BOTOX® Injection Information & BOTOX® Cosmetic Injection Doctors

Botox Injection Use in Migraine Surgery

A migraine is a type of vascular headache typically characterized by throbbing pain on one side of the head. The pain may be accompanied by nausea or vomiting and sensitivity to light, sound, and/or touch. In about 15 to 20 percent of patients, the attacks are preceded or accompanied by an aura (a group of warning symptoms, such as visual disturbances, or changes in smell or taste). Attacks can last from four to 72 hours and be debilitating. Alcohol, certain foods, changes in sleep patterns, stress, menstruation, smells, bright lights and changes in barometric pressure are some of the things that can trigger a migraine in susceptible people.

According to the National Headache Foundation, about 28 million Americans experience migraines. Women are affected about three times more often than men. The condition leads to more than 157 million lost workdays a year. Heredity seems to play a role in the risk for migraines. When only one parent suffers from migraines, a child has a 50 percent chance of also being affected. If both parents have migraines, a child's risk jumps to 75 percent.

Treating Migraines

An important method in treatment of migraine is avoidance of known trigger factors. Patients may need to keep a food diary to identify possible foods that trigger the symptoms. Once the symptoms start, medications may be helpful. Three over-the-counter medications have been approved for migraine relief -- Excedrin® Migraine, Advil® Migraine, and Motrin® Migraine Pain. Sumatriptan (Imitrex®) and other medications are helpful for most patients. Patients who have frequent, severe migraines may benefit from preventive medications.

Patients who have facelifts sometimes discover the frequency of their migraines decreases after the surgery. That observation led some surgeons to look more closely at surgery for migraine sufferers. To perform the surgery, a small incision is made in the crease of the eyelids. Then the doctor carefully removes the bulk of the corrugator supercilii, a pair of muscles used to make frowning expressions. In migraine patients, it's believed these muscles somehow pinch the nearby nerves and trigger the headache symptoms. After the surgery, patients will experience swelling, black eyes, and forehead numbness. The numbness usually lasts for two to three months after the surgery.

Migraine surgery is recommended for patients who have a documented diagnosis of migraines and are unable to gain relief from standard medications and treatment. To determine if the procedure will have the intended effect, doctors may first inject BOTOX® into the area. BOTOX temporarily paralyzes the muscles and, hopefully, eliminates or reduces migraine pain. Roughly 80 percent of patients who respond to BOTOX gain relief with the surgery. About half of patients remain migraine-free. The rest experience a significant reduction in the frequency and severity of attacks.

Since the surgical incision is made in the eyelid, the scars are hidden. As an added benefit, patients get a mini-facelift with the removal of the wrinkles that cause frown lines. Possible complications include infection, risk of damage to vision, and adverse effects from anesthesia. Cost of the surgery is about $2,500, and some insurance companies will cover the procedure when it's done specifically for migraines. For information or consultation, contact a board-certified plastic surgeon.