SARPE before or after bimax?

[zygotic]

I had camouflage orthodontics for three years which included non-surgical palate expansion. I believe it was a failure and that my teeth were only moved slightly outwards, rather than the palate being expanded.

I have numerous outstanding issues that I would like to fix such as nasal breathing when lying down, condylar resorption, receding gums, high occlusal plane, canted upper jaw, off-centre midline & facial asymmetry.

My current thinking is that I need decompensation orthodontics to prevent the stretching of the gums and move the teeth back to the original positions. But then will the decompensation then give my tongue less resting space? I can only just rest it flat now. So I am also thinking that SARPE would also be required, but when would be the ideal time for that? Would a maxfac create a plan to include SARPE? I can't find any surgeons that do SARPE!

[XXRyanXXL]

SARPE is usually indicated before Orthognathic Surgery, installed by your Orthodontist, and kept in after the surgery, unless of course, a cast is prepared. I believe you are correct that Orthodontics did not expand your palate but tipped the teeth. I can't find a reason how a SARPE could possibly alter bony structures when you stopped growing unless surgery was done. 

[idk]

Sarpe is always before orthognatic surgery. About the malocclusion it self, would be very good to see a frontal and profile pic to better feedback.