How Do I Get Botox Injections for Migraines?

I would encourage you to get a consultation with a neurologist if you've  never seen one for your migraines and ask them about Botox.  The number of units may be different from what many of us are accustomed to using for cosmetic reasons and the trigger points may be different in different patients.

Botox has been clinically indicated for the treatment of migraines. A conservative approach is often a good start. Raffy Karamanoukian Los Angeles

Treatment of migranes is a very individualized process.  The first step is to see a qualified plastic and reconstructive surgeon that can understand and guide you through the multiple surgical and nonsurgical options.  The patient must present with an active migrane.  Only migranes that are triggered by compression of peripheral nerves can be treated with botox, luckily at least in my practice this includes the majority.  A plastic surgeon with craniofacial experience can easily identify the possible locations of triggering and a diagnosis is made by stimulating and relaxing the muscles manually with special massage techniques or injecting a small amount of lidocaine near the triggering nerve.   If the migrane is treated, the diagnosis is made and options are reviewed.  The next step is to give the patient a trial of local muscular relaxation with botox administration which must not only significantly chemodenervate the local muscles, but also must be balanced through the face so as not to create an aesthetic deformity.  depending on level of relief, duration of relief and patient preferences, most patients opt for a permanent treatment without recurring cost.  The identified trigger nerve is decompressed in a quick in office surgical procedure and a small amount of fat is placed around the nerveto cushion and protect it from further irritation.   Patient staisfaction is very high with this protocol.  Remember there are many practitioners that will be willing to inject Botox for migranes who do not have the anatomical, physiological or surgical knowledge and experience to produce a result.  I strongly recommend seeing a plastic and reconstructive surgeon who can guide you.

All the best,

Rian A. Maercks M.D.