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In this discussion, Dr. Koval explores asymmetries — how and why they develop during skeletal expansion and facial growth, and what they reveal about underlying structural imbalances. 0:00 Intro 2:08 Guided Midpalatal Piezocorticotomy and Rationale 14:36 Desired Outcomes of Expansion 20:18 Why Asymmetries Matter 33:30 Pre-expansion Asymmetries 44:40 Intra-expansion Asymmetries 50:42 Correcting Asymmetries 55:00 Nasal Breathing Improvement 56:13 Potential Custom MARPE Limitations 58:49 When will the FMA be released? 59:25 Palatal expansion with condylar dysplasia? 1:00:55 Reversing dropdown effect from MARPE? 1:02:54 Pulling upwards vs downwards with facemask? 1:04:01 Wearing aligners to support frontal bone and teeth tipping? 1:05:38 Achieving CCW rotation of maxilla or mandible during expansion? 1:06:31 MARPE placement to maximize cheekbone widening? 1:07:56 Do you do international consultations? 1:08:31 Did expansion affect your asymmetries? 1:10:46 Can MARPE correct asymmetries? 1:13:10 Treatments for mandibular asymmetry? 1:14:09 Alt-RAMEC protocol and facemask? 1:16:22 Do most people need protraction with expansion? 1:17:58 Possible for the condyle to remodel during expansion? 1:19:58 Outro Contact Dr. Svitlana Koval: https://www.drssk.com/ / drsvitlanakoval Disclaimer: The content shared on this channel is for educational and informational purposes only. It should not be considered medical advice. Always consult with a qualified healthcare provider before making decisions about your health or treatment options.