Facegenics Midface Expander (FME): Complete Review and Guide

If you've been researching ways to expand your upper jaw as an adult—whether for better facial aesthetics, more space for your tongue, or improved nasal breathing—you may have come across the Facegenics Midface Expander (FME). It's a newer bone-anchored palate expander that's generating significant interest in the world of adult orthodontics and airway health.

But what exactly is the FME? Is it safe? How does it work? And how does it compare to established options like MSE? In this comprehensive review, we'll break down everything you need to know.

What Is the Facegenics Midface Expander?

The FME is a custom-made, bone-borne expansion appliance designed specifically for adults. Unlike traditional expanders that push on your teeth, the FME uses 6-10 titanium screws (called TADs or temporary anchorage devices) anchored directly into the bone of the palate.

This allows it to apply strong, precise force directly to the maxillary bones—widening the upper jaw and midface in a controlled, surgical-free way.

Key Features

• Purely bone-borne: No attachment to teeth
• Custom-designed: Made from 3D imaging for each patient
• Multiple TADs: 6-10 screws for distributed force
• Removable design: Can be taken out for cleaning
• Precision engineering: Computer-designed for optimal force distribution

What Makes the FME Different?

Let's compare the FME to other expansion options:

FME Advantages

• More anchorage points: 6-10 TADs vs. 4 in MSE distributes force better
• No dental side effects: Teeth aren't used for anchorage
• Customized fit: 3D-designed for each patient's anatomy
• Potentially greater expansion: Some cases report significant results

FME Considerations

• Newer technology: Less long-term research than MSE
• Limited providers: Fewer trained clinicians available
• Cost: May be higher than MSE in some areas
• More TADs: More screws to place and maintain

How Does the FME Work?

Step 1: Digital Planning

Your provider uses 3D cone-beam CT imaging and digital scans to create a precise treatment plan. The FME is custom-designed to fit your specific palatal anatomy.

Step 2: Surgical Guide and TAD Placement

A custom surgical guide ensures accurate placement of the 6-10 titanium TADs directly into the palatal bone. This is done under local anesthesia and takes about 30-60 minutes.

Step 3: Device Fitting

The custom-made FME attaches to the TADs. It's designed to distribute expansion force evenly across the midface.

Step 4: Daily Expansion

Patients typically turn the expansion screw 1-2 times daily, gradually widening the upper jaw over several weeks to months. Each turn is about 0.2mm of expansion.

Step 5: Retention

After active expansion is complete, the device remains in place for 6-12 months to allow bone to fill in the expanded suture and stabilize.

Is the FME Safe?

Early data and patient reports suggest the FME is relatively safe when placed by trained professionals.

Common Side Effects

• Pressure or tightness in the palate (normal during activation)
• Temporary gap between front teeth (expected and desired)
• Minor gum soreness near the TADs
• Temporary speech changes during adjustment
• Pressure sensation in nose or around eyes

Reported Complications (Uncommon)

• TAD loosening (may require replacement)
• Incomplete expansion in very fused cases
• Minor soft tissue irritation
• Infection around TADs (rare with proper hygiene)

Safety Considerations

• Choose an experienced, trained provider
• Follow all home care instructions
• Attend all follow-up appointments
• Report any unusual pain or symptoms immediately

What Results Can You Expect?

Based on patient reports and provider data, FME treatment typically produces:

Skeletal Changes

• Palatal width increase: 4-10mm depending on case
• Midface expansion: Visible widening of the upper face
• Nasal floor expansion: Improved nasal airway dimensions

Functional Improvements

• Better nasal breathing and reduced congestion
• More space for the tongue
• Improved sleep quality in some patients
• Reduced mouth breathing

Aesthetic Changes

• Wider, more attractive smile
• Improved cheekbone support and projection
• Better facial symmetry
• Enhanced facial balance

Timeline for Results

Who Is a Good Candidate for FME?

Ideal Candidates

• Adults with narrow palate or midface seeking non-surgical expansion
• People with mouth breathing, UARS, or tongue space issues
• Those seeking facial balance and a wider smile
• Patients wanting to avoid jaw surgery
• Those who haven't succeeded with other expansion methods

May Not Be Ideal For

• Patients with extremely fused sutures (may need SARPE)
• Those unwilling to commit to 12+ month treatment
• Patients with inadequate palatal bone density
• Those seeking only minor dental changes

Required Evaluation

• 3D CBCT scan to assess bone and suture
• Comprehensive airway evaluation
• Dental and periodontal health assessment
• Discussion of goals and expectations

Real Patient and Provider Feedback

Early reports from patients on Reddit, Facebook groups, and other forums are largely positive.

Provider Data

• Success rate: 90%+ reported by trained providers
• Complications: Lower than older expander types
• Patient satisfaction: High among properly selected cases

Note: More long-term studies are needed to confirm these early findings.

How Much Does FME Treatment Cost?

Typical Cost Range

$5,000 - $10,000 for the FME device and treatment

Cost Factors

• Provider experience and location
• Complexity of your case
• Geographic region
• Additional procedures needed (orthodontics, etc.)

Cost Comparison

Insurance Coverage

Most insurance plans consider palatal expansion cosmetic and don't cover it. However, if you have documented sleep apnea or breathing issues, some medical insurance may cover part of the cost. Always check with your provider and insurance company.

FME vs. MSE: Which Is Better?

This is one of the most common questions. Here's an honest comparison:

MSE Advantages

• More research: Years of published studies and data
• More providers: Wider availability of trained clinicians
• Proven track record: Thousands of successful cases documented
• Lower cost: Generally less expensive than FME

FME Advantages

• More TADs: Better force distribution (6-10 vs. 4)
• No tooth involvement: Purely skeletal anchorage
• Custom design: Made specifically for your anatomy
• Potentially fewer dental side effects: No molar tipping

Which to Choose?

• Choose MSE if: You want proven technology, more provider options, or lower cost
• Choose FME if: You want maximum skeletal anchorage, have had MSE complications, or prefer cutting-edge technology

Both are excellent options. The best choice depends on your specific case, goals, and available providers.

Finding an FME Provider

Currently, FME is offered by a limited but growing number of trained providers worldwide.

What to Look For

• Specific training and certification in FME placement
• Experience with adult palatal expansion
• Before/after photos of previous patients
• Comprehensive consultation process
• Willingness to discuss alternatives

Questions to Ask

• How many FME cases have you completed?
• What results can I realistically expect for my case?
• What is the total cost including all follow-up?
• What happens if I need additional treatment?
• Can I see before/after photos of similar cases?

Where to Find Providers

• GetExpanded.org provider directory
• Facegenics official website
• Airway orthodontist networks
• Sleep medicine referrals

The Treatment Journey: What to Expect

Consultation Phase (1-2 visits)

• Comprehensive evaluation and imaging
• Discussion of goals and expectations
• Treatment planning and cost estimate
• Decision to proceed

Placement Day

• Local anesthesia administration
• Surgical guide positioning
• TAD placement (30-60 minutes)
• FME device fitting
• Home care instructions

Active Expansion (1-3 months)

• Daily screw turns at home
• Regular check-up appointments
• Monitoring progress with imaging
• Adjustments as needed

Retention Phase (6-12 months)

• No more active turning
• Device stays in place
• Bone fills in expanded suture
• Regular monitoring

Completion

• Device removal
• Final imaging and assessment
• Transition to retention or orthodontics
• Long-term follow-up plan

Maximizing Your FME Results

During Treatment

• Follow activation instructions precisely
• Maintain excellent oral hygiene
• Attend all follow-up appointments
• Report any concerns promptly
• Consider myofunctional therapy

After Treatment

• Wear any prescribed retainers
• Practice proper tongue posture
• Continue nasal breathing habits
• Complete recommended orthodontic treatment
• Maintain regular dental care

Conclusion: Is FME Worth It?

If you're an adult dealing with a narrow palate or midface underdevelopment, the Facegenics Midface Expander represents one of the most exciting innovations in non-surgical expansion available today.

The Bottom Line

Pros:

• Non-surgical skeletal expansion for adults
• Purely bone-anchored (no tooth side effects)
• Custom-designed for optimal results
• Can be life-changing for breathing and aesthetics

Cons:

• Newer technology with less long-term data
• Limited provider availability
• Significant commitment (12+ months)
• Cost may be higher than alternatives

Who Should Consider FME?

The FME is worth exploring if you:

• Have a narrow palate affecting breathing or appearance
• Want non-surgical expansion as an adult
• Have researched alternatives and want cutting-edge technology
• Can commit to the treatment timeline
• Have access to a trained provider

As with any significant medical decision, thorough research and consultation with qualified providers is essential. The FME isn't right for everyone, but for the right candidates, it can provide truly transformative results.