The only thing that would change is that more people would be calling me "Miles" instead of my real name. So juggling conversations in real life with conversations on Xbox Live would be easier than ever before.
Lots of people would be struggling with the pronunciation of my last name, but they do on Xbox Live anyway. Might get comments about having a stupid last name more often, but I hear that online anyway.
So, in short, nothing would change. HA!