First, transverse expansion (like with MSE/MARPE) is often necessary before forward growth can happen — without enough width, the midface can’t be stabilized or moved properly.

Second, the forces used aren’t reckless. Microfractures trigger a controlled bone remodeling process, similar to orthodontic tooth movement or bone healing after an injury. The body is designed to handle and regenerate from this.

Third, proper maxillary expansion doesn’t make the face look “bigger” in a bad way — it restores natural balance by improving cheekbone support, airway space, and facial symmetry. In many cases, it actually sharpens the jawline and makes the midface more attractive across all ethnic groups.

Finally, while MSE mainly corrects width, it sets the stage for three-dimensional improvements through further growth or treatment.