FRIDAY, Feb. 11 (HealthDay News) -- Facial surgery to
"deactivate" painful migraines may offer some patients long-lasting
relief, a new study suggests.
The vast majority of the study participants experienced partial
relief from migraines, while one-third saw them disappear, the
Specifically, based on the findings in 69 patients in the
five-year follow-up study, 88 percent experienced an improvement in
symptoms, 59 percent noted a substantial decrease in symptoms, and
29 percent had their migraine headaches eliminated, the study
The research was published in the February issue of
Plastic & Reconstructive Surgery.
Before surgery, patients were given Botox injections to identify
which trigger sites caused the pain that they were experiencing.
One surgery involved disruption to the frowning muscles in the
forehead and relieving pressure on key nerves, the researchers
explained. Other surgical options included the temple trigger site
and the back of the head, where nerves can also cause migraine
Dr. Bahman Guyuron, chairman of Plastic and Reconstructive
Surgery at University Hospitals at Case Medical Center and Case
Western Reserve University School of Medicine, estimates this
surgery may cost around $4,000, and that about half of his patients
are paying for their surgery with insurance.
For the minority of patients for whom this surgery did not work
(12 percent), Guyuron pointed out that patients could be left with
a somewhat immobilized face, while still experiencing
But in his view, "the immobilization only involves the frowning
muscle, which not only is not detrimental to the face, it actually
makes the face younger and happier."
In his studies, Guyuron noted that he became interested in
treating migraines resistant to medical management (that is, those
in which the migraine drugs typically used didn't work). In 2009,
he led a study that compared a control group of patients getting
"sham" surgery with another group receiving surgery on one of three
trigger points. He and his colleagues found that 57 percent of the
treatment group reported complete elimination of migraine
headaches, compared to 4 percent in the fake surgery group.
As with any surgery, of course, there are potential
complications. The risks of surgery on the forehead, for example,
include unfavorable scarring, bleeding, infection, blood clots,
facial nerve injury, numbness and intense itching, according to the
American Society of Plastic Surgeons.
Adverse side effects among the patients in the current five-year
study included skin numbness (two patients), hyper- or
hyposensitivity (four patients) and mild neck weakness or stiffness
(three patients), along with 20 patients who reported occasional
According to statistics from the American Migraine Foundation,
36 million Americans have migraine headaches. Statistics show that
3 percent of the population is shown to have chronic migraines,
which must be present for 15 days a month for the minimum of six
months, in order to be considered chronic migraines.
Neurologist Dr. Jack Schim, of the Headache Center of Southern
California, explained that patients with chronic migraines often
suffer from terrible headaches, and are desperate for relief.
According to Schim, chronic migraines can be disruptive to a
person's lifestyle, and they can play a role in his or her quality
However, Schim believes facial surgery should only be used as a
last resort, and not as a first line of treatment for migraines.
"The data needs to be replicated," said Schim. "It seems like an
Schim noted that other treatment measures, such as taking
multiple oral medicines and getting nerve blocks, may be helpful
before turning to surgery. Additionally, Schim also uses Botox
treatment for his patients.
"Seventy to 75 percent of patients get a good improvement or full resolution of headaches from Botox," said Schim, in reference to his practice.
"If someone has tried everything, including avoiding medicine overuse, and addressed their lifestyle issues that could help or hinder headache problems, I would talk to the patient [about this] as an option," said Schim.
In October, the U.S. Food and Drug Administration approved Botox
as an acceptable measure of treatment for chronic migraines.
Find out more about migraines at the
U.S. National Library of Medicine.