Has MARPE (MSE / SRAPE) just become a meme in 2026?

[Room 1408]

My original plan was running MSE or SRAPE as a base before going for a Bimax + custom implants, thinking it would create a better skeletal foundation. But looking at the asymmetry risks, cost, and time investment, the ROI feels terrible for an adult.
Now I’m leaning towards just letting Le Fort I / Sagittal movements fix my smile width/show.
Can custom implants and Le Fort I completely fix the asymmetry caused by MSE anyway? Or is the hassle of fixing expansion-induced asymmetry just not worth it? Is the ROI ever there for an adult, or are we just coping?

 

[Room 1408]

Bump

 

[Room 1408]

I've noticed several discussions about why maxillofacial surgeons generally dislike MSE.
It highly comes down to the fact that MSE-induced structural asymmetry compromises surgical predictability. For most patients here with a narrow vault, top-tier surgeons usually employ other expansion modalities.
MSE appears to be primarily indicated for adult patients with refractory obstructive sleep apnea and severe airway resistance.