Thanks for sharing your question. I can appreciate your concern. Trigeminal neuralgia is the consequence of piercing muscles around the face on branches of the trigeminal cranial nerve. ( a sensory nerve of the face). Botox which paralyzes the muscles, have being approved for the use of migraine headaches for this main reason. Depending on the location of your neuralgia, botox should help with the symptoms. On the same token, surgery in this area will stretch your nerves, creating a temporary numbness to the nerves. You may experience potential improvement to the areas where the surgery is performed. Make sure to have an evaluation by a board certified plastic surgeon who has experience in facial cosmetic surgery and migraine surgery. Best wishes