My MARPE Before and After - Stronger/Higher Cheekbones and Upturned Orbitals

ActualMax

ActualMax

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Ask me anything.

Nasal breathing gains are the best part.

IMO, MARPE/FME should be the first step on anyone's surgical journey. :D
 
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I have wide palate already. Do i need it?
 
Have your eyes changed somehow?
Did your upper lip get wider?
 
Dathomirian Zabrak said:
I have wide palate already. Do i need it?
Click to expand...
Feel free to DM me your palate/face and I can recommend treatment or not.
sigmamogger said:
Has your mouth become any wider?
Click to expand...
Yes, mouth is 5mm wider, lips are slightly wider.
zaebalsya said:
Have your eyes changed somehow?
Did your upper lip get wider?
Click to expand...
Yes, eyes look better, upper lip slightly wider.
Codeinlover said:
How many tads
Click to expand...
6 TADs.
Napoleon1800 said:
What does MARPE mean
Click to expand...
Miniscrew assisted rapid palatal expansion.
 
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will get sarpe this summer bro :) excited asf
 
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zaebalsya said:
will get sarpe this summer bro :) excited asf
Click to expand...
Grats man. Just watch out, SARPE won't get you cheekbone gains or nearly as much nasal breathing gains. Have you tried expanding without surgical assist yet?
 
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ActualMax said:
Grats man. Just watch out, SARPE won't get you cheekbone gains or nearly as much nasal breathing gains. Have you tried expanding without surgical assist yet?
Click to expand...
oh, but whats the difference between sarpe and marpe
 
zaebalsya said:
oh, but whats the difference between sarpe and marpe
Click to expand...
SARPE involves surgical cuts that literally detach the palate from the rest of the maxilla and zygomas for less resistance while expanding. Give it a google, you can see the difference in midfacial changes.
 
ActualMax said:
SARPE involves surgical cuts that literally detach the palate from the rest of the maxilla and zygomas for less resistance while expanding. Give it a google, you can see the difference in midfacial changes.
Click to expand...
Can you check dm please
 
Codeinlover said:
@RealSurgerymax
Click to expand...

I agree if patient has time. Previously added +1year to treatment plan.
I am working on a MARPE-to-Bimax in 3-4 months protocol. I thought of a way to probably pull it off.

Now we are using custom MARPE - no MSE or FME. MSE is so 2020, and we did maybe 20 of them. FME unfortunately hit the market too late - next to custom marpe they are obsolete - Custom mogs every time. Not to mention it costs as much as a custom MARPE or even more. I could see FME being the superior option over MSE-II for budget patients who cant afford custom MARPE but I dont see why anyone would choose a none custom for more money.

Our custom MARPE uses the Tiger screw ($100 last time I checked), design $1500, Custom Fabrication $2000. 4 x MSE Screws (we still use MSE TADS) $200. Total $3,800 (Device Only)

Last I heard FME costs over $4K. Someone correct me if im wrong because it makes no sense to me.

Type II MSE costs $385

KLS Martin Rotterdam expander is also several thousand dollars, also never used anymore. I believe this is the fate of FME unless they abandon the version they have and go fully custom.
 
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RealSurgerymax said:
I agree if patient has time. Previously added +1year to treatment plan.
I am working on a MARPE-to-Bimax in 3-4 months protocol. I thought of a way to probably pull it off.

Now we are using custom MARPE - no MSE or FME. MSE is so 2020, and we did maybe 20 of them. FME unfortunately hit the market too late - next to custom marpe they are obsolete - Custom mogs every time. Not to mention it costs as much as a custom MARPE or even more. I could see FME being the superior option over MSE-II for budget patients who cant afford custom MARPE but I dont see why anyone would choose a none custom for more money.

Our custom MARPE uses the Tiger screw ($100 last time I checked), design $1500, Custom Fabrication $2000. 4 x MSE Screws (we still use MSE TADS) $200. Total $3,800 (Device Only)

Last I heard FME costs over $4K. Someone correct me if im wrong because it makes no sense to me.

Type II MSE costs $385

KLS Martin Rotterdam expander is also several thousand dollars, also never used anymore. I believe this is the fate of FME unless they abandon the version they have and go fully custom.
Click to expand...
Sounds great. I could envision a protocol where after expanding to desired width, you go in and insert a plate that bridges both halves of the maxilla at the time of the bimax. Then remove the device from the roof of the mouth as it is no longer needed for consolidation.

With that being said, all teeth will be in difficult positions at the time of bimax as a result of the expansion, so I assume that would make the procedure/bite a bit more tricky, but not impossible.
 
ActualMax said:
Sounds great. I could envision a protocol where after expanding to desired width, you go in and insert a plate that bridges both halves of the maxilla at the time of the bimax. Then remove the device from the roof of the mouth as it is no longer needed for consolidation.

With that being said, all teeth will be in difficult positions at the time of bimax as a result of the expansion, so I assume that would make the procedure/bite a bit more tricky, but not impossible.
Click to expand...
The main limiting factor is LF1 Screws not being between tooth roots that still need to move orthodontically. Possible in most cases I think - using custom planning, custom guides, and custom plates.

Orginially I thought to leave the MARPE in, but maybe an infection & blood supply risk. Probably place a bonded retainer between molars (no anterior teeth.)
 
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RealSurgerymax said:
The main limiting factor is LF1 Screws not being between tooth roots that still need to move orthodontically. Possible in most cases I think - using custom planning, custom guides, and custom plates.

Orginially I thought to leave the MARPE in, but maybe an infection & blood supply risk. Probably place a bonded retainer between molars (no anterior teeth.)
Click to expand...
Very interesting.

I've also always been curious about tricks to get purely posterior expansion (one of the main criticisms of MARPE/MSE/FME is that it gives unnatural expansion in the front).

What if you cut the midpalatal suture from ANS to PNS then placed a plate at the front of the maxilla that bridges the two halves.

With the plate in, expansion in the front can't occur, and as you turn the back would widen.

Would be very curious to see how it would turn out.

Also, any plans to work with U.S. surgeons more in the future?
 
isn't the only way for palate expansion for adults is surgery ?
 
RealSurgerymax said:
The main limiting factor is LF1 Screws not being between tooth roots that still need to move orthodontically. Possible in most cases I think - using custom planning, custom guides, and custom plates.

Orginially I thought to leave the MARPE in, but maybe an infection & blood supply risk. Probably place a bonded retainer between molars (no anterior teeth.)
Click to expand...
What about EASE?
 
zaebalsya said:
What about EASE?
Click to expand...
EASE isn't a device its the release procedure.

We dont do endoscopic we do oral and this is our pattern: Palatal midline osteotomy, Septal release from nasal floor, Pteygoid Osteotomies. That's it.
 
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ActualMax said:
Feel free to DM me your palate/face and I can recommend treatment or not.

Yes, mouth is 5mm wider, lips are slightly wider.

Yes, eyes look better, upper lip slightly wider.

6 TADs.

Miniscrew assisted rapid palatal expansion.
Click to expand...
Can I dm you my face/palate
 
I don’t understand, how do you know if you will benefit from MARPE?
 
Aqualad said:
I don’t understand, how do you know if you will benefit from MARPE?
Click to expand...
MARPE widens/lengthens the face. So if you already have an overly long or wide face, you probably want to be careful.

You also need to make sure that your mandible is wide enough to support such expansion. Otherwise you will permanently ruin your bite and face.
Ogionth said:
Can we see the facial before and afters :)
Click to expand...
Unfortunately, keeping my identity private. Sorry about that! (y)
 
ActualMax said:
Unfortunately, keeping my identity private. Sorry about that! (y)
Click to expand...
That'd have helped w the results alot because bone change results can be found quite alot on the internet but the face itself, quite rare.

I can understand your concern tho, would be some what safe in pms but ig you'd not want yo
 
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ActualMax said:
Feel free to DM me your palate/face and I can recommend treatment or not.

Yes, mouth is 5mm wider, lips are slightly wider.

Yes, eyes look better, upper lip slightly wider.

6 TADs.

Miniscrew assisted rapid palatal expansion.
Click to expand...
1745713076138


Do you think I should get MARPE? I plan on getting Invisalign to fix the gap + unevenness

I plan on getting jaw surgery + implants in the future hopefully in the next 5 years
 
UrGirlsMcm said:
View attachment 3682808

Do you think I should get MARPE? I plan on getting Invisalign to fix the gap + unevenness

I plan on getting jaw surgery + implants in the future hopefully in the next 5 years
Click to expand...
Yeah, you could probably due with a bit of expansion to fix ur buccal corridors. All expansion is limited by the width of your mandible, so if you feel like you have some room to expand, then go for it.
 
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RealSurgerymax said:
I agree if patient has time. Previously added +1year to treatment plan.
I am working on a MARPE-to-Bimax in 3-4 months protocol. I thought of a way to probably pull it off.

Now we are using custom MARPE - no MSE or FME. MSE is so 2020, and we did maybe 20 of them. FME unfortunately hit the market too late - next to custom marpe they are obsolete - Custom mogs every time. Not to mention it costs as much as a custom MARPE or even more. I could see FME being the superior option over MSE-II for budget patients who cant afford custom MARPE but I dont see why anyone would choose a none custom for more money.

Our custom MARPE uses the Tiger screw ($100 last time I checked), design $1500, Custom Fabrication $2000. 4 x MSE Screws (we still use MSE TADS) $200. Total $3,800 (Device Only)

Last I heard FME costs over $4K. Someone correct me if im wrong because it makes no sense to me.

Type II MSE costs $385

KLS Martin Rotterdam expander is also several thousand dollars, also never used anymore. I believe this is the fate of FME unless they abandon the version they have and go fully custom.
Click to expand...
I heard mse and all other types of expanders will cause the face to lengthen slightly, meanwhile FME and a few custom MARPES will cause it to shift up slightly. Does your custom MARPE cause the face to shift up slightly too? Also, how is the nose widening, zygo widening, and asymmetry?
 
DonaldJTrump said:
I heard mse and all other types of expanders will cause the face to lengthen slightly, meanwhile FME and a few custom MARPES will cause it to shift up slightly. Does your custom MARPE cause the face to shift up slightly too? Also, how is the nose widening, zygo widening, and asymmetry?
Click to expand...
Face definitely shifted up, definitely lengthened a bit as well, it expands in all directions.

Nose widening for me wasn't noticeable at all, but my nasal breathing is wayyy better.

Zygo widening happened for sure.

No noticeable asymmetry caused by the expander. (y)
 
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ActualMax said:
MARPE widens/lengthens the face. So if you already have an overly long or wide face, you probably want to be careful.

You also need to make sure that your mandible is wide enough to support such expansion. Otherwise you will permanently ruin your bite and face.

Unfortunately, keeping my identity private. Sorry about that! (y)
Click to expand...
i understand how it could widen but how could it lengthen?
 
Sicilian Cyclops said:
i understand how it could widen but how could it lengthen?
Click to expand...
When you expand, the maxilla halves don't just go perfectly side to side, they rotate a bit. With this in mind, the center of that rotation goes down while the edges (the cheekbones/orbitals as shown above) rotate upward.

Hope that makes sense.
 
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DonaldJTrump said:
I heard mse and all other types of expanders will cause the face to lengthen slightly, meanwhile FME and a few custom MARPES will cause it to shift up slightly. Does your custom MARPE cause the face to shift up slightly too? Also, how is the nose widening, zygo widening, and asymmetry?
Click to expand...
The type of expander makes no difference for that. Gimmick to claim otherwise.

The main difference is higher success rate of splitting, with minor differences in parallel expansion, and dental tipping. Custom MARPE is the best for all of these factors.
 
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ActualMax said:
Face definitely shifted up, definitely lengthened a bit as well, it expands in all directions.

Nose widening for me wasn't noticeable at all, but my nasal breathing is wayyy better.

Zygo widening happened for sure.

No noticeable asymmetry caused by the expander. (y)
Click to expand...
Think its worth it for me? I have long midface and very narrow skull, def my hugest failo and wouldnt wanna risk any further lengthening at all but RealSurgerymax says lengthening is only 1mm or less and the zygo widening easily balances it out.

Curious what you think?

Also, do you think 4-6mm expansion is ideal for keeping facial harmony but also getting breathing gains? You think you overall objectively look worse or better now? Even if just a tiny bit worse or better, be honest.
 
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Did anything change in FWHR?
 
DonaldJTrump said:
Think its worth it for me? I have long midface and very narrow skull, def my hugest failo and wouldnt wanna risk any further lengthening at all but RealSurgerymax says lengthening is only 1mm or less and the zygo widening easily balances it out.

Curious what you think?

Also, do you think 4-6mm expansion is ideal for keeping facial harmony but also getting breathing gains? You think you overall objectively look worse or better now? Even if just a tiny bit worse or better, be honest.
Click to expand...
Yes, I had a long narrow skull too and it definitely made it wider/balanced everything out more. I would look into it and go for it. (y)
slice said:
Did you notice any difference in symmetry? Your face seems to be a bit more symmetrical
Click to expand...
I agree! I think it got more symmetrical. Once I get my invisalign buttons completely removed in about a month, I'm gonna do another scan and overlay to see my results.
devonhendryx999 said:
Did anything change in FWHR?
Click to expand...
Yes, while height increased ever so slightly, my FWHR definitely went up.
 
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If I'm still growing, would you say RPE is worth it? Do you sleep better, what changes did you notice
 
RoadToLowMTN said:
If I'm still growing, would you say RPE is worth it? Do you sleep better, what changes did you notice
Click to expand...
Yes, go for it, but consult with a good orthodontist that knows their shit about expansion in young people.

I sleep better for sure.

Breathe through my nose the whole night and just feel 20% calmer throughout the day because I have more oxygen.
 
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