surgically assisted rapid palatal exp...

surgically assisted rapid palatal expansion SARPE

Posted in the Orthodontics Forum

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#1 Aug 23, 2007
Me teeth are straight but I'd like them expanded. An orthodontist said SARPE would expand them but make the front teeth move backwards. He showed me a wire shaped like teeth and when he widened it the front did move back. Does this always happed? I'd obviously have to get the lower ones done to match, but he said SARPE can't be used for this and the teeth would simply be tilted outwards. Is this true? I wouldn't want that or the uppers moved backwards. Is there another answer? Ta ta for any advice.

United States

#2 Jan 25, 2009
Hi, did you finally figure out the answer? If so, please let me know. Thanks.
do not do it

United States

#3 Jan 25, 2009
Jim wrote:
Hi, did you finally figure out the answer? If so, please let me know. Thanks.
I had this procedure done and I did NOT like the outcome. I wish to GOd I had never done such a thing. And to think I did it out of pure vanity to look BETTER. It didn't make me look better, made look different. I would give everything I own to have my old face back. It's been almost 20 years now, and I still cry about it sometimes.
Be happy with your palate. It makes YOU uniquely YOU
It will not only push your teeth back it'll change your cheeks/eyes/nose. Basically the center of your face.

United States

#4 Jan 26, 2009
Thank you for the answer. I have a cross-bite, but it isn't that bad, I definitely do not want to go through surgery, I think I might have a tooth extracted to solve the problem.

United States

#5 Jan 26, 2009

I would like to thank you once again, I feel touched by your answer and I pray. I think there is too much pressure with perfection, I agree with you and sincerely appreciate your honest answer.

United States

#6 Jan 30, 2009
Jim wrote:
I would like to thank you once again, I feel touched by your answer and I pray. I think there is too much pressure with perfection, I agree with you and sincerely appreciate your honest answer.
You are so very welcome. Yes, I think there is pressure when you venture into improving your looks with orthodontics. Not because of you so much, but because the ortho himself/herself PUTS the pressure on you because they want to do it THEIR way. You walk in thinking "Hey, lets fix my teeth!" They come up with this grand plan, surgery and all, and suddenly you may feel out of control.

This surgery will put you through weeks and months of a healing process. And the outcome, I honestly think does NOT give you the look you're after. You want to fix your TEETH. They want to fix your FACE because it helps them to achieve what they were taught.

But they CAN fix/help your cross bite using orthodontics only, it's just more difficult for THEM.

Even removing a tooth may not be necessary. They wanted to do that to me as well, prior to surgery but I said no. And boy am I glad I didn't.

You really can get the fix you desire by orthodontics only, and zero tooth extraction. They just have to agree to it, and go forth with what YOU want. They'll do it, too. If I could do it all over again, I myself would've been the boss - they're MY teeth! And WE are paying THEM! Keep that in mind.
Just tell them up front you want to know everything they are wanting to achieve every step of the way. And if you don't feel you like that, say something. You might walk away as "the difficult patient" but they'll respect you for that, and you'll like your look better.

My regular dentist today knows my problem with SARPE. He said he never recommends it for any patient that doesn't have a facial deformity where it would definitely IMPROVE their look.

Truly, I firmly believe our palettes define a God-given look to our face. It really does make you unique.

I do not look 'bad' but I did lose a particular feature of my face that I liked. I've noticed this in the before and after pictures of people I've seen on the internet. There hasn't been ONE picture I've ever seen where I can say WOW! that definitely helped that person. Other types of jaw surgery may have that effect, but not SARPE.

Well, I'm so glad to have been able to help you.

May you be blessed with a lovely outcome. I wish you well.

Hilliard, OH

#7 Feb 8, 2009
I'm currently 1 month out of SAPRE and while my cheeks and upper lip have gained more fulness, i haven't noticed any change to the center of my face. I had teeth removed during the surgery, 4 to be exact. I will also have my upper jaw repositioned in 6-9 months.
This is my second round with braces. I was told by my orthodontist that I would have to have all of this done if I wanted it done the right way. However, he told me that I could go through treatment without surgery of any kind but results wouldn't be as desired and I still would have to have teeth removed.
I'm sorry in your case that your unhappy but that was 20 years ago. The procedure has changed a bit since then.
While there are days that I feel I shouldn't have done it, it's mainly because of a gap that has occured inbetween my front teeth. Every thing will turn out fine, and I'll have a beautiful smile afterwards.

Cuttingsville, VT

#8 Mar 9, 2009
I will be having SARPE, and although late, I HAD to add this comment! SARPE is typically NOT a decision most people make based on looks, b/c you're right- "straight" appearing teeth CAN be achieved a number of ways & without surgery! However I have chosen to have the surgery (despite the fact that I'm terrified) for SEVERAL MEDICAL reasons.
I need SARPE b/c my pallette is too narrow (as is the problem with ANYONE having SARPE), and it's intruding upon my sinus cavity, and I can barely breathe through my nose. It's been this way since I was a teen & I thought this was how everyone breathed! B/c of this issue, I sleep with my mouth open- making my teeth more vulnerable to cavities since they dry & the saliva isn't protecting them like it should. I also am begining to develop TMJ, b/c of my bad bite. ADDITIONALLY, as you age, if your bite doesn't meet like it should you're teeth can fracture from the stress of the teeth hitting at the wrong points.
Also, my top teeth are EXTREMELY crowded (I have a tooth on the ROOF of my mouth b/c that was the only place it had room to go). There is simply NO WHERE for the teeth to go w/out widening the top jaw to create more room. My other option is to pull teeth to make room, but this would lead to a "sunkin in" look over time as you age.
While I do not like the idea of changing my face, with the quirks that I love, it's a risk I have to take to protect my dental health & experience normal breathing. I've seen hundreds of before and after pics & think the changes are quite minute (probably dramatic to the "owner" of the face I imagine) to others, and I haven't seen ONE result that didn't end up more aesthetically appealing. I view the facial symettry & balance as an added BONUS to a surgery that I must have for various medical reasons.
I think SARPE should not be done SOLELY for appearance (nor do I know of ANYONE who did it for this reason alone), but only when needed to protect dental health and/or improve quality of life (by giving the sinus cavity the appropriate amount of room).
This is just my opinion, of course, and I agree with itsuptoyou's comment...yours WAS 20 years ago- medical technology has changed TREMENDOUSLY in 20 years:)

Orlando, FL

#9 Apr 1, 2009
Does SARPE make you lose gums or the gums inbetween the teeth? I think the gums are more important than teeth in aesthetics.


#10 Apr 13, 2009
I have been searching for sites about SARPE being carried out in the UK, and I have to say results are extremely far nothing! Can anyone tell me if it's actually performed in the UK? I'm guessing yes since ladyluck is in the UK. But my dentist who's also an ortho is cluuuuueless. And if it is done somewhere here then where/ which hospital? Give me a link please please please.:o}

Holbrook, NY

#11 Apr 21, 2009
I'm considering SARPE for my mouth. I was born with a cleft lip and palate and have a very narrow palate. I've also run into trouble with two of my teeth that were crowned together. I've decided to do the palate expander, braces, and a bone graft. But because of medical insurance issues I need to wait until next year to do this.

Melbourne, Australia

#12 Apr 21, 2009
The problem I have with sapre is that a large percentage of the expension is acheive by dipping of the teeth, which will simply move back over time once the expander is removed. You should discuss with your doctor whether they have considered ways to maximise the expansion in the palate, and reduce tooth dipping
amanda Portwood

United States

#13 May 4, 2009
My ten year old daughter has the palatal expander and has had it for two weeks now. She has had trouble with her sinus's every since. Runny nose, I wanted to know if anyone else who has a platal expander has had the same problem.

Sudbury, Canada

#14 Aug 26, 2009
Hi, I am going in for a RPE or SHRPE in a few weeks. I Have braces and an expension device. The baces caused a gap between my front teeth that will only get bigger after surgury haha. After this I will have to turn the device to help expand my palate and then have another surgery to set back my jaw. Then another round of baces haha. It's all worth it in the end thought. I know a few people who've had it done and they look fabulous afterwards! I'm getting it done because I too have sinus problems and my teeth don't line up well either. It will also help me pronounce better. Becasue of my misshaped jaw its hard to enunciate. I was feeling good about the surgery until I looked at picture and videos on youtube haha, but hey your knocked out for it and plus its a few days off!


#15 Sep 22, 2009
I had palate expansion surgery 3 years ago .i would NEVER,EVER do it was the most painful thing i went through..i had the surgery then i wore an expander for 3 months then had full them off finally and had a mouth full of root canals because the nerves died from the surgery so another 3000.00 dollars worth of dental work my teeth are long as i dont eat anything!!i am 30 years old and from what i hear now palatial expansion surgery is not recommed for adults..oh well theres nothing i can do was a very long painful ordeal and if i knew now i would never do it ..hope the helps someone else .

Roseville, CA

#16 Sep 27, 2009
My SARPE surgery is scheduled for the end of Nov. I'm starting to get nervous. I have an extremely narrow palate with an overbite. At the aage of 40, I'm finally going to do something about it. Insurance is paying for the surgery but I will be paying for the braces. I'm expanding to 5mm and the oral surgeon said that this is a smaller expansion and my face will not change. The overbite will be fixed with braces and I'm hoping my profile will look better. I keep reading these posts about people regretting the surgery. I'm getting very nervous. I like my smile and I'm hoping to improve on it and also get rid of the difficulties with chewing and jaw discomfort. Has anyone else expanded to 5mm? If so, are you happy with the results? Did your face change dramatically?
carire az

Peoria, AZ

#17 Nov 11, 2009
I just had the sarpe done, and let me tell you the surgeon has a lot to do with your pain and outcome. Your ortho and oral surgeon should be working together. I had mine done for TMJ issues, cross bite, and an extremely narrow palate ,I have the expander as well and my face hasn't changed .I was extremely swollen for the first week and I am doing fine.

Burlingame, CA

#18 Nov 16, 2009
I am 50 and had my SARPE done on July 22, 2009. I elected to do it, after postponing the decision for many years, because I was losing bone in my upper jaw as a result of malocclusion due to poor jaw alignment. Yes, I've always wanted a better smile but I mostly didn't want to have to eventually wear dentures.

I read through the posts here and I agree that the surgery and healing is not especially fast and not without some pain - although reading a lot of blogs on the topic (Graham's SARPE blog) helped to set my expectations.

I am now 4 months post surgery. The expander has been taken out and my TPA and upper braces have been on for a couple weeks. The biggest issue for me at this point is that I still have some parasthesia (numbness) in my upper gum. However, it appears to be getting less and less each week.

I had Dr. Janice Lee, a Harvard-trained oral surgeon at UC San Francisco, do my surgery. I did a thorough background check on Dr. Lee and she was the surgeon that was the most recommended by other oral surgeons and orthodontists in the SF Bay Area. The surgery was not painless. The healing was not painless but I feel that UC SF hospital, staff and Dr. Lee did a great job. The rest is up to me.

I have had a lot of broken bones and surgeries from sports injuries over the years so perhaps I am more acquainted with dealing with the pain of recovery. This wasn't the easiest but it certainly wasn't even close to the worst.

It's natural to be nervous (scared) about having surgery and each of us has a different level of tolerance for pain and a different sense of what makes something worthwhile to do.

My personal opinion is that as long as you are working with board certified surgeons and physicians who are well trained and experienced, and you use your own personal judgment to evaluate whether the time/pain is worth the effort, I believe you will come to the right decision for yourself.

I haven't completed the entire process (my two front teeth don't even yet touch; they were at 8mm), I still look a little goofy compared to what I looked like before the surgery but I think I would do it over again given how things are progressing.

Finally, I think anyone who agrees to going through SARPE needs to be prepared to put 1-2 years into it before they can assess whether or not it was worthwhile. From the blogs I've read, the vast majority are happy with their decision.
Ready to be Out of Pain

Doniphan, MO

#19 Jan 8, 2010
carire az wrote:
I just had the sarpe done, and let me tell you the surgeon has a lot to do with your pain and outcome. Your ortho and oral surgeon should be working together. I had mine done for TMJ issues, cross bite, and an extremely narrow palate ,I have the expander as well and my face hasn't changed .I was extremely swollen for the first week and I am doing fine.
Hey Carire,
Thanks for your post. I am having the same surgery done in a week for the same reasons you had to have yours...tmj, narrow palate and cross bite. How are you doing now? I get my expander put in next week. I am nervous, but have to correct the problem to get out of the pain that I am experiencing from tmj. Did you have a lot of gaping between your front teeth?
christopher h sydney


#20 Jan 12, 2010
i had a complete maxo done 25 yeras ago. My left joint is now deteriating. my advice is; surgeons are good but they disappear once the work is done, there in no recall 20 years later. teeth bites are complicated and dentists cannot handle the 100s of facial/tooth/aesthetic/functio nal/healing variations with patients let alone a 15 yaer old verses a 50 year old (age factor). therefore they use standard surgery/expansion techniques as do plastic surgeons. this way they try to avoid problems from physicains solving problems and getting it wrong. let me tell you jaaw expansion isnt the only way but often the most suitable for everyone. we need a better system.

my mum is dying of cancer. she was tolled by doctors it was good for the throat. i am a graphic designer . i have all the ads from the 30s and 40s saying this endorsed by medical profession. now mum has lung cancer. where the fuck are the fucked up doctors.

we need a better system with less brain washed people.

love chris x

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