Jaw Surgery question, Sagittal split or FME

[MischlingTruecel]

I'm a 19 yo poorcel who needs trimax with impaction/ccw but my palate is fairly narrow. Is it possible/safe to get LF1 sag split WITH impaction/ccw or should I spend 1-2 yrs of my prime saving and expanding with a bone borne expander like FME before getting Trimax.

 

[Jgns]

bump

 

[Nifty]

I'm a 19 yo poorcel who needs trimax with impaction/ccw but my palate is fairly narrow. Is it possible/safe to get LF1 sag split WITH impaction/ccw or should I spend 1-2 yrs of my prime saving and expanding with a bone borne expander like FME before getting Trimax.

If its pretty narrow get the fme or marpe first. I did it that way and was worth it in the end. Aesthetically and functionally. Some Drs are transitioning to incorporating marpe over segmental for their surgeries.

I'm glad I chose to get the full treatment. Expensive as hell though and your just hyped the whole time waiting for surgery. But you could get some nice midface augmentation from the expander in the meantime. I did.

 

[MischlingTruecel]

If its pretty narrow get the fme or marpe first. I did it that way and was worth it in the end. Aesthetically and functionally. Some Drs are transitioning to incorporating marpe over segmental for their surgeries.

I'm glad I chose to get the full treatment. Expensive as hell though and your just hyped the whole time waiting for surgery. But you could get some nice midface augmentation from the expander in the meantime. I did.

Thanks, did u get marpe or FME? I've heard FME is significantly more expensive but ultimately worth it

 

[gravlek]

Thanks, did u get marpe or FME? I've heard FME is significantly more expensive but ultimately worth it

There are not many FME cases yet, keep that in mind. I’m also looking into FME and the main thing stopping me rn is the scarcity of data. Custom marpe just has an abundance of data over FME. Fme is looking very promising however

 

[Nifty]

Thanks, did u get marpe or FME? I've heard FME is significantly more expensive but ultimately worth it

I got custom marpe since my provider was more experienced with it and fme was still very new. He tried it during the initial phase.

Yes I hear good things from fme and underwhelming things as well. Its not an end all be all if you go custom marpe because even fme providers still use it and starting to use it more. It's case by case.

But I do urge you maybe get fme if you have tooth filler! Since custom marpe is usually anchored to the teeth and can cause teeth cracking when removing the arms. I didn't know about this but luckily my provider was very careful on removal.

Whether you get marpe or fme make sure your provider is very experienced with it.

 

[duduboy]

If its pretty narrow get the fme or marpe first. I did it that way and was worth it in the end. Aesthetically and functionally. Some Drs are transitioning to incorporating marpe over segmental for their surgeries.

I'm glad I chose to get the full treatment. Expensive as hell though and your just hyped the whole time waiting for surgery. But you could get some nice midface augmentation from the expander in the meantime. I did.

Can multi segment lefort be better?

 

[Nifty]

Can multi segment lefort be better?

From all the data marpe is better and because it expands higher than where the cuts of a segmental are giving better airway improvements and aesthetics. Its also more stable than segmental since its slow and gives soft tissues and bone time to stretch and adapt.

Some jaw surgeons are now opting for marpe over segmental. Its vital if you're a candidate.

 

[MischlingTruecel]

I got custom marpe since my provider was more experienced with it and fme was still very new. He tried it during the initial phase.

Yes I hear good things from fme and underwhelming things as well. Its not an end all be all if you go custom marpe because even fme providers still use it and starting to use it more. It's case by case.

But I do urge you maybe get fme if you have tooth filler! Since custom marpe is usually anchored to the teeth and can cause teeth cracking when removing the arms. I didn't know about this but luckily my provider was very careful on removal.

Whether you get marpe or fme make sure your provider is very experienced with it.

I live in NYC so I'll probably just go to Newaz or Jaffari for FME

 

[MischlingTruecel]

There are not many FME cases yet, keep that in mind. I’m also looking into FME and the main thing stopping me rn is the scarcity of data. Custom marpe just has an abundance of data over FME. Fme is looking very promising however

Main thing stopping me from getting FME is the price; I'm not sure how much custom marpe typically is

 

[Sicilian Cyclops]

There are not many FME cases yet, keep that in mind. I’m also looking into FME and the main thing stopping me rn is the scarcity of data. Custom marpe just has an abundance of data over FME. Fme is looking very promising however

Does fme widen the bizygo like with marpe? That’s one of the main reasons I’m cautious about doing it due to my low IPD

 

[gravlek]

Does fme widen the bizygo like with marpe? That’s one of the main reasons I’m cautious about doing it due to my low IPD

Again, a lot of the data on fme is self reported and still limited. So far it seems like it does widen the bizygo but with a more pronounced emphasis on forward growth rather than just lateral.

This shouldn’t have to be a problem if your other ratios are forgiving.

 

[gravlek]

Main thing stopping me from getting FME is the price; I'm not sure how much custom marpe typically is

The price of a custom marpe kinda depends on where you are in the world. Providers are abundant in let’s say North America, whereas they’re more limited in Europe. A custom marpe should realistically not run you more than 10k I believe

 

[MischlingTruecel]

The price of a custom marpe kinda depends on where you are in the world. Providers are abundant in let’s say North America, whereas they’re more limited in Europe. A custom marpe should realistically not run you more than 10k I believe

much cheaper than FME it seems, though I'm willing to pay for FME so long as I don't have to pay for most of it upfront, as I'd like to get it installed ASAP

 

[duduboy]

Does fme widen the bizygo like with marpe? That’s one of the main reasons I’m cautious about doing it due to my low IPD

https://looksmax.org/threads/another-fme-case-study-5mm-expansion-before-and-after.1995996/

take a look on this thread

 

[duduboy]

From all the data marpe is better and because it expands higher than where the cuts of a segmental are giving better airway improvements and aesthetics. Its also more stable than segmental since its slow and gives soft tissues and bone time to stretch and adapt.

Some jaw surgeons are now opting for marpe over segmental. Its vital if you're a candidate.

@monecel thoughts?

 

[monecel]

@monecel thoughts?

I've never seen a case of MARPE where the aesthetic result is very impressive, largely because the mandible is never expanded with it. You can get a higher cut segmented lefort depending on the height of your midface. The major benefit for segmented is the reduction in nasal expansion that you would get with a device, also you can avoid having the front teeth split if you get a 3-piece which is more ideal imo. For airway you are probably correct but I focus on aesthetics here

 

[gravlek]

much cheaper than FME it seems,

Absolutely, without a doubt. It’s an ancient compared to fme

though I'm willing to pay for FME so long as I don't have to pay for most of it upfront, as I'd like to get it installed ASAP

Don’t forget that you might need to travel frequently to America. Which can quickly add up over time. This is, if you don’t live in northern/southern America of course

 

[gravlek]

I've never seen a case of MARPE where the aesthetic result is very impressive, largely because the mandible is never expanded with it. You can get a higher cut segmented lefort depending on the height of your midface. The major benefit for segmented is the reduction in nasal expansion that you would get with a device, also you can avoid having the front teeth split if you get a 3-piece which is more ideal imo. For airway you are probably correct but I focus on aesthetics here

Whether you get FME or a custom marpe, you’ll most likely still need a jaw surgery afterwards regardless

 

[gravlek]

https://looksmax.org/threads/another-fme-case-study-5mm-expansion-before-and-after.1995996/

take a look on this thread

Who made this case study? Is it an independent one?