Marpe or djs? need advice

[bonesymmetry]

my orthodontist recommends custom marpe first, followed by braces and jaw surgery, stating expansion is necessary for my case.

however i also consulted a well known oral surgeon in the U.S., who said expansion isn’t needed and advised going straight to double jaw surgery.

i have two additional jaw surgery consultations scheduled next month, but in the meantime id like to hear your opinions on whether marpe first or straight to surgery would provide better aesthetic results.

 

[Herald420]

Consult with a couple more maxillofacial surgeons on their opinion. If you really needed expansion of the upper jaw you could just get a 3-piece upper jaw lefort 1 possibly? MARPE is better for expansion as they cut the upper pallet but 3 piece may work as well though its just he jaw bone and arch they expand. Depends on your case

 

[bonesymmetry]

Consult with a couple more maxillofacial surgeons on their opinion. If you really needed expansion of the upper jaw you could just get a 3-piece upper jaw lefort 1 possibly? MARPE is better for expansion as they cut the upper pallet but 3 piece may work as well though its just he jaw bone and arch they expand. Depends on your case

appreciate the input, from what i understand marpe targets true skeletal expansion at the palate, while a 3-piece lefort is more about arch form during surgery. i have 2 more maxillofacial consults scheduled so im hoping to get clarity on which approach makes more sense for my anatomy.
im not sure which would likely give me the better aesthetic result however

 

[Herald420]

Interesting, I might ask my orthodontist about MARPE. I doubt they would be willing to do it as my upper pallet is fine; I get my braces on in 2 weeks in prep for surgery.

Defo ask your surgeons on their opinion, probs better than the ortho

 

[bonesymmetry]

Interesting, I might ask my orthodontist about MARPE. I doubt they would be willing to do it as my upper pallet is fine; I get my braces on in 2 weeks in prep for surgery.

Defo ask your surgeons on their opinion, probs better than the ortho

it's worth a shot to hear what they say, but if your palate is good then it's most likely not necessary.
how long are u gonna have the braces on?

 

[Herald420]

I find out on the day of braces, I originally was told 2 months since my teeth are in good alignment but then was told between 6 - 9 months? I'm hoping for surgery as soon as possible October latest cause I want to do rhinoplasty as well and don't want to be chopped going into my late 20's

also MARPE, SARPE & 3 piece all seem to do the same thing it looks like though, MARPE is much better for mid-face expansion vs 3 piece which does do it but not much

 

[bonesymmetry]

i feel that bro. 6-9 months isnt long, you’ll be good. Hope ur surgery goes well.

Thats what intrigues me about marpe, i need some mid face expansion but i dont want it to looksmin me. i feel like everyone has different outcomes with it.

 

[Ascension75]

also MARPE, SARPE & 3 piece all seem to do the same thing it looks like though, MARPE is much better for mid-face expansion vs 3 piece which does do it but not much

I don't think a 3 piece lefort causes any midface expansion at all. Your maxilla gets cut off from the skull, expanded and glued back on, there is no force applied to widen the midface.

Results vary a lot unfortunately which makes the choice difficult. Is it better to invest one year of your time in Marpe to get some actual midface expansion but how much if any is questionable or just go to jaw surgery and expand the midface visually by malar implants?

 

[tyler1234]

Do marpe then djs

 

[bonesymmetry]

I don't think a 3 piece lefort causes any midface expansion at all. Your maxilla gets cut off from the skull, expanded and glued back on, there is no force applied to widen the midface.

Results vary a lot unfortunately which makes the choice difficult. Is it better to invest one year of your time in Marpe to get some actual midface expansion but how much if any is questionable or just go to jaw surgery and expand the midface visually by malar implants?

thats why im kind of leaning towards marpe first being a better option than a segmental le fort. it’ll suck if it creates asymmetry and having a gap for the next 8 months though.

implants on top of surgery is also an option as well. i would rather correct the underlying skeletal issues before implants tho

 

[Ascension75]

thats why im kind of leaning towards marpe first being a better option than a segmental le fort. it’ll suck if it creates asymmetry and having a gap for the next 8 months though.

implants on top of surgery is also an option as well. i would rather correct the underlying skeletal issues before implants tho

Marpe Widens nose though so there is that

 

[bonesymmetry]

Marpe Widens nose though so there is that

I’m not too worried about that ill be getting a rhinoplasty eventually

 

[Herald420]

I don't think a 3 piece lefort causes any midface expansion at all. Your maxilla gets cut off from the skull, expanded and glued back on, there is no force applied to widen the midface.

Results vary a lot unfortunately which makes the choice difficult. Is it better to invest one year of your time in Marpe to get some actual midface expansion but how much if any is questionable or just go to jaw surgery and expand the midface visually by malar implants?

Doing some research you are right. Kinda sucks though because 3 piece lefort only expands of the height of the lefort cut so you will get some expansion of the mid face but it will not be noticeable.

I really don't want to do MARPE then wait longer to do Jaw Surgery. I'm already unattractive and extending it just makes it worse. I also have a wide palate as well so I don't even know if MARPE is worth it.