Sunday, March 6, 2011

Before SARPE photos and why I chose to have SARPE surgery

Here are my before SARPE photos.  These were taken 2 weeks before surgery:

 Class 1 occlusion

 Upper Jaw.  Teeth are flared out.

 Lower Jaw.  Teeth are tipped in.

As you can see from above, my previous orthodontist gave me a nice bite and cosmetically straight teeth, however in order for my teeth to fit together he had to flare out my upper teeth in order to match the bottom teeth.  Unfortunately, if I were to continue this way my top teeth would continue to tip in (teeth do not like to be in a flared out position, it is not stable)  and my bottom teeth would follow (The bottom teeth always follow the upper jaw, unless you are in cross-bite, dentally speaking).  As we age, our teeth continue this caving in process naturally, without wearing a retainer.  In my case, my teeth would continue to tip in and in order to find room they would just get more crowded and start crossing each-other like my two front teeth (Not bad now, but given time I would have looked just like I did in high school.), even wearing a retainer every night, because my top teeth were so flared.  Also, it is hard to tell from the photo, but my skeletal upper and lower jaws are actually in cross-bite (My upper jaw is narrower than my lower jaw, skeletally speaking). I opted to have a SARPE done so that my upper jaw would be set to the correct width so that my upper teeth will not be crowded ever again and therefore my lower teeth would stay in an upright position longer.  This is obviously not going to be a huge cosmetic difference from the way I look now compared to other SARPE before/after photos I have seen.  I am not doing this for cosmetic purposes, rather for the stability of a wider upper jaw as I age.  As I have mentioned previously, if I would have had an expander at the age of 7 or 8 having SARPE surgery as an adult would not be necessary.  That is why my husband and I are such huge supporters of a Phase 1/Phase 2 orthodontic approach (if there are skeletal issues present).  Also, I have suffered from TMJ pain, possibly due to my skeletal cross-bite.  I am hoping that this SARPE surgery will give me a more comfortable biting position and therefore alleviate the pain in my jaw joints as well.  Only time will tell :)


  1. Please post some latest pics. I would also to do a SARPE. Many Thanks

  2. hi
    can you please tell us how you are doing after the surgery? what has changed? how are your tmj symptoms now? im trying to decide whats best for me since i have a crossbite i think since i was born it never bothered seriously until two yrs ago and now i also have an openbite of about 3ml or 4 the open bite i got it after using a stabilization splint and now i dont know what to do saw an ortho and she wants to do full set of braces and elastics and tounge crib and possible upper wident jaw surgery with expander if she doesnt see results in 6/9 months of braces treatment she will consider surgery since you are an orthowife do you think that sounds like a good plan i really hope you read this and give me some advice

    1. Hey Judy, This is Dr. Will, Andrea's husband. Some food for thought:

      1. Uncorrected skeletal crossbites and/or openbites like what you indicated may sometimes be corrected with braces and elastics only, but rarely are stable. The most common "sales trick" orthodontists use to get you started, in my opinion, is to get you into braces then put you in a position where you MUST have surgery or extractions of premolars in combination with braces. Not necessarily the end of the world, but it's good to know your budget and your options before before making a decision.

      2. If you are considering surgery, your orthodontist and especially, your oral surgeon, must determine if you are a good candidate for a Surgically Assisted Rapid Palatal Expander (SARPE) or if you would be a better candidate for a Lefort I expansion and posterior impaction. The latter is a more complicated surgery and money oftentimes dictates choice as surgery is rarely covered by insurance. SARPE $4-6K and Lefort $18-38K. Sometimes a lower jaw surgery is also indicated. That may also mean more money as more work is involved.

      I hope that answers your questions. Sometimes a second opinion is also helpful for peace of mind.

      Good luck!

      -Dr. Will

  3. Hi Judy,
    Honestly I completely forgot about this site and would have no idea how to access it, so thank You for reaching out. I am over the moon happy with my results! I no longer have the TMJ issues I had before surgery/ortho and my smile and outlook on life shines through. It was well worth it. My biggest surprise were the changes to my smile. No more black triangles in the corners when I smile. I receive many compliments on my smile, of course being married to an ortho it's sort of a requirement. To answer your tx question, I will refer it to the ortho himself. My husband is passionate about orthodontics and loves to help people. We are headed out for the night. However, I will have him jump on my profile tomorrow to answer your questions. In the meantime I will start looking for some new photos, Stefan. Now that I know how to access this sight again :) Have a great night! Chat soon...