I've heard of Botox being able to help Migraines and then this morning I heard that people who have had a Forehead Lift surgery have also reported less migraines. Have any of the doctors on this site received the same feedback from their Forehead Lift patients? Is it true?
Forehead Lift to Help Reduce or Eliminate Migraines?
Doctor Answers (21)
Forehead lift for surgical cure of migraines
The Plastic Surgeon with the most experience with this technique is Dr. Guyuron in Ohio. The procedure is more than just a forehead lift. It requires release of muscles and nerves that may be involved including corrugators, procerus and the zygomatico -facial and zygomatico-temporal nerves. To the best of my knowedge it is still being evaluated by the NIH as a surgical treatment for migraines but has shown promise in a select group of individuals.
Forehead lift for migraines
What helps with migraines in forehead lift is the actual removal of a muscle called the Corrugator muscle. This muscle is responsible for bringing the eyebrows together (forming the number 11 wrinkles). This muscle entraps the forehead nerves and causes the attacks. Botox weakens that muscle and improves the migraines temporarily while surgery does that permanantly. Botox has been approved by FDA in Oct 2010 for the treatment of migraines.
Botox and surgery for Migraines by Dr. Whitfield
There is scientific data to support the use of Botox in those who sufer from Chronic Migraines and are refractory to medical therapy. I have personally einjected patients in the appropriate areas to relax the muscles around the peripheral nerves assumed to be responsible for the generationof the migraines. If the patient can keep a diary and show that they have had complete elimination of migraine symptoms then they are considered a good candidate for peripheral nerve release. The forehead lift is not the same operation depending on how it is performed.
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Botox Can Help Migraines, So can A Brow Lift in Many Patients
The short answer is that if botox does relieve your migraines then there is a significant chance that surgery will also be effective. This has been studied the most by Dr Guyuron, Bahman M.D, a plastic surgeon in the mid west. What he found is " If intervention with botulinum toxin yields a sustained elimination of migraines or significant improvement, defined as at least 50 percent reduction from baseline intensity and/or frequency for at least 4 consecutive weeks, surgical management should be considered"
For example "Patients with frontal migraines may undergo resection of the glabellar muscle group, including the corrugator supercilii, depressor supercilii, and procerus muscles, using a palpebral incision to access the supraorbital and supratrochlear nerves, which are often compressed within the substance of these muscles." This technique can be done using endoscopic techniques. For more information about the above information that was taken directly from his Jan 2011 article in the Journal Plastic and Reconstructive Surgery - please read his entire article or ask your neurologist or interest that manages your migraines to interpret it for you. If you think you are a candidate see a board certified plastic surgeon.
Surgical Treatment of Migraine Headache Pain
Headache pain sufferers and their loved ones are all too familiar with the lost social activities and decreased productivity at work and home that occurs during an attack. Until recently, common migraine treatment options have included taking life-long medications or undergoing a combination of expensive therapies, such as acupuncture or massage, aimed at preventing or stopping a headache. Unfortunately, in spite of these treatment advances, many still suffer from migraines.
In some patients, we can identify a peripheral trigger site(s) as the source of your migraine headache pain. A peripheral trigger site is a consistent region on the head & neck where the headache pain is first noticed. For example, "I always rub my temples when I know I am getting a headache." When a frontal, temporal, occipital or nasal peripheral trigger site is identified, migraine surgery is more than 90% effective at reducing the frequency, intensity and duration of future attacks. Certain patients may experience complete elimination of migraines after our outpatient procedure.
Forehead lift and migraines
Forehead lifts may improve migraines in those patients that have some resolution of symptoms when the muscles of the forehead ( usually the corrugators) are injected with Botox. Migraines can stem from other focal points like the occiptal( back of the head) region. In this case browlifts will not help.
Forehead lift for migraines
Obviously, a forehead lift will not be covered by insurance as a treatment for migraines. That said, I have had success treating migraines with Botox and have heard from some patients that their headache severity was greatly reduced after surgery.
Video on Browlift and Migraines.
There is the possiblity that the nerves around your forehead could be the cause of migraine headaches. In the video below we show you why that is. It is possible that removing these muscles could improve your headaches. But this is rather a new concept and needs more studies. Let me know what you think about the video. Warning the video is graphic in nature.
Thanks for reading, Dr Young
Brow Lift and Migraine Relief
Dr. Guyuron has published results from about 12 patients he did brow lifts on for treatment of migraines. His conclusion is that it works in the properly selected patients when the brow lift is done a certain way.
Certainly if you have a migraine triggered by the corrugator muscle you have a logical reason to assume that removing the muscle may eliminate the headache. If Botox is effective, then logic follows that surgery may as well. During a brow lift, I attempt to remove the entire corrugator muscle, however successfully removing 100% of the muscle is impossible. I suspect that I get about 80% of it. Most surgeons don't remove much if any of the muscle but rather just transect it. I have not found any long term benefit from doing that, cosmetically or otherwise. I have had patients tell me they have less headaches after brow lift. I will not tell anyone that it is a treatment for headaches. It is a treatment for low eyebrow position and creasing between the eyebrows. If your headaches also go away, that is just icing on the cake!
Forehead lift and treatment of migraine headaches
Although there may be anecdotal reports of migraine headaches being reduced or eliminated after a forehead lift, forehead lift surgery is NOT a treatment for migraines. Botox, on the hand, has been successfully used to treat tension headaches by relaxing the muscles involved in triggering the the headache.