How does EASE compare to MSE?

[mvp2v1]

EASE – Sleep Apnea Surgery Center

How does EASE compare to MSE when it comes to aesthetic improvement?

 

[Deleted member 19157]

 

[Silver]

It basically guarantees a parallel split between the ANS and PNS and you don't end up with a cone shaped expansion pattern that often occurs in MSE patients. The parallel split is essential for breathing gains and I'd like to think that it's essential for aesthetic gains too if that's your approach. Example of cone shaped split that occurs in MSE patients where they see gains in the ANS but none in the PNS as it barely splits.

The device which is used in EASE patients, the KLS Martin (RPE), is installed high up on your palate and its arms only pushes your maxilla outwards, it has no dental stabilization unlike the MSE which has their molar bands. This is good as you won't fuck up your alveolar bone due to the device extruding the force into your teeth as it sometimes happens with MSE, this is also the reason as to why SARPE and MSE patients often see a bigger diastema than those who undergo EASE and who have true maxillary expansion.

The downside is that Kasey Li in the U.S is basically the only one who consistenly performs this surgery and installation so he basically knows the ins and outs and the do's and don'ts and Kasey Li is expensive af.

 

[mvp2v1]

It basically guarantees a parallel split between the ANS and PNS and you don't end up with a cone shaped expansion pattern that often occurs in MSE patients. The parallel split is essential for breathing gains and I'd like to think that it's essential for aesthetic gains too if that's your approach. Example of cone shaped split that occurs in MSE patients where they see gains in the ANS but none in the PNS as it barely splits.
View attachment 1686108

The device which is used in EASE patients, the KLS Martin (RPE), is installed high up on your palate and its arms only pushes your maxilla outwards, it has no dental stabilization unlike the MSE which has their molar bands. This is good as you won't fuck up your alveolar bone due to the device extruding the force into your teeth as it sometimes happens with MSE, this is also the reason as to why SARPE and MSE patients often see a bigger diastema than those who undergo EASE and who have true maxillary expansion.

The downside is that Kasey Li in the U.S is basically the only one who consistenly performs this surgery and installation so he basically knows the ins and outs and the do's and don'ts and Kasey Li is expensive af.

Can I do MSE+FM more than once?

Is it possible to do 2 rounds of MSE+FM (assume the first was successful). My goal would be to get that bit more of cheekbone expansion as well as more forward growth. My maxilla is currently quite undersized, but perhaps not to a severe degree. (I do have quite bad breathing issues and sleep...

looksmax.org

Would the new MSE solve this expansion issue?

Splitting the suture first/weakening it could perhaps also solve this issue?

 

[Silver]

Can I do MSE+FM more than once?

Is it possible to do 2 rounds of MSE+FM (assume the first was successful). My goal would be to get that bit more of cheekbone expansion as well as more forward growth. My maxilla is currently quite undersized, but perhaps not to a severe degree. (I do have quite bad breathing issues and sleep...

looksmax.org

Would the new MSE solve this expansion issue?

I'm no expansion expert, by reading that short description of the "new" MSE the only change is that there won't be any molar bands and they will add another 2 screws to it which alot of people already have tried variants of, I've also seen 8 screws. Personally I think it's cope and it won't guarantee no parallel expansion of the ANS and PNS unlike EASE which over and over produces big breathing gains cause of its expansion pattern. I think it also depends on how the screws are installed, whether it's bicortical or unicortical penetration.

My personal take on MSE is that's missing some type of mass that pushes directly at either side of the MPS and directly onto the palate to try and split it and push it out laterally. This is what the MSE looks like once it's installed without molar bands,

Here's what it looks like when installed on the palate,

It's lacking "mass" or "plates" to apply force to the bone, I don't think screws are enough. Where I've drawn on the picture is where I personally think it's lacking, it needs something to push the maxilla in addition to the weak screws which everyone has so much trust in.

Here's the power expander which has those "plates/arms (whatever)" that I'm trying to refer to which I believe are the cause for good lateral expansion between the ANS and the PNS, I have marked what the MSE is missing.

Here's the RPE from KLS,

Both the power expander and the RPE have that additional "mass" or the additional "plates" that I think are crucial for good expansion.

Splitting the suture first/weakening it could perhaps also solve this issue?

Splitting the suture should help, this is done when installing the EASE with Kasey Li. The midpalatal suture is split with a piezoelectric blade. Usually these days surgeons are using corticopuncture to weaken the MPS and they cope with believing that the MSE will take care of the rest .

Kasey Li also seperates the pterygomaxillary sutures by using the piezoelectric saw but I don't personally know how that contributes to the expansion pattern, I haven't read enough into it but I believe it has to do with that it acts as a point of resistance.

 

[mvp2v1]

I'm no expansion expert, by reading that short description of the "new" MSE the only change is that there won't be any molar bands and they will add another 2 screws to it which alot of people already have tried variants of, I've also seen 8 screws. Personally I think it's cope and it won't guarantee no parallel expansion of the ANS and PNS unlike EASE which over and over produces big breathing gains cause of its expansion pattern. I think it also depends on how the screws are installed, whether it's bicortical or unicortical penetration.

My personal take on MSE is that's missing some type of mass that pushes directly at either side of the MPS and directly onto the palate to try and split it and push it out laterally. This is what the MSE looks like once it's installed without molar bands,
View attachment 1686217
Here's what it looks like when installed on the palate,
View attachment 1686224
It's lacking "mass" or "plates" to apply force to the bone, I don't think screws are enough. Where I've drawn on the picture is where I personally think it's lacking, it needs something to push the maxilla in addition to the weak screws which everyone has so much trust in.

Here's the power expander which has those "plates/arms (whatever)" that I'm trying to refer to which I believe are the cause for good lateral expansion between the ANS and the PNS, I have marked what the MSE is missing.
View attachment 1686244

Here's the RPE from KLS,
View attachment 1686245

Both the power expander and the RPE have that additional "mass" or the additional "plates" that I think are crucial for good expansion.


Splitting the suture should help, this is done when installing the EASE with Kasey Li. The midpalatal suture is split with a piezoelectric blade. Usually these days surgeons are using corticopuncture to weaken the MPS and they cope with believing that the MSE will take care of the rest .

Kasey Li also seperates the pterygomaxillary sutures by using the piezoelectric saw but I don't personally know how that contributes to the expansion pattern, I haven't read enough into it but I believe it has to do with that it acts as a point of resistance.

Thanks for sharing. if I'm not mistaken, no forward growth is possible with the current EASE?

 

[Silver]

Thanks for sharing. if I'm not mistaken, no forward growth is possible with the current EASE?

EASE by itself will never give you any forward growth, neither will MSE. It is only in combination with facemask that you can possibly get minimal advancement of the maxilla.

The only reason why facemask is used with MSE is because MSE has the possibility to seperate the pterygomaxillary sutures which act as a point of resistance at the back of the maxilla. This is how facemask sometimes manages to provide 2-3mm of forward growth in the maxilla after the person has undergone MSE.

As EASE involves splitting the pterygomaxillary sutures surgically the facemask theory should be possible but every person is different and there are WAY MORE sutures in the maxilla that could hinder any facemask progress. Best and most safe bet is and will always be Le Fort 1-3.

 

[mvp2v1]

EASE by itself will never give you any forward growth, neither will MSE. It is only in combination with facemask that you can possibly get minimal advancement of the maxilla.

The only reason why facemask is used with MSE is because MSE has the possibility to seperate the pterygomaxillary sutures which act as a point of resistance at the back of the maxilla. This is how facemask sometimes manages to provide 2-3mm of forward growth in the maxilla after the person has undergone MSE.

As EASE involves splitting the pterygomaxillary sutures surgically the facemask theory should be possible but every person is different and there are WAY MORE sutures in the maxilla that could hinder any facemask progress. Best and most safe bet is and will always be Le Fort 1-3.

Safe?

 

[Silver]

Safe?

Le Fort 1 - Safe, shouldn't have mentioned Le Fort 2 and 3.

 

[Tasty17]

Probably much better to do EASE because it not only splits the ANS but also the PNS, thus you achieve symmetric expansion.

MSE is only capable of splitting the ANS, giving you an asymmetrical cone-shaped split. This makes expanding with MSE inefficient, asymmetric and not fully skeletal (only about 50%) while EASE is almost 100% skeletal.

More about it here:

 

[PURE ARYAN GENETICS]

literally only one person in the whole world huh?