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Looking for Advice (MSE?)

9 Posts
5 Users
Posts: 1
Topic starter

Hi all, looking for some advice from knowledgeable folks.

The gist of the situation:

  • 27m
  • Narrow maxilla (30mm)
  • Hard to nose breathe (sucks for sports)
  • Hard to speak properly
  • Bad midface support
  • Always bags under eyes despite good sleep/lifestyle
  • Obvious malocclusion, hard to even be in resting position
  • Bad aesthetics + poor smile + general asymmetry in maxilla


  • No cheekbones
  • 20220613 011206
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Is there anything at this point that can help me in terms of both functional and aesthetic gains?

Is MSE worth it in my case? Is it something that can impact things significantly?

Many thanks for any advice.

Posted : 12/06/2022 7:41 pm
Posts: 1739

I’m glad I did it. Looks like you’d benefit to me. If your suture successfully split, you’d get a wider smile and more tongue space, with the risk of exacerbating asymmetries. Cheekbone and midface support changes are subtle.

Posted : 16/06/2022 9:10 pm
Posts: 1739

It also appears that your lower posterior teeth are lingually inclined (i.e. tilt in toward the tongue to meet your narrow upper arch). So you'd be able to expand your uppers far and still reestablish occlusion by uprighting the lowers. This is often the factor limiting expansion potential.

If it's impacting your nasal breathing and speech as you say, consider myofunctional therapy after expansion. They might advise a functional frenectomy to improve tongue mobility.

Posted : 18/06/2022 9:09 am
Posts: 10

I got MSE w/ surgical assist and had a bad outcome.  It did not help me functionally or aesthetically.


My advice would be to consult with a few of the best doctors you can who specialize in the airway.  It's much better to do your research and be diligent up front as opposed to going with one treatment with permanent irreversible effects that you regret later on (which is what happened to me).  

Posted : 30/07/2022 12:31 am
Posts: 110

@bdurwood  Just curious, could you elaborate on what it was about your procedure that didn't turn out well, functionally and aesthetically?

In my case, I did a very similar procedure (I still post about it often here; I'm still turning the screw every day for now), and am very pleased so far.  Before I did the procedure, I had practically no posterior (i.e. molar) occlusion, and had a "sunken-in" paranasal and upper lip appearance.

I suppose it depends on your jaw situation to begin with.  I needed a lot of transverse expansion, anterior movement, and was already pretty well counter-clockwise rotated

Posted : 02/08/2022 10:20 am
Posts: 110

@bdurwood Also, would you say that you had a Class I, II, or III occlusion to begin with?

Posted : 02/08/2022 7:34 pm
Posts: 10

@mr_man Yes, happy to elaborate.  Here's my story, summarized:

12 years ago I got a septorhinoplasty, which went well, but my breathing was still not that great.  1 year ago I got MSE w/surgical assist and disclosed the prior nasal surgery to my orthodontist and surgeon.  There were several complications from the MSE w/ surgical assist, which I am trying to fix now.  The complications include:

- An anterior open bite.  My bite is off and worse than before.  My orthodontist is trying to correct the issue using TADs and molar intrusion, but he thinks I may need double jaw surgery.  I now have a class 2 bite.  My bite was fine before this treatment.  

- Significant nasal damage.  My nose was perfectly fine before MSE w/ surgical assist, but now I have a badly deviated septum, displaced nasal spine, and damaged nasal valves.  It appears that my prior nose surgery made me more susceptible to nasal damage from MSE w/surgical assist.  I consulted with a doctor recently who criticized my surgeon for not releasing my septum from my nasal spine during the surgical assist to prevent nasal damage.  I will be getting a revision nose surgery soon.    

- My face is less symmetrical and wider than before, and I feel it's less aesthetic.  It looks worse.  

Overall, my experience has been a nightmare, and I feel my surgeon was incompetent.  I now likely have two very invasive surgeries ahead of me to try and correct this damage - double jaw surgery and revision nose surgery.

Happy to provide any other info that would be helpful.  

Posted : 02/08/2022 11:37 pm
Mr_Man and Mr_Man reacted
Posts: 17

@bdurwood Thank you for the information.

I am considering MSE myself in Europe. It seems there are quite a few complications possible.

Did you have surgical assist, and who was the orthodontist that you visited?

Thanks in advance.

Posted : 17/01/2023 3:26 pm
Posts: 17

@bdurwood Thank you for the information.

I am considering MSE myself in Europe. It seems there are quite a few complications possible.

Did you have surgical assist, and who was the orthodontist that you visited?

Thanks in advance.

Posted : 17/01/2023 3:26 pm
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