MSE to fix cheeckbone assymmetry

[IcePretty]

Spoiler: Neat Version by gpt

Issue


I have a noticeably asymmetrical palate. My left side is more developed, while my right side is narrower/underdeveloped. This seems to translate into facial asymmetry as well.

• The left cheekbone (strong side) is more projected.
• The right cheekbone (weak side) appears slightly recessed/inward.
• I estimate around 3–5 mm difference compared to a balanced state.

Additionally, I don’t have enough space for my canine on the weaker (right) side. About a year ago, an orthodontist recommended a palatal expander, but I ignored it at the time. Now I’m considering MSE (Maxillary Skeletal Expander).


I also have recessed infra-orbitals and dark circles, which might be related to midface structure.


Important note:
The asymmetry is mainly visible from the front in the cheekbone/midface region.


I actually decided to take this seriously after family members pointed out that my cheekbones looked unbalanced.

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Possible Solutions (My Current Plan)


1. Slightly Off-Center MSE Placement


My idea is to place the MSE slightly closer to the weaker (right) side.


Example concept:

• Current palate width: *EXAMPLE* 24 mm vs 20 mm
• If the MSE is placed closer to the 20 mm side, theoretically it could apply more expansion force to the weaker side

Potential result:

• Left side → ~26 mm
• Right side → ~25 mm

Even 1–2 mm asymmetry would be basically unnoticeable, so this would be a big improvement.


We would also do slow expansion to allow the bones to adapt gradually and minimize the risk of creating new asymmetries.

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2. Elastics to Control Expansion


Another idea is using elastics to slightly slow expansion on the stronger side.


I’ve also read multiple cases where, when the expander is placed properly, the less developed side often expands more naturally than the stronger side.

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Why I Think This Might Work


My facial asymmetry appears to come almost entirely from the palate, not from the mandible or jaw.


Also, several people told me that once the canine is properly aligned and space is created, the cheekbone asymmetry could improve significantly.


So I'm wondering:

• Could the impacted/misaligned canine be contributing to the midface asymmetry?
• If the canine is corrected and the palate expanded, could this largely resolve the cheekbone imbalance?

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Additional Context

• Sutures should still be open (I'm relatively young).
• I experimented with intense mewing (about 1 hour daily focusing on palate pressure).
• I noticed growth on the stronger (left) side, but I struggle to place my tongue properly on the right side, which may reflect the palate asymmetry.

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Questions

1. Is MSE the best approach here, or are there better options except surgery?
2. Could this asymmetry be mostly caused by the canine crowding, meaning fixing the canine might improve things significantly?
3. Has anyone seen cheekbone asymmetry improve after asymmetric palate expansion?
4. Are there ways to guide expansion more toward the weaker side besides off-center placement?

My main goals:

• Create space for the canine
• Achieve better cheekbone symmetry
  Fix recessed infra orbitals

Is there any better option than MSE or surgery in my case?


I’m also wondering if this could mainly be caused by the canine crowding itself. If that’s the case, would it make sense to first try creating space and aligning the canine and see if the asymmetry improves?


Also, should I post my full treatment plan here for feedback, or would that be unnecessary?


Another thing I’ve been considering is using a face-pull device (reverse headgear) to potentially encourage forward maxillary growth alongside expansion

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Relevant Posts on MSE


Month 5 MSE Progress



MSE Before / After



Cheekbone Expansion With MSE

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Tagging some people from my old account who might have insight:
@asdvek
@Amnesia
@Ghost
@Philosophy
@Lmao
@FastBananaCEO
@FatJattMofo

Raw
Issue:
I have an assymetrical palate, my left side is well grown then right, which shows assymmetry on cheekbones too. Cheekbone on well-developed side are kinda popped out and on the other hand, a little inward grown. I would say there's a solid 3-5mm recession to perfect or un-noticable asymetry. I also don't have enough space for my canine on weaker ( right side ). doctor recommended me an expander about year ago- I ignored it but now im going for an MSE.
2) recessed infra-orbitals-dark circles
Possible Solutions:
1) Applying MSE a little closer to my right (weaker side) might result in a stronger push to that side, like if my palate is 24mm - 20mm and we apply MSE closer to 20mm side, there is a good possibility that it would give more pressure to weaker side and hence almost balance out both to 26mm - 25mm (1-2mm asym is fine n un-noti). We'll be going for slow expansion so that bones could get enough time to move and avoid any further assymetries
2) Applying elastics to slow down expansion on stronger side, also many people say that its pretty common that a well placed expander would push less-developed side more then well developed
My assymmetry is totally from an assymmetrical palate, so it might be successful
any other idea? main goal is to fit canine and get cheekbone symmetry. I asked a couple of peopl and almost everyone said that This assymmetry would vanish once I get canine fit it.
Note that this cheekbone assymetry is noticable when seen from the front, jaw etc are perfectly symmetrical but only the cheekbones. I decided to take action after my family pointed out that my cheekbones were looking unbalanced
Sutures are still open, I did some real hard mewing on palate everyday for an hour straight and noticed growth on left (well dvlpd) side, I can't really place my tongue easily on right(weaker side)
Is there any better option rather then MSE or surgery? I mean what if its all because of my canine? should I give it a go? Also should I put my whole plan here? I might also consider facepull device for forward maxilary growth
Facial ratios:
sry, i didn't calculate my ratios but Cheekbones are a few mm narrower then jaw 1-3mm (except right cheekbone - more inward grown) normal/narrow forehead
Some good reddit posts about MSE



Tagging some people from my old account who might have insight:
asdvek Amnesia Ghost Philosophy Lmao FastBananaCEO FatJattMofo

 

[IcePretty]

The expansion would be of maximum 6-8mm maximum and I think 6mm exp on my zygos would look nice as it would make em little wider then jaw

 

[correction]

this is tricky there is a high risk of assymetrical expansion as you cant really predict how the appliance could potentially reposition itself, we have seen this multiple times even with people who have symmetrical palates ending up with assymetry, as to results of expansion itself it usually is less then what people make it out to be unless you are very deficient in the midface before starting expansion, but hey if u have the money its worth a try i guess

 

[IcePretty]

Main thing is that my canine doesn't have space in the palate and expanding palate just to fit in that tooth might fix my assymmetry. Also, what're your thoughts on using elastics? Or planting it closer to weaker side and expanding very slowly

this is tricky there is a high risk of assymetrical expansion as you cant really predict how the appliance could potentially reposition itself, we have seen this multiple times even with people who have symmetrical palates ending up with assymetry, as to results of expansion itself it usually is less then what people make it out to be unless you are very deficient in the midface before starting expansion, but hey if u have the money its worth a try i guess

 

[correction]

Main thing is that my canine doesn't have space in the palate and expanding palate just to fit in that tooth might fix my assymmetry. Also, what're your thoughts on using elastics? Or planting it closer to weaker side and expanding very slowly

slow expansion would be the best route tbh, and elastics are decent but without retention that tooth will just snap back right into place the expansion itself will most likely fix that issue anyways, do u have a crossbite? if not you will need to tip your lower teeth to match your bite after expansion

 

[IcePretty]

slow expansion would be the best route tbh, and elastics are decent but without retention that tooth will just snap back right into place the expansion itself will most likely fix that issue anyways, do u have a crossbite? if not you will need to tip your lower teeth to match your bite after expansion

I used to have braces when i was 14, so no cross bite dental issues, only canine's problematic here. Honestly brah, tipping doesn't bother me that much as soon as MSE fixes my assymmetry and gives slight growth to both cheekbones

 

[correction]

I used to have braces when i was 14, so no cross bite dental issues, only canine's problematic here. Honestly brah, tipping doesn't bother me that much as soon as MSE fixes my assymmetry and gives slight growth to both cheekbones

how come they didnt fix the canine when you had the braces? or did they and u didnt wear the retainer (dont worry i havent worn mine either lol)

 

[IcePretty]

how come they didnt fix the canine when you had the braces? or did they and u didnt wear the retainer (dont worry i havent worn mine either lol)

So my case was like bef braces, I had fckng 0 space for canine, but after adjusting we came to this result, where we got half space for canine but to really bring it down my dentist said that an expander is a must and idk if it was a good choice or not, but i rejected it and closed my case.
He did give me a retainer and I also didn't wear it hahahahaha, its still in my drawer. I was able to maintain my results simply by mewing

 

[correction]

So my case was like bef braces, I had fckng 0 space for canine, but after adjusting we came to this result, where we got half space for canine but to really bring it down my dentist said that an expander is a must and idk if it was a good choice or not, but i rejected it and closed my case.
He did give me a retainer and I also didn't wear it hahahahaha, its still in my drawer. I was able to maintain my results simply by mewing

yeah a expander is def neccesary then tbh anything else will be a waste of time
ive never had a narrow palate or issues with space but my palate is quite high vaulted due to sucking my thumb when i was younger i should honestly have way more issues than i do but i discovered proper toungue posture when i was 13 so 6 years ago when astrosky was popular so that kinda saved me

 

[IcePretty]

yeah a expander is def neccesary then tbh anything else will be a waste of time
ive never had a narrow palate or issues with space but my palate is quite high vaulted due to sucking my thumb when i was younger i should honestly have way more issues than i do but i discovered proper toungue posture when i was 13 so 6 years ago when astrosky was popular so that kinda saved me

W
My right side is pretty great ngl, I just want left to be balanced and a few mm more.
I think placing it closer to weaker side can reduce asymmetry to some point, like from 5mm asym to 1-2mm which won't be noticeable. Wdya think?

 

[correction]

i also have some cheekbone assymetry but mine is more from my sphenoid being retarded (i think)

i think placing it closer to the weak side is a good concept but i would def consult with a ortho just to be sure

 

[IcePretty]

Sphenoid being retarded, wha?
I see, for me tho I can feel the difference in sides of my palate bcz its typically hard to place tongue on right side.
Yea even gpt recommended me this mse placement idea

 

[IcePretty]

Bump

 

[Krosk]

Bump

honestly i went to get mse it was 7k+ ur better off saving for better roi surgery's

 

[IcePretty]

honestly i went to get mse it was 7k+ ur better off saving for better roi surgery's

It depends, MSE is way cheaper then surgery here.

 

[Krosk]

It depends, MSE is way cheaper then surgery here.

Yeah, ofc, for example, good surgeons will do double-jaw surgeries and other high-ROI surgeries for around 2-3x the price of MSE. MSE + braces will take around 19 months, while surgery will take 2-3 months to heal fully.

 

[IcePretty]

Yeah, ofc, for example, good surgeons will do double-jaw surgeries and other high-ROI surgeries for around 2-3x the price of MSE. MSE + braces will take around 19 months, while surgery will take 2-3 months to heal fully.

Really? What surgeries do you recommend - fix cheekbone asym, upper eye expo, infra orb, forward growth of maxilla.
For surgeries, I wouldn't be able to go for it until 2-3 years so I think MSE would be a better option for now. Wt do yu think?

 

[Krosk]

Really? What surgeries do you recommend - fix cheekbone asym, upper eye expo, infra orb, forward growth of maxilla.
For surgeries, I wouldn't be able to go for it until 2-3 years so I think MSE would be a better option for now. Wt do yu think?

im 14 so i still got A bit to go until i can consider surgery.i personally decided to forget about mse and focus on pharmacology

 

[IcePretty]

Bump.