Surgically assisted rapid palatal expansion consists of a surgical liberation of the sites of resistance combined using orthopaedic forces. Most technical descriptions advocate the use of general anaesthesia with hospital admission. We report a new technique sought to attain a balance between maximum mobilization of the maxilla and minimum morbidity that allows to carry out the surgery under sedation. Between March 2000 and December 2012, surgery was performed on 329 consecutive cases with transverse skeletal maxillary hypoplasia with local anesthesia plus sedation. The incision ran horizontally to reach the level of the laterals. Osteotomies of lateral walls and pterygoid disjunction were performed in all cases. A V–Y closure was performed in 2 layers. Patients were discharged after recovery from sedation. Mean age was 18.3 years. Mean surgical time from incision to last suture was 19 min. At the 1-year follow-up visit, mean expansion was 8.0 at the canines and 8.9 at the mesiovestibular cuspid of the first molar. The new technique that we report seeks to combine both aspects and allows for rapid intervention with local anesthesia plus sedation and a minimal approach with a total liberation of the maxillar. The minimal approach guarantee vascular support to the maxilla.