One of the most common abnormalities in the development of the jaw is the narrowing of the alveolar process of the maxilla. In childhood, the elimination of such a deformation is quite common. But with age, the only effective option is the inclusion of a surgical procedure in the rehabilitation plan. The medial and parasagittal osteotomy of the maxilla for the purpose of its expansion by a distraction device has a number of important nuances which can significantly affect the result. These include: localization of sagittal osteotomy of the palate and alveolar process; the direction of cutting the walls of the maxillary sinus; type of fixation of the device (dental-borne or bone-borne). The article summarizes the experience of 74 surgical-associated expansions of the jaws with asymmetric deformations performed over 2 years. A retrospective analysis according to cone beam computed tomography is given. of complex treatment with the inclusion of sparing osteotomy of the maxilla in the rehabilitation plan and a differentiated approach to performing surgical manipulation allow to achieve optimal aesthetic and functional results and to correct the asymmetry to the greatest extent.