Regarding corticopuncture during MSE

[spark]

I am aware of how common MSE failures are even with midpalatal corticopuncture. I also know that orthos often opt for DOME which I would refuse for obvious reasons. Is it possible to just weaken another suture like the pterygomaxillary suture with puncture? Afaik releasing that even helps with the forward movement that can be obtained via bamp/fm?

@Sergio-OMS
@RealSurgerymax

 

[RealSurgerymax]

I am aware of how common MSE failures are even with midpalatal corticopuncture. I also know that orthos often opt for DOME which I would refuse for obvious reasons. Is it possible to just weaken another suture like the pterygomaxillary suture with puncture? Afaik releasing that even helps with the forward movement that can be obtained via bamp/fm?

@Sergio-OMS
@RealSurgerymax

There is no cortipuncturing that area no it could be very dangerous to try.

I have seen undeniable face widening in people who got DOME.

 

[spark]

There is no cortipuncturing that area no it could be very dangerous to try.

I have seen undeniable face widening in people who got DOME.

the le fort cut destroys the upper maxillary widening which for me is absolutely key

There must be some way of causing more suture weakening without going all the way with DOME. I thought some mild chiseling or drilling into the pterygoma could help with an MSE release but maybe I am saying nonsense.

 

[MSEFM]

the le fort cut destroys the upper maxillary widening which for me is absolutely key

View attachment 1096398


There must be some way of causing more suture weakening without going all the way with DOME. I thought some mild chiseling or drilling into the pterygoma could help with an MSE release but maybe I am saying nonsense.

You could consider the EASE procedure. I think it involves cuts to the pterygomaxillary junction (in addition to the midpalatal suture) but not the zygomatic buttress. Although it is exclusively an airway treatment and isn't expected to give noticeable aesthetic changes. Cutting the pterygomaxillary junction must be done in hospital because of the bleeding risk.

 

[RealSurgerymax]

the le fort cut destroys the upper maxillary widening which for me is absolutely key

View attachment 1096398


There must be some way of causing more suture weakening without going all the way with DOME. I thought some mild chiseling or drilling into the pterygoma could help with an MSE release but maybe I am saying nonsense.

Its not a LeFort cut and it isnt all the way through the bone

 

[spark]

Its not a LeFort cut and it isnt all the way through the bone

Sure but you get me right? I want my undereyes to be improved. DOME is unacceptable.

 

[RealSurgerymax]

Sure but you get me right? I want my undereyes to be improved. DOME is unacceptable.

One of the most undeniable midface MSE Transformations I have ever seen got DOME

 

[ChristianChad]

The MARPE expansion pattern is very atypical of MARPE. Usually it's a cone shaped expansion pattern. Do you know the context for that MARPE patient?

:/ image is from here but the full text isn't available https://doi.org/10.1007/978-3-030-24413-2_6 how'd you even find this image lol.

 

[Deleted member 20631]

Why are you so against getting DOME? What are the negatives of getting it.

 

[mvp2v1]

Why are you so against getting DOME? What are the negatives of getting it.

Do u even know what it is? Your separating the upper maxilla from the lower so your expansion won’t do anything for cheekbones eyes etc.

 

[Deleted member 20631]

Do u even know what it is? Your separating the upper maxilla from the lower so your expansion won’t do anything for cheekbones eyes etc.

So what's the ideal expansion method? genuinely curious I just want to find the best way to expand my narrow ass palate.

 

[mvp2v1]

So what's the ideal expansion method? genuinely curious I just want to find the best way to expand my narrow ass palate.

Not enough data to say what is best imo. Bioblock and MSE or EASE these are "safer" in that you know roughly what to expect. Nothing stands out right now as a the best palatal expansion technique and device. As for what Im doing: since im over 20 im going with MSE in a slow expansion pattern with plenty of chewing.

 

[Deleted member 20631]

Not enough data to say what is best imo. Bioblock and MSE or EASE these are "safer" in that you know roughly what to expect. Nothing stands out right now as a the best palatal expansion technique and device. As for what Im doing: since im over 20 im going with MSE in a slow expansion pattern with plenty of chewing.

That's what I plan to do as well, I was interested in EASE but it's only provided in the US and the price for that shit is too insane. I'm most likely going to get surgically assisted MSE and just moderately expand so I don't end up expanding one side way too much and just end up fucking myself over with asymmetry.

 

[ChristianChad]

That's what I plan to do as well, I was interested in EASE but it's only provided in the US and the price for that shit is too insane. I'm most likely going to get surgically assisted MSE and just moderately expand so I don't end up expanding one side way too much and just end up fucking myself over with asymmetry.

EASE is available for 5K Euro in Germany, not sure if it's good quality and done properly or not though.
Also if you have sleep apnea you could maybe get EASE partially covered in the US by insurance

If MSE fails next logical step would be some type of SARPE probably, though I haven't researched different SARPE types too much so I don't know.