Migraine Surgery Developed from Cosmetic Brow Lift

When a plastic surgeon noticed that after undergoing endoscopic brow lift surgery some migraine patients were having less headaches, he developed a migraine surgery technique. The treatment, which involves “surgical deactivation” of “trigger sites” in the muscles or nerves that produce pain, appears to have some success: after five years, 88 percent of patients had less frequent or severe migraines, according to a new study in Plastic and Reconstructive Surgery journal.

In addition, the study found that 59 percent of patients reported that their headaches were significantly better and 29 percent said their migraines were eliminated completely five years after surgery.

The researchers followed 69 patients after they had migraine surgery; in order to confirm the trigger sites prior to surgery, each patient was tested with Botox in places like the forehead, temple and nose. For most patients the surgery targeted at least two trigger sites.

Other findings from the study included:

• Average migraine frequency decreased from about eleven to four per month
• Average migraine duration decreased from 34 to eight hours
• Migraine surgery led to significant improvements in quality of life, with few serious adverse effects

An additional benefit to the migraine surgery is that patients may end up with fewer wrinkles. “For those patients, commonly the aesthetic outcome is pleasing. They just look like they’re less angry or are less serious,” said Bahman Guyuron, MD, the surgeon who developed the technique.

While more research is needed to refine the surgical techniques and to clarify the reasons for the effectiveness of surgical deactivation of trigger sites, the researchers wrote that “the findings provide strong evidence that surgical deactivation of one or more trigger sites can successfully eliminate or reduce the frequency, duration and intensity of migraine headache, and the results are enduring.”

Experts say migraine surgery is probably only a good idea for those who’ve tried less invasive treatments first.