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QUESTION: Hello Dr. Jafri,

I was interested in having customized medpor jaw implants on my lower jaw, and wanted to get some idea of how bad the scars would be?  I had a previous bsso and genioplasty which left notches on both sides of my chin as well as a loss of volume on the left side...The idea would perhaps make an implant for each side...I had the the first surgery six years ago, and I still have mild residual numbness on my lip, because that surgeon injured the mental nerve...I am reluctant to have internal incisions, because I heard that the external approach is safer both from a nerve issue as well as the lack of bacteria from the oral cavity...Can you give me your thoughts on the external approach with regards to the nerve, infection, and scarring issues compared to an internal approach?  Thanks in advance, Doug

ANSWER: Hi Doug,

This is a very good question and the advantages and disadvantages of each approach must be weighed carefully before deciding which way to go.

You have had previous surgery resulting in mental nerve injury and there will also be some scarring present. Therefore it is very important that your surgeon guide you in deciding which approach to utilize since these are both factors that will impact your implant placement.

In general the intra-oral approach is nice since it allows for direct visualization of implant placement onto the jawbone. However you already have one mental  nerve knocked out and it must be questioned wether risking injury to the opposite one is worth it (potentially leaving your entire lower lip numb). With good surgical closure and good postop care, bacteria infecting the intra-oral approach should be a rather rare complication.

Extra-oral approach is safer than intra-oral in terms of nerve injury or infection but leaves an external scar and can sometimes make it harder to place lateral implants in the jaw. Also your previous surgeries may have associated scar tissue that could impact the extra-oral approach.

Both approaches will have their benefits and drawbacks - really best thing to do is sit down with your surgeon who can see and examine your specific anatomy and give you their opinion.

Take care,

Dr. Kamran Jafri

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QUESTION: Hello Dr. Jafri,

You gave me very good advice...I don't yet have a surgeon for the custom jaw implants, and I want to know if you do this type of work?  It sounds like you are incredibly knowledgeable about this process...Thanks for your email


ANSWER: Hi Doug,

Thank you. I do do jaw and chin implants. It would be very important that whoever does your surgery they have a chance to examine you and go over the best options in your case.

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QUESTION: Hi Dr. Jafri,

I noticed that you have several locations...Can I make an appointment at your Levittown office?

Thanks much...


Hi Doug,

I can see you in Levittown 5167316644. Please be advised though that at that location I do more of medical head and neck surgery so they may charge a consultation fee (100.00)

If you are able to come to my office / surgery center in Manhattan 2128880607 (ask for Tracy) there is no consultation fee and that is where I do my cosmetic / implant surgeries.

Either location is fine by me and will be happy to give you the best advice I can.

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Kamran Jafri, MD


Any and all topics relating to Facial Plastic Surgery: Facelifts, Mini-Lifts, Necklifts, Botox for Pores / Oily Skin, Botox for wrinkles, Fillers, Chemical Peels, Liposuction, Eyelid Surgery, Browlifts, Fat Injections. Cannot talk about Plastic Surgery of the Body.


Highly experienced double board certified Surgeon who has worked with thousands of Patients since 2002. Dr. Jafri has a niche private practice in Manhattan, New York specializing and focusing on Plastic & Reconstructive Surgery of the Face and Neck. Dr. Jafri is a leading expert in the area of Facelifts with local anesthesia. To learn more about Dr. Jafri, visit his website at or call 212-888-0607.

American Academy of Facial Plastic & Reconstructive Surgery American Academy of Cosmetic Surgery American Academy of Otolaryngology - Head & Neck Surgery New York State Medical Society New York State Medical Society Committee on Ethics in Medical Practice

Board Certified American Board of Facial Plastic & Reconstructive Surgery Board Certified American Board of Otolaryngology - Head & Neck Surgery

Awards and Honors
Alpha Omega Alpha Medical Honor Society

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