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https://facesurgeon.in/what-is-anterior-maxillary-distraction-or-amd/
Apparently, there now exists a way to expand the upper jaw forward, rather than moving it forward, similar to MSE w/ surgical assist but in the anterior/posterior dimension. It should be much cheaper and less involved (perhaps just a simple office procedure like I did with the surgical assist for MARPE) than a LeFort I. It's just a question now of which providers will offer such. I think it will be tremendously useful. The link has a good video involving the young man that had it done in India.
It appears that the surgical cut is approximately between the premolars and first molar, so everything in front of that would expand forward