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

[repulse]

View attachment 3673105

Ask me anything.

Nasal breathing gains are the best part.

IMO, MARPE/FME should be the first step on anyone's surgical journey.

Is this like actual surgery or just expander ?

 

[ActualMax]

Nice! What are your thoughts about getting an expander when you already have a wider face but a narrow palate?

Good in moderation. You want to stay within the 4-6mm range of expansion.

Will also really help with nasal breathing and smile width, which is a bonus. Feel free to DM me your face/scans and I can help you out.

Is this like actual surgery or just expander ?

Just expander.

 

[RoadToLowMTN]

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.

The only thing left is convince the ortho to give me RPE instead of cucking me with braces

 

[HorseMan7]

IMO, MARPE/FME should be the first step on anyone's surgical journey.

I disagree. If nasal breathing and zygomatic width are already good, what's the point? Segmental lefort could be better for some people. Also, why not do SARPE instead if you are going for skeletal expansion? Isn't that more precise?

 

[ActualMax]

I disagree. If nasal breathing and zygomatic width are already good, what's the point? Segmental lefort could be better for some people. Also, why not do SARPE instead if you are going for skeletal expansion? Isn't that more precise?

Most people that have recessed maxilla/mandible etc. probably have it as a result of poor nasal breathing over time. Even those that feel like their nasal breathing is good will see benefit.

A good rule of thumb is to look at your mandible in relation to your maxilla. You want your maxilla to be around 5mm wider than your mandible. If it's not, expansion can help you have a better bite.

At the end of the day, it helps a TON with your face's function.

Sure, if your nasal breathing is already PERFECT, then go with segmental if that's what works for you and your doctor.

 

[HorseMan7]

Most people that have recessed maxilla/mandible etc. probably have it as a result of poor nasal breathing over time. Even those that feel like their nasal breathing is good will see benefit.

A good rule of thumb is to look at your mandible in relation to your maxilla. You want your maxilla to be around 5mm wider than your mandible. If it's not, expansion can help you have a better bite.

At the end of the day, it helps a TON with your face's function.

Sure, if your nasal breathing is already PERFECT, then go with segmental if that's what works for you and your doctor.

Your first point on the cause of recession is debatable. I'm not really convinced, but that's besides the point.

Segmental improves nasal breathing too. And I think you have to consider the aesthetic side effects of MARPE vs segmental. If your mid face width is already where it's supposed to be, expansion can make you look like a balloon. Plus, MARPE will create a gap. When you pull your incisors in to close that gap, your teeth move backwards. That's an aesthetic compromise. It's a functional compromise because your lips lose support. The other issue is maybe you are narrower towards the posterior of your palate. In that case, segmental might be the better option. Marpe will give the most expansion towards the anterior. Maybe it's worth it for some people, but not for all.

 

[ActualMax]

Your first point on the cause of recession is debatable. I'm not really convinced, but that's besides the point.

Segmental improves nasal breathing too. And I think you have to consider the aesthetic side effects of MARPE vs segmental. If your mid face width is already where it's supposed to be, expansion can make you look like a balloon. Plus, MARPE will create a gap. When you pull your incisors in to close that gap, your teeth move backwards. That's an aesthetic compromise. It's a functional compromise because your lips lose support. The other issue is maybe you are narrower towards the posterior of your palate. In that case, segmental might be the better option. Marpe will give the most expansion towards the anterior. Maybe it's worth it for some people, but not for all.

I agree, MARPE is a tool to accomplish certain things and a segmental is another tool. It depends on what you want.

In terms of nasal breathing gains, MARPE is significantly superior in increasing nasal volume.

 

[Elijah_leo]

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.

How to know if mandible is wide enough for expansion? I have crowding in the lower jaw buy that's due to the fact the upper jaw is a bit narrow so the lower jaw didn't get full expansion, so what can be done in this case?

 

[ActualMax]

How to know if mandible is wide enough for expansion? I have crowding in the lower jaw buy that's due to the fact the upper jaw is a bit narrow so the lower jaw didn't get full expansion, so what can be done in this case?

Go to an orthodontist and you can ask them for an opinion.

Also, feel free to send me some pics and I can take a look.

 

[hungrythanos414]

View attachment 3673105

Ask me anything.

Nasal breathing gains are the best part.

IMO, MARPE/FME should be the first step on anyone's surgical journey.

wait ur orbitals got wider?

 

[ActualMax]

wait ur orbitals got wider?

yes

 

[HorseMan7]

I agree, MARPE is a tool to accomplish certain things and a segmental is another tool. It depends on what you want.

In terms of nasal breathing gains, MARPE is significantly superior in increasing nasal volume.

True

 

[hungrythanos414]

yes

how at 25? thats crazy bro wtf are u larping

 

[ActualMax]

how at 25? thats crazy bro wtf are u larping

easy at 25 tbh with custom marpe, didn't even have surgical assist, no larp here brother

 

[adam_ross2549]

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.

if you widen your upper jaw what happens to the lower jaw?

 

[ActualMax]

if you widen your upper jaw what happens to the lower jaw?

If you want the bite to line up, you have to tilt the lower jaw teeth outward to accompany the expansion of the upper jaw to maintain a good bite. Orthodontics are required.

 

[dages]

View attachment 3673105

Ask me anything.

Nasal breathing gains are the best part.

IMO, MARPE/FME should be the first step on anyone's surgical journey.

Face pics?

 

[adam_ross2549]

If you want the bite to line up, you have to tilt the lower jaw teeth outward to accompany the expansion of the upper jaw to maintain a good bite. Orthodontics are required.

whats the difference between doing this and having a segmental lefort done

 

[normie tiktoker]

For anyone here under 45mm maxilla this is practically mandatory.

But I have a question @ActualMax, did you see mandibular gains? Or symmetry gains? Thanks

 

[slice]

Good in moderation. You want to stay within the 4-6mm range of expansion.

Will also really help with nasal breathing and smile width, which is a bonus. Feel free to DM me your face/scans and I can help you out.

thanks, I DMed you

 

[moze]

Dont listen to giant he is saying custom marpe is better than fme just coz he is doing it.i have many scans i can show the differences if you want

 

[moze]

Dont listen to giant he is saying custom marpe is better than fme just coz he is doing it.i have many scans i can show the differences if you want

@RealSurgerymax Also i dont know why you are doing it.coz skeletal expanders are looksmin most of the time unless its too narrow.if you are doinng it for breathing benefits its fine but dont say that you are doing it for looksmax

 

[ActualMax]

For anyone here under 45mm maxilla this is practically mandatory.

But I have a question @ActualMax, did you see mandibular gains? Or symmetry gains? Thanks

No mandiublar gains, slightly more symmetry.

whats the difference between doing this and having a segmental lefort done

Tons, it expands the entire midface as opposed to just the maxilla the Lefort 1 level.

Dont listen to giant he is saying custom marpe is better than fme just coz he is doing it.i have many scans i can show the differences if you want

Interested in seeing them!

 

[RealSurgerymax]

@RealSurgerymax Also i dont know why you are doing it.coz skeletal expanders are looksmin most of the time unless its too narrow.if you are doinng it for breathing benefits its fine but dont say that you are doing it for looksmax

1. They aren't a looksmin most of the time as a first step before bimax
2. Nothing remodels/opens the nasal passages like SA-MARPE
3. Some people need to generate new bone to de-crowd their teeth
4. More stable than segmental LF1

 

[RealSurgerymax]

Dont listen to giant he is saying custom marpe is better than fme just coz he is doing it.i have many scans i can show the differences if you want

Retard logic.
I do it because its better.
I know the FME people well. I can order it and use it easily if I thought it was better.
Custom MARPE is obviously better if you spend 1 minute thinking about it.
Look at Marriana Evans results.

@ActualMax

 

[ActualMax]

Retard logic.
I do it because its better.
I know the FME people well. I can order it and use it easily if I thought it was better.
Custom MARPE is obviously better if you spend 1 minute thinking about it.
Look at Marriana Evans results.

@ActualMax

Yeah, I agree.

I feel like the only "advantage" I hear about is the lack of rotational expansion that occurs with FME, but I honestly dgaf about that because rotational expansion helps with so many things like upturning the cheekbones/orbitals, but nobody talks about that.

Regardless, the fact that there are people that have been postponing treatment for literally years to be a guinea pig for FME just baffles me.

Also curious about your opinions on hydroxyapatite implants (Gunson, etc.)

Hate how unpredictable they are and their lack of pre-operative customizability, but do you think there's a world where we could make molds to craft the hydroxyapatite implant to the exact shape we want? (Still tough though, because I've heard they shrink about 30% over time.)

Definitely looking to get cheekbone implants in the future, but have always wanted to explore hydroxyapatite more as it is more "native" to the body.

 

[ActualMax]

Retard logic.
I do it because its better.
I know the FME people well. I can order it and use it easily if I thought it was better.
Custom MARPE is obviously better if you spend 1 minute thinking about it.
Look at Marriana Evans results.

@ActualMax

Also, I think you got me mixed up with the other guy haha

 

[alexias]

how old are you at the time of the surgery?

 

[ActualMax]

how old are you at the time of the surgery?

25, no surgery, just skeletal expander.

 

[HerpDerpson]

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)

Hi. So can you perform MARPE on an adult patient with fused bones? I was under the impression that only SARPE is usable in such cases. I'm mainly interested in nasal expansion, so SARPE would be useless for me.

 

[RealSurgerymax]

Hi. So can you perform MARPE on an adult patient with fused bones? I was under the impression that only SARPE is usable in such cases. I'm mainly interested in nasal expansion, so SARPE would be useless for me.

Yes because we always use surgical assist.
We will NEVER do non-SA or with Cortipuncture anymore. Youre not flying all the way to istanbul for a 25-50% chance of not splitting.
We do not use a SARPE pattern. I designed the pattern for maximal midface and nasal airway expansion with minimal nasal widening:

• A-Point to PNS - SUBSPINAL (ANS is not included) to avoid columella widening (which happens in other Surgical Assist patterns and Non Surgical Assist Expansion)
• Nasal Septum separated from nasal floor so it doesnt asymmetrically get dragged to one side during expansion
• Pterygoid Osteotomies
• 

 

[adam_ross2549]

No mandiublar gains, slightly more symmetry.

Tons, it expands the entire midface as opposed to just the maxilla the Lefort 1 level.

Interested in seeing them!

is it as predictable as a segmental lefort? can it cause assymetrys

 

[imnotincelcore]

I am working on a MARPE-to-Bimax in 3-4 months protocol. I thought of a way to probably pull it off.

Sound very interesting. When performing MARPE on a patient, you do or your partners perform regular check ups for assymetry in Istanbul? Of course, nothing should go wrong, but I'd rather be sure than sorry. My main concern with MARPE in another country is the check ups. Finding a dentist with a CBCT machine that is willing and managing communication between the different parties. At that point, travelling to Istanbul every few weeks for 3-4 months seems more convinient if you are from Europe or Middle East.

 

[bp_]

Yes because we always use surgical assist.
We will NEVER do non-SA or with Cortipuncture anymore. Youre not flying all the way to istanbul for a 25-50% chance of not splitting.
We do not use a SARPE pattern. I designed the pattern for maximal midface and nasal airway expansion with minimal nasal widening:

• A-Point to PNS - SUBSPINAL (ANS is not included) to avoid columella widening (which happens in other Surgical Assist patterns and Non Surgical Assist Expansion)
• Nasal Septum separated from nasal floor so it doesnt asymmetrically get dragged to one side during expansion
• Pterygoid Osteotomies
• 

I have narrow upper jaw and lower jaw if I got expander for my upper jaw and it has expand what about my lower is there anything I can do to expand it ?

 

[RealSurgerymax]

Sound very interesting. When performing MARPE on a patient, you do or your partners perform regular check ups for assymetry in Istanbul? Of course, nothing should go wrong, but I'd rather be sure than sorry. My main concern with MARPE in another country is the check ups. Finding a dentist with a CBCT machine that is willing and managing communication between the different parties. At that point, travelling to Istanbul every few weeks for 3-4 months seems more convinient if you are from Europe or Middle East.

Im sorry what do you think this is? A retail store? A restaurant? This is surgery. Of course things can go wrong.

However in the case of MARPE yes the expansion only takes 2-3 weeks and you need to stay for the whole time. We will bring you to the office every 3rd day and do panoram/cbct. If anything is expanding asymmetrically then we decide to either abandon the treatment or continue and plan a later corrective surgery. Weakening other areas of the bones with additional osteotomies may also be a potential salvage procedure to continue expansion.

You will leave after full expansion and leave the expander in for the consolidation phase.