TomoIsLearning
BoneMaxisFun
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- Mar 25, 2026
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I keep seeing posts where guys get MSE, split the suture, expand 5-6mm, and then come out looking worse. Cheeks look flatter. Eyes look more hollow. They don't understand what happened because the internet told them MSE was free forward growth and zygomatic width gains.
Turns out the anatomy here is more complicated than the forum bro let on.
What actually happens when MSE expands
The standard forum take is: MSE splits the midpalatal suture, disarticulates the circummaxillary sutures, and gives you wider cheekbones plus forward growth with facemask. And yeah, that can happen. But the direction and magnitude of that movement depends entirely on where your sutures release and how the bone rotates.
When MSE expands, your cheekbones don't just move sideways. They rotate. The center of that rotation is near your temple, around the zygomatic-sphenoid junction. So when the expander turns, the lower part of your cheek swings outward, but the upper part near your eyes moves differently.
Why this sometimes flatten the midface
Here's the mechanism that screws guys over.
If your cheekbones were already your best feature, the outward rotation can actually reduce how much they project forward. You might gain width but lose the "high cheekbone" look from the front.
The area under your eyes is another problem. That region doesn't always get the same outward movement as the lower cheek. So if you already had some hollowness there, MSE can make it worse. Your infraorbital rim stays recessed while your lower cheek moves out, creating a disharmony.
Some guys also get asymmetry. The split isn't always even. One side expands more than the other, or the rotation happens differently left vs. right. If you already had facial asymmetry starting out, MSE can amplifyit
Who's most at risk for this
Based on forum logs and talking to guys who've been through it, certain guys are more likely to get unfavorable results:
Guys with already prominent cheekbones
If your zygomas were a strong point, the rotation can kill your anterior projection. You end up with wider but flatter cheeks.
Guy with pre existing infraorbital hollownes
If your under-eye area is already recessed, MSE won't fix it and can make it look more obvious because the lower cheek moves out while the upper stays put.
Guys with asymmetry starting out
If one side of your face is already different from the other, the expansion often follows that asymmetry rather than correcting it.
Guys over 25 (it's over)
The older you are, the harder it is to get clean suture separation. The bones resist more, so the movement becomes less predictable. More chance of uneven expansion or rotation that doesn't follow the ideal path in short it over just rope.
How to figure of you an good candidate
Before dropping $5-10k on MSE, do this:
Check your current cheekbone projection
Take a side profile photo. Look at how far your cheekbone sticks out forward relative to your eye. If it's already flat, MSE isn't going to give you projection—it might even reduce what you have.
Feel your infraorbital rim
Run your finger along the bone under your eye, from inner corner outward. Is it sharp and projecting forward? Or flat and recessed? If it's flat, you need to know that MSE won't fix this. Some guys end up needing infraorbital implants after expansion to restore what got lost.
Look for asymmetry
Take a straight-on photo. Are your eyes level? Is your jaw centered? If you've got existing asymmetry, ask your orthodontist specifically how MSE will affect it. If they say "it'll fix itself," that's a red flag.
Ask about facemask timing
If you're doing facemask with MSE, the timing matters. Starting facemask too early or too late changes how the midface moves. Some protocols get forward growth. Others get downward rotation that makes your face look longer. Ask your orthodontist exactly when they plan to start facemask and why.
What to do if you already got hollowed
If you're post-MSE and noticing flattening or hollowing, here's what guys are doing:
Filler to the infraorbital rim and zygomatic arch
Temporary but effective. HA filler can restore projection. Costs $800-1500 per session. Lasts 6-18 months. Risk of migration if overdone or placed wrong.
Fat grafting
More permanent than filler. Results depend heavily on surgeon skill. Some guys get great results. Others end up with lumps or reabsorption. Cost $3-5k. Need someone who specializes in facial fat grafting, not a general plastic surgeon.
Infraorbital rim implants
If the hollowing is severe, custom implants can restore the orbital vector. Cost $8-12k. Names: Eppley, Taban, Ramieri.
Malar implants
If the flattening is the main issue, custom cheek implants can add back projection. Same surgeon list.
The annoying part is you're basically paying twice once for expansion, again to
fix what it did.
Bottom rock
MSE can work. But it's not a magic bullet. The rotation pattern is real. Your cheekbones don't just move sidewaysthey pivot around a point near your temple. Depending on your starting anatomy, that rotation can flatten your cheeks, hollow your under-eyes, or both.
If you're considering MSE, get a CBCT. Find an orthodontist who's done hundreds of these, not tens. Ask the hard questions. And be honest about whether you're chasing width or projection because you might only get one
Turns out the anatomy here is more complicated than the forum bro let on.
What actually happens when MSE expands
The standard forum take is: MSE splits the midpalatal suture, disarticulates the circummaxillary sutures, and gives you wider cheekbones plus forward growth with facemask. And yeah, that can happen. But the direction and magnitude of that movement depends entirely on where your sutures release and how the bone rotates.
When MSE expands, your cheekbones don't just move sideways. They rotate. The center of that rotation is near your temple, around the zygomatic-sphenoid junction. So when the expander turns, the lower part of your cheek swings outward, but the upper part near your eyes moves differently.
Why this sometimes flatten the midface
Here's the mechanism that screws guys over.
If your cheekbones were already your best feature, the outward rotation can actually reduce how much they project forward. You might gain width but lose the "high cheekbone" look from the front.
The area under your eyes is another problem. That region doesn't always get the same outward movement as the lower cheek. So if you already had some hollowness there, MSE can make it worse. Your infraorbital rim stays recessed while your lower cheek moves out, creating a disharmony.
Some guys also get asymmetry. The split isn't always even. One side expands more than the other, or the rotation happens differently left vs. right. If you already had facial asymmetry starting out, MSE can amplifyit
Who's most at risk for this
Based on forum logs and talking to guys who've been through it, certain guys are more likely to get unfavorable results:
Guys with already prominent cheekbones
If your zygomas were a strong point, the rotation can kill your anterior projection. You end up with wider but flatter cheeks.
Guy with pre existing infraorbital hollownes
If your under-eye area is already recessed, MSE won't fix it and can make it look more obvious because the lower cheek moves out while the upper stays put.
Guys with asymmetry starting out
If one side of your face is already different from the other, the expansion often follows that asymmetry rather than correcting it.
Guys over 25 (it's over)
The older you are, the harder it is to get clean suture separation. The bones resist more, so the movement becomes less predictable. More chance of uneven expansion or rotation that doesn't follow the ideal path in short it over just rope.
How to figure of you an good candidate
Before dropping $5-10k on MSE, do this:
Check your current cheekbone projection
Take a side profile photo. Look at how far your cheekbone sticks out forward relative to your eye. If it's already flat, MSE isn't going to give you projection—it might even reduce what you have.
Feel your infraorbital rim
Run your finger along the bone under your eye, from inner corner outward. Is it sharp and projecting forward? Or flat and recessed? If it's flat, you need to know that MSE won't fix this. Some guys end up needing infraorbital implants after expansion to restore what got lost.
Look for asymmetry
Take a straight-on photo. Are your eyes level? Is your jaw centered? If you've got existing asymmetry, ask your orthodontist specifically how MSE will affect it. If they say "it'll fix itself," that's a red flag.
Ask about facemask timing
If you're doing facemask with MSE, the timing matters. Starting facemask too early or too late changes how the midface moves. Some protocols get forward growth. Others get downward rotation that makes your face look longer. Ask your orthodontist exactly when they plan to start facemask and why.
What to do if you already got hollowed
If you're post-MSE and noticing flattening or hollowing, here's what guys are doing:
Filler to the infraorbital rim and zygomatic arch
Temporary but effective. HA filler can restore projection. Costs $800-1500 per session. Lasts 6-18 months. Risk of migration if overdone or placed wrong.
Fat grafting
More permanent than filler. Results depend heavily on surgeon skill. Some guys get great results. Others end up with lumps or reabsorption. Cost $3-5k. Need someone who specializes in facial fat grafting, not a general plastic surgeon.
Infraorbital rim implants
If the hollowing is severe, custom implants can restore the orbital vector. Cost $8-12k. Names: Eppley, Taban, Ramieri.
Malar implants
If the flattening is the main issue, custom cheek implants can add back projection. Same surgeon list.
The annoying part is you're basically paying twice once for expansion, again to
fix what it did.
Bottom rock
MSE can work. But it's not a magic bullet. The rotation pattern is real. Your cheekbones don't just move sidewaysthey pivot around a point near your temple. Depending on your starting anatomy, that rotation can flatten your cheeks, hollow your under-eyes, or both.
If you're considering MSE, get a CBCT. Find an orthodontist who's done hundreds of these, not tens. Ask the hard questions. And be honest about whether you're chasing width or projection because you might only get one
