic accident or injury and are now suffering from breathing difficulties or an undesirably altered appearance, you may be an excellent candidate for broken nose surgery.
The best way to determine if broken nose surgery is right for you is to set up a consultation with Dr. Miller in his NYC office. Please call us our practice in New York City or complete the convenient contact form to request more information. One of our helpful Patient Advisers will get back to you as soon as possible to schedule your consultation. You can also visit harvard.edu to learn more about a broken nose.
Next, learn about ethnic rhinoplasty.

Nose Reduction Surgery in New York

Nose reduction, also called reduction rhinoplasty, is one of the most common rhinoplasty surgeries performed by New York top facial plastic surgeon, Dr. Miller.

One of the most common complaints made by nose job candidates in New York City is that they want a smaller nose. Big noses are definitely a top ranking culprit when it comes to complaints among prospective rhinoplasty patients. After all, a large nose can throw off the proportions of the entire face, drawing attention right to it, and causing you endless frustration. Whether they are unhappy with the width, profile or nostril size, many people struggle with a nose that is disproportionately large for their face.

In reduction rhinoplasty, nasal cartilage and bone is removed, trimmed or rearranged to achieve a smaller shape. This is accomplished through small incisions inside the nostrils which allow access to the underlying bone and cartilage. Although the underlying structure is reduced, the exterior skin is left intact. During the healing process, the skin shrinks down to adopt the new shape.

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Depending on how much of a reduction is desired, the nostrils may need to be reduced to keep everything in proportion. If that is the case, tiny incisions will be made on each nostril. These incisions will leave only very fine scars and are hidden within the crease between the nostril and the face. Our guide on rhinoplasty has additional info on the surgical procedures.

Reduction Rhinoplasty Details

Typical rhinoplasty surgeries are performed in a similar fashion, beginning with incisions for the closed rhinoplasty or open rhinoplasty approach. During a closed, or endonasal, rhinoplasty, your facial plastic surgeon will make careful incisions inside the nostrils, leaving behind no visible stitches or scars.

From here, he can lift the underlying cartilage and bone to re-contour or reconstruct the nose. During an open, or external, rhinoplasty, a very small incision will be placed between the nostrils on the underside of the nose. Through this approach, the surgeon can access the top of the nose as well as the structures of the lower and middle third of the nose.

There is no set way that a facial plastic surgeon will approach a reduction rhinoplasty, although the end result of a smaller nose is always the same. Regardless of the incision placement, your surgeon will need access to the cartilage and bone that will be rearranged or removed to make your nasal structure smaller.

How your surgeon accesses the bone and cartilage will largely depend on where he must do the bulk of his work. Discuss the surgical approach for your own reduction rhinoplasty directly with your facial plastic surgeon. In some cases, adjustments may be made to your nostrils to keep them in proportion to the rest of your nose, but you will also know about this beforehand.

Am I A Candidate For A Nose Reduction?

If you struggle with self-consciousness due to a large nose, you may be a good candidate for reduction rhinoplasty. The first step to determine whether a nose reduction procedure is right for you is to schedule a consultation with Dr. Miller in New York City.

At this consultation, Dr. Miller will examine your existing nasal structure and skin conditions to determine what is surgically possible. Some limitations on the amount of reduction that can be achieved include age, skin condition or thickness, and pre-existing injuries.

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What are the Benefits of a Reduction Rhinoplasty by Dr. Miller?

For NYC patients who pursue a nose reduction surgery with Dr. Miller, the benefits can be many.

Better Facial Symmetry

An oversized nose can throw the entire facial appearance out of balance. By reducing its size, the nose can be brought into proportion with the eyes, mouth and cheeks to produce a harmonious overall appearance.

More Flattering Nose Shape

A nose that is too wide or that has noticeable ridges and bumps can be aesthetically displeasing to the eye. A nose reduction can address these issues by reducing the incongruities and streamlining the nose to make it flow with other facial features.

Improved Quality Of Life

A patient who is self-conscious about a large nose tends to lose confidence in all areas of life. By reducing the nose size and bringing it into proportion with the balance of the face, the patient gains renewed self-confidence and enjoys a higher quality of life.

before after nose reduction nyc

*Patient results may vary

When Can I Expect Results?

Full results usually take 6-12 weeks to be seen while  your healing will continue for the entire first year. As with any rhinoplasty procedure, results are different for each patient. You can expect bruising and swelling, especially around the eyes.

It usually takes up to three weeks for these symptoms to disappear. You will also need to wear a firm splint over your nose for at least one week. Even though there is usually not much post-operative pain associated with reduction rhinoplasty, pain medication will be prescribed and can be taken as needed.

You can usually return to work and daily activities within one week, but should refrain from rigorous physical activity for 3-6 weeks following the procedure. Throughout the recovery period, if you wear glasses you should avoid resting them on the bridge of your nose. You may experience a numbness or stiffness around the tip of the nose for several months.

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Planning for a Reduction Rhinoplasty

When you’re hoping to reduce the size of your nose, your first step is to meet with a board-certified and experienced facial plastic surgeon to discuss your specific case. During this rhinoplasty consultation, you’ll have the opportunity to talk about what makes you unhappy with your nose and what changes you’re hoping to make.

If it’s just a smaller nose you’d like, a reduction rhinoplasty will do the trick. If you also want to change the shape of your nose, the tip of your nose, or something else, your facial plastic surgeon will device a combination of techniques to complete your surgery and deliver the results you desire.

During this meeting, you should also be ready for your facial plastic surgeon to perform a thorough examination of your nose and other facial features. He may take measures to calculate how out of proportion your nose is and how drastic a change can be safely made without resulting in an unnatural look. You certainly don’t want to wind up with a nose that is too small for your face, so be sure to listen to the advice your facial plastic surgeon has to give.

Although you have had your nose for your whole life, your surgeon has looked at many different kinds of noses for years, maybe decades. Trust the he has a good understanding of what size nose will look best among your other facial measurements.

After Your Reduction Rhinoplasty

Reduction rhinoplasty does not require any specific limitations or extra time for recovery. Your nose and surrounding tissue will heal on the same timetable as any other nasal surgery and your results will gradually become apparent as the swelling goes down. Your facial plastic surgeon will not do anything to reduce the skin on your nose, as it will shrink up to fit your new, smaller nose all on its own. You should expect this to happen during your recovery time without you even noticing it.

What is the cost of a nose reduction surgery?

There are a lot of factors to consider when assessing the cost of a nose reduction surgery. We do have a rhinoplasty cost-analysis guide, however.

Other Options

Yes, there are numerous nose surgery options available – visit this page to see them all.

How Do I Learn More About NYC Nose Reduction by Dr. Miller?

It is easy to find out more about a nose reduction procedure with Dr. Miller in New York City. Simply fill out our convenient contact form or call us and one of our friendly patient advisers will help you get started on the journey to the new and improved you.

To learn more about nose reduction you can visit medlineplus.gov.

Microsurgery: MicroRhinoplasty™ in New York

For patients in NYC wishing to remove a hump or bump on the bridge of the nose, MicroRhinoplasty may be the answer. MicroRhinoplasty is the latest advancement in nose job procedures that allows the surgeon to reduce a hump or bump on the nose in a less invasive manner than traditional techniques. The development of MicroRhinoplasty is especially exciting, as hump or bump removal is the most common request among rhinoplasty patients.

In a traditional rhinoplasty procedure, an osteotomy is the usual technique employed to reduce humps or bumps on the bridge of the nose. An osteotomy requires that the surgeon manually fracture the nasal bones to re-shape the nasal structure and eliminate the hump. While quite effective, an osteotomy is a complex procedure. It is typically performed under general anesthesia and results in significant swelling and bruising and significant recovery times. Some patients also experience complications from the procedure.

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With the introduction of MicroRhinoplasty, Dr. Miller can now eliminate unsightly humps and bumps without resorting to bone fracturing or highly invasive procedures. Using an innovative air-powered microrasp and utilizing only a local anesthesia, MicroRhinoplasty procedures are done in the office and completed in as little as five minutes.

To learn more about MicroRhinoplasty™ in NYC, please contact our office to set up a consultation with Dr. Miller. You can fill out our convenient contact form or call our practice in New York. One of our Patient Advisers will be happy to help you start the journey to a new improved you. More information on the difference between a rhinoplasty and MicroRhinoplasty can be found here scholar.harvard.edu.

What Problems Does MicroRhinoplasty Correct?

The primary problem a MicroRhinoplasty corrects is a bump or hump on the nasal bridge, also known as a dorsal hump. This concern is a common one among Eastern and Northern European populations but can occur to nearly anyone regardless of ethnicity.

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How Does MicroRhinoplasty Work?

To perform MicroRhinoplasty, Dr. Miller accesses the treatment area through a tiny incision in the nostril. Then, using a specialized microrasp, he removes the obtrusive bony layers with extreme precision until the desired contour is achieved. Patients report very little pain, minimal swelling and bruising, and usually, return to normal activities within a few days.

before and after photos
Rhinoplasty to improve patient profile by Dr. Miller. After surgery, nasal hump is gone and tip is more refined.
before and after photos
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Are you a good candidate for MicroRhinoplasty in NYC?

While the MicroRhinoplasty is an excellent alternative to the more traditional rhinoplasty procedure, not everyone is an appropriate candidate. Individuals who are frustrated with a ‘nasal hump’ or bump along the bridge of the nose may make an excellent candidate for a MicroRhinoplasty procedure. Patients should also be in generally good health and have realistic expectations from the procedure. Before a surgery is scheduled, a consultation appointment will be set up with Dr. Miller. At this time, it will be determined if a MicroRhinoplasty is the correct procedure for the specific situation.

What Are The Benefits Of MicroRhinoplasty by Dr. Miller?

For the right patient, the benefits of MicroRhinoplasty by Dr. Miller in NYC are many.

Short Treatment Time

Perhaps the number one benefit of MicroRhinoplasty is the short duration of the procedure. Most procedures can be completed in as little as five to fifteen minutes and only require a localized anesthesia.

Minimal Pain and Discomfort

The nature of MicroRhinoplasty means that the patient will experience very little pain – either during or after the procedure. Minor swelling or bruising may occur but usually resolves in a few days or weeks.

Quick Resolution

Microrhinoplasty is ideal for those patients who are bothered by having a very small bump and want to remove it, but the bump is not so obtrusive to justify a complete rhinoplasty.

Fast Recovery

Once the procedure is complete, a patient is free to resume normal activities in one to two days, although strenuous activity should be avoided for 4-6 weeks. Unlike traditional nose job procedures that require weeks of devoted recovery time, MicroRhinoplasty allows a patient to return to normal life within a day or two of leaving Dr. Miller’s office.

How Do I Prepare For My MicroRhinoplasty Procedure?

Prior to your MicroRhinoplasty procedure, you will receive detailed pre-operative instructions from Dr. Miller. MicroRhinoplasty patients should also remember the following:

Review All Materials

During your consultation, you will receive a packet of information regarding your MicroRhinoplasty. If you have any questions about your procedure, you should contact Dr. Miller’s office before the day of your procedure.

Fill All Prescriptions Ahead Of Time

Make sure you have any prescriptions filled before your surgery date. The hours immediately following your procedure should be devoted to rest and recovery, not standing in line at the pharmacy.

Arrange For Transportation Home

Even though the nature of MicroRhinoplasty is not as invasive as a traditional nose job, you will still receive anesthesia during the procedure. Each patient recovers differently from anesthesia, and driving or traveling alone is not allowed.

Keep Contact Information Handy

While you are recuperating, it is important that your friends, family or caregiver has immediate access to Dr. Miller and other emergency personnel. Make a list of all contact numbers and keep it handy in case you need assistance once you’re home.

Schedule Your Follow-Up Appointments

Dr. Miller wants to carefully assess your recovery progress and does this through your post-procedure appointments. This follow up is critically important to your healing process, so mark your calendar and don’t miss these appointments.

Schedule Your Nose Bump Removal by Dr. Miller in New York

To learn more about MicroRhinoplasty in NYC, please contact our office to set up a consultation with Dr. Miller. You can fill out our convenient contact form or call us. One of our patient advisers will be happy to help you start the journey to a new improved you.

Alarplasty / Wide Nostril Reduction Surgery in New York

The ideal nose creates a triangle shape with symmetrical nostrils that are of proportionate size. 

Whether owing to ethnic heritage or genetic makeup, many NYC patients with wide, large, or long nostrils and a bulbous nasal tip are often unhappy with their nose because it does not complement the rest of their facial features. Wide or flared nostrils can sometimes create or contribute to the appearance of an oversized nose that prevents people from achieving facial harmony. Rhinoplasty can be a surgical option that improves the appearance of the nose and facial balance overall. 

Philip J. Miller, MD, FACS, specializes in nose, nostril, and alar base reduction surgery in NYC. Alarplasty is a cosmetic procedure for nostril reshaping. For those who want to reduce their nostril size, alter their nostril shape, or correct a crease on the nose, alar reduction or nostril narrowing helps patients achieve a nose that looks symmetrical. 

Dr. Miller performs flared nostril reduction surgery to address overly wide or big nostrils in his NYC office for a variety of patients. 

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How Do You Make Your Nose Smaller?

For reduction rhinoplasty or nose size reduction, Dr. Miller uses a small, wedge-shaped piece of nasal soft tissue which is removed from where the nostril connects to the cheek at the alar base. The rhinoplasty stitches on the nose cause the skin to achieve a narrower position at the base of the nose. Dr. Miller makes incisions either inside or at the base of the nose, typically hidden within the natural nose crease. The result is narrow or smaller nostrils and minimal to no obvious alarplasty scars.

You may learn more about rhinoplasty terminology here.

What Does Alarplasty Treat?

Alarplasty treats the following cosmetic concerns:

  • Nasal shape – Changes to the alar nose or alar crease make the nostrils smaller, creating an overall narrower nose shape.
  • Nasal size – Through nostrils surgery, different sized nostrils can be corrected and nostril size reduction can be achieved.
  • Breathing issues – Whether performed alone or combined with rhinoplasty, nostril surgery can correct asymmetry issues or different size nostrils, enabling better airflow and breathing function.
rhinoplasty surgeon, Dr. Philip Miller consulting with a patient in NYC

Dr. Miller’s Approach to Nose Reduction Surgery

If you are considering nose reduction surgery in NYC, the importance of a plastic surgeon’s expertise and experience cannot be overstated. Wide nostril rhinoplasty requires a facial plastic surgeon who is well-versed in the latest rhinoplasty techniques and has intricate knowledge of nasal anatomy. It is a good idea to view the surgeon’s before and after photos of previous patients to get an idea of the work and the type of results you can expect to achieve.

Dr. Miller is a double-board certified facial plastic surgeon with offices in both New York City and New Orleans. He brings more than two decades of experience and is considered by his peers to be an expert in rhinoplasty and facial rejuvenation procedures. He develops personalized treatment plans that combine desired changes with the preservation of their unique features, including ethnic identity, for the best possible results.

Dr. Philip Miller Headshot

If you are considering nose reduction surgery in NYC, the importance of a plastic surgeon’s expertise and experience cannot be overstated. Wide nostril rhinoplasty requires a facial plastic surgeon who is well-versed in the latest rhinoplasty techniques and has intricate knowledge of nasal anatomy. It is a good idea to view the surgeon’s before and after photos of previous patients to get an idea of the work and the type of results you can expect to achieve.

Dr. Miller is a double-board certified facial plastic surgeon with offices in both New York City and New Orleans. He brings more than two decades of experience and is considered by his peers to be an expert in rhinoplasty and facial rejuvenation procedures. He develops personalized treatment plans that combine desired changes with the preservation of their unique features, including ethnic identity, for the best possible results.

His proprietary consultation process is known as Natralook, which is a process that includes an evaluation of the patient’s nose and other facial features while considering carefully the patient’s specific issues and aesthetic goals. NatraLook enhances the usual plastic surgery experience into a safe, collaborative environment where patients can explore their aesthetic confidence. Dr. Miller works with each of his patients to create a unified vision for optimal results and the most natural outcome possible.

Alarplasty Before and After

alarplasty (wide nostril surgery) before and after
Revision rhinoplasty to narrow nasal bridge and refine tip on a female patient by Dr. Miller. Surgery creates a more proportionate nasal bridge and tip for a more balanced facial contour.
wide nose reduction surgery in new york city
Rhinoplasty, upper blepharoplasty, chin implant, and fat grafting for facial contouring of a female patient by Dr. Miller. Treatments bring facial features in proportion to improve the facial contour.
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Am I a candidate for alar base reduction?

If you are dissatisfied with your appearance because your nostrils are too long or wide, you are a potential candidate for alar base reduction. Those who want to refine the results of their previous rhinoplasty or would like to address a traumatic facial injury can also benefit from a nose job for the nostrils.

The ideal rhinoplasty nostril reduction candidates are non-smokers, in good general health, and at least 16 years of age to ensure the facial features are fully developed. Noses reach full growth in girls between the ages of 13-14 and boys between 15-16. The first step in determining your candidacy for a nose job is to set up a consultation with Dr. Miller.

Nostril Reduction Surgery FAQ

What are the benefits of nostril reduction rhinoplasty?

  • Improved appearance – Nostril reduction can produce a whole new look. Whether you want subtle or distinctive changes, a new nostril shape can be the foundation for a new you.
  • Increased self-confidence – When you feel good about how the world sees you, you feel good about yourself. Even small changes can make a big difference and help you gain confidence in your appearance.
  • Better health – Perhaps it isn’t just your large nostrils that have you bothered. Maybe having one nostril smaller than the other is causing you breathing difficulties or other health problems. A rhinoplasty reduction or alar crease reduction can improve both the nose’s appearance and functionality, allowing you to breathe easier.

How much does alarplasty cost in NYC?

Nostril reduction costs anywhere between $6,000 to $9,000 in New York City. This is the average price for the area, but the true cost varies from patient to patient, depending on factors such as the patient’s aesthetic goals, the length and involvement of the surgery, anesthesia and facility fees, and the surgeon’s experience. The actual cost will be provided during your consultation. For more information on alar base reduction cost, please contact Dr. Miller at his Manhattan, New York, or New Orleans, Louisiana, plastic surgery office.

How will the procedure go?

Dr. Miller will make an incision in the nose’s alar region where the nostrils meet the cheeks, either inside or at the base of the nose. He will sculpt the tissue and then close the incisions with sutures to reinforce the narrower shape of the alar base. 

Dr. Miller can perform a nose job for big nostrils under local anesthesia in less than one hour. Alarplasty is performed on an outpatient basis, and you will be released to go home after your surgery.

What does recovery from alarplasty look like?

Recovery time is relatively quick. Unlike a typical rhinoplasty procedure, no cartilage or bone is removed in an alarplasty. Any swelling, bruising, and tenderness will be resolved within 1-2 weeks, and stitches will be removed around the same time. Most patients can resume their normal activities within one week. Strenuous activities must be avoided for 2-3 weeks after surgery. Full recovery from alarplasty typically takes 1-3 months.

Does it hurt?

Typically, alarplasty alone can be performed under local anesthesia, and the surgery is well tolerated. It is a quick procedure and done in a very conservative manner. Pain medication is provided and may be taken to alleviate any pain, although few find it necessary.

It is important to discuss all your concerns with your surgeon before your surgery. Dr. Miller will be able to set your expectations for your recovery and recommend specific after-care solutions to make your healing process as smooth as possible. 

Will insurance cover my wide nostril reduction surgery?

If the reason for rhinoplasty reduction is purely cosmetic, it is not covered by insurance. If it is provided to correct breathing or other functional issues, then it may be covered by your insurance policy.

Schedule an Alarplasty Consultation in New York

Learn more about alarplasty or wide nostril reduction surgery in NYC by contacting us to schedule a consultation with Dr. Miller. You may fill out our contact form or contact us at (646) 791-3025. You will be put in touch with a patient advisor who will help you get started on your rhinoplasty goals.

Next, learn about Hispanic rhinoplasty.

Teen Rhinoplasty

Teen rhinoplasty is the most-often requested procedure by teenage patients in New York City. This is not surprising given today’s societal pressure to fit in combined the popularity of social media websites and the “selfie” culture that comes with it.

While some professionals assert that teens are not mature enough to understand or deal with the implications of plastic surgery, Dr. Philip Miller believes that parental involvement and careful patient selection can ensure the process is beneficial and highly successful for the right adolescent patient.

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How Does Dr. Miller Evaluate a Teen Rhinoplasty Candidate?

Dr. Miller takes a very conservative approach to evaluating teenage rhinoplasty patients in New York City. He understands that it is critically important for these patients to have realistic expectations about the procedure’s outcome. He is careful to ensure that the teen does not view rhinoplasty as a “cure all” solution. Dr. Miller’s careful screening process – which includes both the teen and parents – is a testament to the special professional responsibility he assumes for this particular type of patient. He does a thorough assessment to ensure the teen is psychologically mature enough for the entire process and that the teen fully understands the benefits and potential risks. In some cases, Dr. Miller may also call upon a psychologist to assist with the evaluation process. Dr. Miller does not accept every teenage rhinoplasty candidate with whom he consults. As a responsible medical professional, he believes his ultimate obligation is to ensure that the nose job procedures are only performed on those teenagers who are physically and psychologically ready for all aspects of the surgery.

male rhinoplasty before and after results in New York City

What Are the Benefits of Teen Nose Job Surgery by Dr. Miller?

For the teenage rhinoplasty patient, the benefits of a nose job surgery can be great.

Improved Self-Confidence

The teenage years are difficult under the best of circumstances. With social media, “selfies” and bullying at all-time highs, today’s teen faces an endless amount of pressure. When a teen’s focus of dissatisfaction is his or her nose, it can overshadow all other aspects of day-to-day life and make the teen years an unpleasant experience. Often times, these concerns can be easily corrected with a nose job. Teens recover quickly from rhinoplasty procedures, and end results can be positively life-changing.

Better Health

In some cases, teens require rhinoplasty to address structural deficiencies that cause breathing difficulties. Whether caused by nature, accident or trauma, misshapen noses can cause other significant health issues, such as interrupted sleep patterns. Poor sleep has a negative impact on all aspects of a teen’s life. With rhinoplasty, a teenager can alleviate any structural abnormalities and enjoy a return to a healthy, normal breathing state.

Comfortable Breathing

Often times, through accident or traumatic injury, a teen’s nose can be damaged, resulting in obstructed nasal passages that impede his or her ability to easily breathe. A nose job, often combined with other procedures like septoplasty, can correct these structural issues and allow the teen to return to normal, natural appearance and functionality.

teen rhinoplasty before and after

At What Age Can a Teen do a Nose Job?

If you are a teenager considering rhinoplasty, your nose must have reached full development. This typically happens between the ages of 14-15 for girls, and 16-18 for boys. The average ages of Dr. Miller’s teen rhinoplasty patients runs from age 15 to 19.

Dr. Miller does not advise any teen to get rhinoplasty before their nose has fully matured. He will assess a patient’s nasal bones, cartilage, and septum to determine if the patient’s nose is fully developed. Dr. Miller will never encourage the surgery if he is not 100% confident that the patient is a suitable candidate.

Best Age for Adolescent Nose Job

The primary factor for teenagers considering rhinoplasty isn’t a specific age, but rather whether the nose has reached its full adult size. The best rhinoplasty outcome is achieved with a fully developed nose, and most surgeons will only perform rhinoplasty on noses that have reached at least 90% of its adult size.

Responsible surgeons will always be concerned with the teen’s emotional maturity as well, while ensuring they have realistic expectations for what the surgery can and cannot do. With a thorough consultation and proper assessment, adolescents and teens can be ideal rhinoplasty patients.

Am I A Good Candidate For Teen Nose Job?

First and foremost, if you are a teen in New York City and considering rhinoplasty, your nose must have reached full development. This typically happens between the ages of 14 and 15 for girls and 16 or 18 for boys. The average age of Dr. Miller’s teen rhinoplasty patients is 15 to 19. During the consultation, Dr. Miller will assess your nasal bones, cartilage, and septum to determine if your nose has reached this stage.

The other major consideration is whether you, as a teenager, are psychologically ready for nose surgery. Teen patients that can clearly identify their rationale for the procedure and enunciate an understanding of all benefits and risks, make the best candidates.

Whether it is to correct appearance or breathing abnormalities, with proper assessment and support, teens can be excellent rhinoplasty patients. To learn more about teenage rhinoplasty, visit ncbi.nlm.nih.gov

Rhinoplasty to enhance noses one week post-op. After surgery nasal tip is rotated and bridge is straightened to improve facial profile.

What is the Difference Between Teenage Rhinoplasty and Adult Rhinoplasty?

There were 44,686 rhinoplasty procedures performed on people aged 13 to 19 in 2020, according to the American Society of Plastic Surgeons. While experts say that adults tend to have plastic surgery such as rhinoplasty to stand out from the crowd, teens who want to go under the knife have different motivations and goals. 

Teenagers seek rhinoplasty procedures for a variety of reasons, ranging from functional or breathing problems to fixing undesirable issues in order to fit in, look similar to others, and avoid bullying. Whether the concern is a nose that is too big, too flat, or crooked, these traits can make teens feel awkward and even affect their self-esteem. 

Common Concerns With Teenage Rhinoplasty

When a teenager is considering rhinoplasty, there are a few issues that make their situation more complex than that of adult patients considering the same surgery. 

  • Physical readiness – A teenager’s nose might not be fully-grown yet. If a teen’s nose has not finished developing, rhinoplasty can affect its continued growth, leading to malformation or a distorted look, which negates the goals or purpose of the procedure. 
  • Emotional and psychological readiness – This is, perhaps, the biggest concern and most important factor a surgeon considers before determining whether a teen patient is a good candidate for rhinoplasty. Teenagers must have a healthy mental attitude and the emotional maturity to understand that their new appearance is not a magic cure for solving problems. They must also understand the possible risks and complications involved in the procedure. 
  • Motivation for rhinoplasty – The teenager must want the change because of a personal decision, and not because of outside factors. Specifically, teens respond better to any surgical procedure when they are the ones to initiate the request, as opposed to a parent or friend pressuring them to undergo plastic surgery.

A teen and their parents must weigh the pros and cons of a rhinoplasty to determine whether it is the best option. The surgeon will act as a guide to ensure everyone involved has realistic expectations about the procedure. 

Rhinoplasty to remove nasal hump and refine tip by Dr. Miller. After surgery, dorsal hump is gone and nasal tip is slightly rotated for a more attractive profile.

This is why Dr. Miller developed his proprietary consultation process called NatraLook. During the NatraLook consultation, he evaluates the patient’s nose and facial features while listening to their concerns and goals. He will also outline the benefits and risks, limitations, expected postoperative course, and possible complications of teenage rhinoplasty. He will also answer all of a patient’s questions and concerns. 

This process ensures the plastic surgery experience is a safe, collaborative environment where patients can explore their aesthetic confidence. This opportunity allows patients and Dr. Miller to create a unified vision for optimal results and the most natural outcome possible. 

How Can I Learn More About Teen Rhinoplasty by Dr. Miller in NYC?

To learn more about teen rhinoplasty in New York City, you can review our rhinoplasty (nose job) guide or contact our office to set up a consultation with Dr. Miller. You can fill out our convenient contact form or call us. One of our Patient Advisers will help you get started.

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Male Rhinoplasty

Men make up nearly 10% of all cosmetic procedure patients and account for more than 200,000 of the plastic surgery procedures performed each year. Despite the idea of plastic surgery being predominantly the domain of women, each year more and more men turn to plastic surgery to improve esteem and appearance.

Rhinoplasty is one of the most often requested procedures from male patients. Any stigma attached to male rhinoplasty is long gone. Men want to change the look of their noses without fundamentally altering its masculine structure—a major difference between the cosmetic goals of men and women. Continue reading to learn how Dr. Miller performs rhinoplasty for male patients in his New York City plastic surgery clinic.

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How Does Male Rhinoplasty Differ From Female Rhinoplasty?

male rhinoplasty results in NYC

*Patient results may vary

While most women seek reduction rhinoplasty because they want narrower, more feminine noses, men usually want the opposite. Since masculine features are the perceived key to male attractiveness, most men look to rhinoplasty to eliminate the unsightly features while maintaining a strong nose. At our New York City plastic surgery clinic, we offer this service to both our male and female clients.

The male nose can be augmented with a variety of techniques, including strengthening the dorsum and increasing the projection of the nasal tip. The overall goal is to ensure that the revised nose better fits the man’s face.

Why Do Men Choose Rhinoplasty by Dr. Miller?

Just like women, men can be unhappy with their overall appearance because of their nose. Whether the nose is too big, too small or misshapen due to accident, injury or birth, a nose job can improve a man’s appearance and create symmetry and balance in the face.

There are also a number of men who suffer from breathing difficulty, sleep apnea, excessive snoring and other medical conditions due to malformations in the nasal cavity. A nose job, combined with other procedures, can repair and restructure the inner nose and provide relief from these conditions.

rhinoplasty before and after image of male NYC patient

*Patient results may vary

No matter what your reason for seeking out male rhinoplasty, Dr. Miller understands that your ultimate goal is to still look like you – only better. He knows that male nose job patients are very sensitive to perceived changes in appearance and that they want natural results that do not attract the wrong sort of attention. Calling upon his twenty years of experience with male rhinoplasty patients in New York City, Dr. Miller is able to provide subtle yet impressive finished results.

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How Does Male Rhinoplasty Create a More Masculine Nose?

Every man’s rhinoplasty will involve different improvements, depending on the individual’s specific concerns, facial structure, and aesthetic goals. Most men strive for a prominent, powerful nose with very distinctive features. Some changes that can increase the masculine appearance of the nose are:

  • Widening the nose overall
  • Adding fullness to the tip
  • Strengthening the nasal dorsum (bridge) by widening or straightening it
  • Creating more angular dimensions
  • Straightening the nasal tip (ensuring it does not point upwards)

Dr. Miller can likely accomplish any of these changes and more, always dependent on the patient’s nose structure and overall health.

What Are The Benefits Of Male Nose Job by Dr. Miller?

Men who seek out a nose job enjoy many benefits from the procedure, including:

Better Sleep At Night

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, rendering a good night’s sleep just a dream. Male nose job surgery, combined with other procedures to reshape the inner nasal passageway, can help eliminate these common sleep problems.

Easier Breathing

For some men, the simple act of taking a deep breath through the nose is difficult or even impossible due to blockage of the nasal openings, caused by a misshapen septum – the structure that separates the two nasal cavities. Whether the deformity occurred naturally or as a result of trauma or accident, a qualified and skilled plastic surgeon can reshape the inner nose and correct these issues, allowing you to breathe easier once again.

male nose job results in NY, NY

*Patient results may vary

Improved Self Confidence

Your nose is the focal point of your face. When you are self-conscious about your nose, your overall confidence suffers. Getting a nose job can be the easiest way to boost your self-confidence and put your best face forward.

Am I A Good Candidate For Male Rhinoplasty in NYC?

If you are a man dissatisfied with the appearance of your nose or if you struggle with sleep apnea, excessive snoring or breathing difficulties, you may be an excellent candidate for male rhinoplasty. Non-smoking males over the age of 16 who are in general good health and who have realistic expectations about the outcome of the procedure make excellent male nose job patients.

Male Nose Job Recovery

Your rhinoplasty procedure may take between 1.5 and 2.5 hours, and you may choose to be asleep under general anesthesia or awake with sedation. You may feel more groggy after your procedure if you were under general anesthesia, but being under either anesthesia will require you to be driven home by someone other than yourself and have someone with you for 24 hours. When you get home, rest should be your priority. Be sure to keep your head elevated to help minimize swelling.

Some patients need several days to rest after their procedure before they return to regular activities, but others, like one of Dr. Miller’s own staffers, only needed a day to recover.

Dr. Miller will place a cast on your nose after your surgery, and you will keep this on for at least a week. Dr. Miller will remove your cast at your one-week follow-up appointment. He will also remove any non-dissolvable sutures that he placed inside or between the nostrils on the underside of your nose. These incisions heal quickly and leave nearly invisible scars. 

One week post-op, you will likely be feeling congested and have significant bruising and swelling. After another week of recovery, you can expect great improvement in how you feel and look. Swelling will subside, and much of the bruising will be gone. Slight swelling will remain for about a year, but it won’t be noticeable to the people around you.

After three months of rhinoplasty recovery, you should be feeling well enough to resume all regular activities. Be sure to protect your nose from any type of impact by wearing protective gear or avoiding contact sports. At this point, you will have an idea of how your nose will look once all the swelling subsides.

Are the Results of Male Rhinoplasty Natural Looking?

For a rhinoplasty to create a natural-looking nose, your facial plastic surgeon will need to examine your entire facial structure and match your nose to your other features. Your eyes, nose, and mouth should balance each other out and enhance one another. As a leader in rhinoplasty techniques, Dr. Miller understands that each procedure will be slightly different from one another. He tailors each procedure to the patient, considering their facial structure, ethnic background, and aesthetic goals as he designs their end result.

Male Rhinoplasty Testimonials From Our Plastic Surgery Clinic


How Do I Learn More About Male Rhinoplasty?

It is easy to find out more about male rhinoplasty during a consultation with Dr. Miller in New York City. Simply fill out our convenient contact form or call us and one of our friendly Patient Advisors will help you start discovering the new and improved you. Additionally, you can visit medlineplus.gov to learn more about rhinoplasty.

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Located in New York City, the office of Dr. Philip Miller is nestled in the heart of Manhattan positioned close to famous places such as Prada, Coach, Armani, Dior, and many other amazing things to do nearby. Get directions to our office or take a virtual tour.
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Endonasal Rhinoplasty

Dr. Miller never uses a “cookie-cutter” or one-size-fits-all approach to nose surgery. Because every patient is unique in their facial features, your consultation will determine which surgical approach is best for your particular circumstances. Double board-certified facial plastic surgeon Philip J. Miller, MD, FACS, performs both closed rhinoplasty (endonasal) or open rhinoplasty depending on the specific needs of each patient. 

Dr. Miller offers patients in Manhattan, New York, and New Orleans, Louisiana, expert rhinoplasty techniques, with the goal of bringing balance to your facial features and achieving beautiful, natural-looking results. 

What is endonasal rhinoplasty?

Also called a closed rhinoplasty, endonasal rhinoplasty is an internal procedure in which all incisions are confined to inside the nostrils. The nose is not opened fully, and the nasal structure is not exposed. The work is done entirely through narrow openings in each nostril. Patients concerned about visible scarring need not worry with a closed rhinoplasty. During the procedure, Dr. Miller carefully lifts the underlying bone, cartilage, and tissue through the nostrils, so you won’t be able to see any scarring.

Open vs. Closed Rhinoplasty

While both open and close rhinoplasty procedures can achieve exceptional results, each has its own advantages and drawbacks to consider during your consultation.

During an open rhinoplasty, Dr. Miller makes a small incision in the columella – the piece of tissue that separates the nostrils at the base of the nose. Also called external rhinoplasty, this technique opens the tip of the nose to reveal the internal structure. Dr. Miller can reshape the nose and repair damage while keeping structural support intact. An open rhinoplasty provides improved precision, enhanced visibility, and enhanced structural support. However, there can be minor scarring under the base of the nose. An open rhinoplasty may also require a slightly longer recovery process compared to a closed technique.

Rhinoplasty, chin implant, and fat grafting for facial enhancement by Dr. Miller. After surgery, facial contour is more proportionate and youthful.

Dr. Miller typically recommends open rhinoplasties for patients with complex structural concerns, such as a severely crooked nose, nasal trauma or deformities, an asymmetrical tip, a large nasal tip, or a large dorsal hump (bump on the nasal bridge). For these patients, the possibility of a nearly imperceptible scar is a good trade-off for the most natural nose reshaping possible.

A closed rhinoplasty is especially appealing for those who want to make minor modifications to their nose. Dr. Miller might also recommend this approach if you have breathing problems, such as chronic sinusitis. It is a more conservative type of rhinoplasty, which means it may not produce the more dramatic results achieved with an open rhinoplasty. 

The closed technique is ideal for minor adjustments to the nasal tip and bridge. If you have a dorsal hump, wide nasal bridge, or enlarged nasal tip, endonasal rhinoplasty can deliver subtle results with little impact on the surrounding tissue.

rhinoplasty results on patient with realistic rhinoplasty expectations in NY, NY

Benefits of Endonasal Rhinoplasty

Because all stitches are located inside the nose, patients will not have any visible scarring after the surgery. Recovery may also be a bit faster, with many patients returning to work and other activities within one week rather than the two weeks usually allotted for open rhinoplasty recovery. Other benefits include:

  • Decreased operative times
  • Profile adjustments are easier to judge because the structural support remains undisturbed
  • Reduced postoperative edema
  • Quicker return to a normal appearance

How is Endonasal Rhinoplasty Performed?

You can undergo endonasal rhinoplasty using local anesthesia with sedation or general anesthesia. To begin, Dr. Miller will make incisions inside the nostrils to separate the skin from the cartilage. Dr. Miller can then begin the process of reshaping the cartilage or shaving off or adding bone (bone graft) through the narrow openings in each nostril. Once the shaping is complete, absorbable stitches will close any incisions. You will have a cast or nose splint after surgery to protect the nose and maintain the new shape. The procedure typically takes 1-2 hours to complete.

Recovery After Endonasal Rhinoplasty Surgery

You will need to arrange for someone to drive you home after your surgery. The cast or splint helps support the nose as it heals for the first week. You can expect to take a few days off from work so you can comfortably recover at home. It is best to keep your head elevated to help reduce any swelling. To ensure faster healing, avoid the following:

  • Strenuous exercise/activity
  • Blowing your nose
  • Swimming
  • Sleeping facedown
  • Excessive chewing
  • Drinking alcohol
  • Smoking
  • Wearing eyeglasses
  • Pulling tight clothing over your head

We will remove your cast or splint after one week. You can usually return to work and normal activities within 1-3 weeks, but you should refrain from strenuous physical activity for 3-6 weeks. You will begin to see the swelling and bruising subside within 2-3 weeks, at which time you will start to appreciate the results. 

Full results usually take 6-12 weeks to be seen, while your healing will continue for the entire first year. Dr. Miller and his team will follow you through this entire process.

Scarring After Closed Rhinoplasty

The primary benefit of a closed rhinoplasty is that there’s no external evidence of the procedure. All stitches are located inside the nose, so you may feel more comfortable resuming your normal activities sooner than you might after an open rhinoplasty.

Is Endonasal Rhinoplasty Right For You? Ask the Expert

Open and closed rhinoplasty surgery are different surgical approaches, but one is not superior to the other. To determine the best procedure for you and ensure the best possible results, Dr. Miller offers a proprietary consultation process called NatraLook®. During your NatraLook consultation, he evaluates your nose and facial features while listening to your concerns and goals. This process evaluates and expands the typical plastic surgery experience into a safe, collaborative environment where you can explore your aesthetic confidence. This opportunity allows you and Dr. Miller to create a unified vision for your results and the most natural outcome possible. 

To learn more about the different types of rhinoplasty procedures Dr. Miller performs and to find out which technique is best for you, contact our New York City plastic surgery clinic today.