Diary of a palatal expander patient

[jfbjfb]

Damn so does widening the palate increases mouth width too(lips length)? I kinda have narrow lips.

I did not notice any significant improvement in this direction, although I had full lips from the start. If you want to change your lips I would say the way to proceed is by having soft tissue work as it is mostly not about the underlying bone.

What I did notice an improvement on is my side profile. The mandible seems to be rotating a bit and the chin becomes more defined. Still some more months to go before the open bite is fully solved.

 

[polishcel]

So I eventually got the palatal expander I had been long waiting for. The model is the so-called DS expander. It was custom-made from my CBCT scans and installed just today. I have been bleeding for hours, and so while I would like this thread to be a sophisticated one, I feel like I am too tired to write much.

View attachment 2286639

Things I am expecting:

- Move from a 30 mm IMW to 37.5 mm.
- Enhance the midface by making it wider, thus having a bizygomatic width that is larger than the bigonial width, and not the other way around as of now.
- Improve the undereye support thanks to the lateral expansion of the cheekbones.
- Wider smile, ideally it should be a 10-teeth smile.

I hope to update the forum regularly on the process, like showing the resulting diastema and what effects it has exerted on my face aesthetics. I will be taking any question you may have.

damn so did your palatal expansion with schwarz appliances fail or something? would you still recommend a toothborne expander for an adult?

 

[ABCDEFGHIJKLMNOP]

My chin is considerably recessed and I have a high gonial angle, I am not denying that. But strangely enough my maxilla is correctly projected. This same surgeon said he was not willing to give me more than 3 mm at max of lefort 1 because I did not need it.

Who was it? Alfaro? That's the only surgeon that really works with the Ortho that does the Power Xpander as far I know

 

[PrinceofDarkness]

did you notice asymmetry, or alar base getting wider? That issue comes from this type of procedure.

 

[jfbjfb]

damn so did your palatal expansion with schwarz appliances fail or something? would you still recommend a toothborne expander for an adult?

Kind of because I did not stick to it once the expansion was completed. That is, I should have left the appliance more time for the bone to fully solidify.

Anyway, the MSE or any kind of variation is superior to toothborne expanders.

 

[jfbjfb]

Who was it? Alfaro? That's the only surgeon that really works with the Ortho that does the Power Xpander as far I know

Someone who wrote his PhD thesis under Alfaro. But the ortho who treated me collaborates with another surgeon (kind of mediocre to say the least).

 

[jfbjfb]

did you notice asymmetry, or alar base getting wider? That issue comes from this type of procedure.

Not really. I had a bit of asymmetry before the treatment started, maybe 1 or 2 mm on my arch, relatively hard to notice for the untrained eye. It stayed the same after expansion. I think the planning is crucial here, as the expander was attached to the right spots and everything was carefully planned. The alar base had very minimal changes. When I was turning the expander I could notice my nose becoming a bit larger, but once the suture fused and the diastema disappeared, the change is imperceptible.

You are right on the fact that these are some of the potential drawbacks of MSE. Fortunately I was lucky and it turned alright.

 

[ABCDEFGHIJKLMNOP]

Someone who wrote his PhD thesis under Alfaro. But the ortho who treated me collaborates with another surgeon (kind of mediocre to say the least).

Got it.

How is the long term outcome. Ant noticeable alveolar or tooth degradation.

From reading your post it looks like Varelas BAME approach is to turn it as fast and aggressive as possible to overcome the suture and split effectively which isn't necessarily the healthiest thing for the roots and palate

 

[jfbjfb]

Got it.

How is the long term outcome. Ant noticeable alveolar or tooth degradation.

From reading your post it looks like Varelas BAME approach is to turn it as fast and aggressive as possible to overcome the suture and split effectively which isn't necessarily the healthiest thing for the roots and palate

I had my suture artificially split with a piezoelectric, so the speed is not that criticial. They told me we had 3 months to expand before the bone was fused.

Overall the process went smooth. No degradation afaik. I am now getting aligners to finish the treatment and hopefully by the time summer ends I can show you all the before and after of my palate

 

[ABCDEFGHIJKLMNOP]

I had my suture artificially split with a piezoelectric, so the speed is not that criticial. They told me we had 3 months to expand before the bone was fused.

Overall the process went smooth. No degradation afaik. I am now getting aligners to finish the treatment and hopefully by the time summer ends I can show you all the before and after of my palate

When you do before and afters ensure you get an updated CBCT so we can compare the ACTUAL skeletal expansion vs dental expansion

So many of these expansion devices claim to expand skeletally when they're really just pushing teeth outwards in the alveolus / tipping them as you see in so many MARPE cases

More importantly, it helps quantify what the rotation movement of the *zygomas* was - did they move up or did they move down. One is a looksmin the other a looksmax.

I don't think that's the case with this device but without an updated CBCT you can't quantify this, the airway change, any induced asymmetry at the maxilla level etc

Honestly, you could probably do it now. The aligners are just moving your teeth. The skeletal change at the mid face is already done (if there was any) and is quantifiable but cosmetic change isn't until aligners are done

Looking forward to the update before I do this myself

 

[jfbjfb]

Hi all, I think it is time to revive this thread with some results.

How it started:

Current status:

Had I not found this place I would have never imagined these results. I am deeply grateful to all of you. Now onto planning the next procedure.

Spoiler: Tags

@Giorgio @NegativeNorwood @Yassin @Struggler03 @slop slinger @nobodyspecial369 @noprogressno @AscendingHero @malicieusss

 

[Giorgio]

Hi all, I think it is time to revive this thread with some results.

How it started:

View attachment 3319875

Current status:

View attachment 3319890
View attachment 3319893

Had I not found this place I would have never imagined these results. I am deeply grateful to all of you. Now onto planning the next procedure.

Spoiler: Tags

@Giorgio @NegativeNorwood @Yassin @Struggler03 @slop slinger @nobodyspecial369 @noprogressno @AscendingHero @malicieusss

looks great
it has been quite the journey too
looking forward to what path you take next

 

[Doomer]

This is exactly what I need. I'm going to make sure to get my ~30mm IMW palate expanded to ~40mm IMW palate since my bones are young. I'm also going to make sure to get a mandible expander with it so my teeth fit well together. Testosterone/DHT can only do so much, fixing a narrow maxilla seems to be very very important for aesthetics and health.

 

[NZb6Air]

30 mm IMW start btw @Melly first time i see this too, confirms everything I said

 

[Doomer]

is this better or MSE or SARPE?

Do NOT get SARPE. SARPE makes a cut to where only the maxilla will expand and you get no benefits for cheekbones/zygos and undereye support.

 

[Doomer]

30 mm IMW start btw @Melly first time i see this too, confirms everything I said

I'm 16. Do you think expanding from 30mm IMW to 40mm IMW would ascend me?

 

[NZb6Air]

I'm 16. Do you think expanding from 30mm IMW to 40mm IMW would ascend me?

it's way too expensive for what it does, u defo need more imw, depends if u can pay for it

but the non cope are obv implants , tripod, lf1 segmented etc

 

[Doomer]

it's way too expensive for what it does, u defo need more imw, depends if u can pay for it

but the non cope are obv implants , tripod, lf1 segmented etc

I'm going to get a toothborne expander since my bone development is delayed meaning my bones are malleable. I'd rather not wait until I'm 18 and just fix the root problem early.

 

[AverageCurryEnjoyer]

tag

 

[Melly]

Out of the hypothesis I formulated initially, some of them have been validated and some have not. For instance, the cheekbones are a bit more laterally projected, I have expanded the palate the millimeters I was hoping for, the smile is wider, but the under eye support has not improved a single bit. In terms of aesthetics, assuming a sealed mouth, the changes are minimal. Some people tend to view MSE as a transformational device that will all of a sudden provide them with model tier cheekbones, but the reality is far from it. In my case I am most happy about the lateral projection of the zygomatic process. Specially on my right side, my cheekbone was sunken, which caused the bitemporal width to be wider than the bizygomatic width. The change in my face silhouette looks something like this (poorly drawn but you get the idea):
View attachment 2395360
The midface has become a bit fuller, which is ideal in my case. Some people report ending up with a bigger nose. In my opinion this is probably the biggest looksmin associated with MSE. It tends to happen if you get significant amounts of anterior expansion. Ironically I had more anterior than posterior expansion as you can infer from taking a look at the before and after pictures below. However, my nose has remained almost the same, it is even hard for me to notice the difference. Maybe when the diastema was larger I got the feeling it had been widen a bit, but now it is imperceptible.
View attachment 2395318
I do not think MSE alone has the capability of ascending someone a ton. But on the other hand it can help indirectly at fixing some other things. For example, I have a quite extreme open bite, a very bad chin, and an exceedingly long lower third. Expanding with the MSE is the first step towards fixing my bite orthodontically. Then, if the orthodontist delivers on what he planned, he will be able to give me a nice occlusion. This will in turn bring the chin a bit forward and improve somewhat my gonial angle. (Disclaimer: I am not coping by saying orthodontics can fix my problems. I know for a fact I will need trimax. This was just an explanation on the slight improvements one could expect in such a situation).

When it comes into the smile, the change is quite noticeable. My arch is wider and as a consequence the buccal corridors are minimized. There are several aspects yet to be fixed, such as the canines given that they are interiorly inclined and taller than desired. I would say that being able to smile without sensing a feeling of inferiority due to the extremely narrow palate I had is alleviating.
View attachment 2395319
In terms of function, I can breathe much better during the night and wake up feeling more refreshed. It should also become easier to maintain proper tongue posture once the expander is removed.

So all in all I would recommend everyone with a narrow palate to get MSE but at the same time to remind them it will not ascend them hard.

Can u plz dm me the before/after photos change of lateral zygo contouring which u depicted with your drawing

 

[idkwhattoputhere]

Hi all, I think it is time to revive this thread with some results.

How it started:

View attachment 3319875

Current status:

View attachment 3319890
View attachment 3319893

Had I not found this place I would have never imagined these results. I am deeply grateful to all of you. Now onto planning the next procedure.

Spoiler: Tags

@Giorgio @NegativeNorwood @Yassin @Struggler03 @slop slinger @nobodyspecial369 @noprogressno @AscendingHero @malicieusss

Can I see the zygos?

 

[sensu]

why get a palate expander? they barley give aesthetic value

 

[Melly]

Can u plz dm me the before/after photos change of lateral zygo contouring which u depicted with your drawing

@NZb6Air Nga i was just curious i got your point

 

[jfbjfb]

why get a palate expander? they barley give aesthetic value

That is generally the case and in my experience it did not ascend me massively. However, I see it as a first step towards better planning for surgeries. Bear in mind I had a significant open bite that has been solved through orthodontics. It is now simple to assess if my chin, mandible and maxilla are recessed, and act based on it.

So in a sense, palatal expansion gives you a new baseline to build upon. I am quite sure most people are better off jumping straight into osteotomies + implants though

 

[Giorgio]

Do NOT get SARPE. SARPE makes a cut to where only the maxilla will expand and you get no benefits for cheekbones/zygos and undereye support.

that is entirely dependant on the individuals case
for many, additional facial width is undesirable

SARPE expands the whole midface just as any other bone-born palate expander, there is no way to prevent an expander from doing so (even if you decided you don't need wider midface & wanted just the palate)

 

[Doomer]

that is entirely dependant on the individuals case
for many, additional facial width is undesirable

SARPE expands the whole midface just as any other bone-born palate expander, there is no way to prevent an expander from doing so (even if you decided you don't need wider midface & wanted just the palate)

SARPE makes cuts so your cheekbones stay the same. There’s no benefit from that, only wider smile that’s it. MSE actually expands the entire midface and lifts up and widens the zygos for prominence.

 

[hasba1feuj]

did your nose became wider ? also you didnt have braces during this time ?

 

[jfbjfb]

did your nose became wider ? also you didnt have braces during this time ?

During the expansion process I could notice my nose becoming a bit wider, yes. However, once I finished with the expansion, the changes were imperceptible. Something similar occurred with the separation between the central incisors; a diastema was formed and it was gradually closed until you could only spot a very minor gap between the teeth.

I did not have braces during this process. Well, I did many years ago, but as part of this treatment we finished up with the alignment through invisalign. It also helped at dentally expanding the arch alongside SFOT and pushing the molars upwards through elastics and screws placed on my maxilla.

 

[hasba1feuj]

During the expansion process I could notice my nose becoming a bit wider, yes. However, once I finished with the expansion, the changes were imperceptible. Something similar occurred with the separation between the central incisors; a diastema was formed and it was gradually closed until you could only spot a very minor gap between the teeth.

I did not have braces during this process. Well, I did many years ago, but as part of this treatment we finished up with the alignment through invisalign. It also helped at dentally expanding the arch alongside SFOT and pushing the molars upwards through elastics and screws placed on my maxilla.

nice to hear that because i’m interested into having a palate expander but i dont want to wear braces cause i already worn them many years ago, thanks for the answer

 

[jfbjfb]

nice to hear that because i’m interested into having a palate expander but i dont want to wear braces cause i already worn them many years ago, thanks for the answer

No problem, best of luck with the process. Feel free to reach out for more details if necessary

 

[moze]

You could have done facemask with it