Excising Supraorbital and Supratochlear Nerves for Headache Relief?

I experience an almost daily headache in the left brow region. The pain is specifically located at the start of my left eyebrow. Sinus scans have not found any disease in the sinuses. I have previously had a brow lift where corrugators have been re-sectioned but the pain still persists. My surgeon did advise that I have the option to excise these nerves but would have permanent numbness in the forehead. Would you recommend this? I know some peripheral nerve surgeons are doing it.

Doctor Answers 3

Cutting more nerves is not the first answer

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Cutting the nerve probably caused the end of the nerve to form a neuroma. I would have someone diagnose this by injecting a small amount of anesthetic into the area. Bupivicaine is long lasting and you will soon know if you have the right spot. Treatment could be steroid injection into the area or massage of the painful area that you can perform. Cutting the nerve may have caused the problem and recutting it may set you up for more problems. Start conservatively first.

Manhattan Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Supraorbital Headache

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I would never recommend this form of treatment, as this type of pain is usually related to a small neuroma in the area. Neuromas are areas of nerve inflamation and should be treated with a local injection of the anti-inflamatory Kenalog, first.

James B. Orr, MD
Atlanta Facial Plastic Surgeon

Have you tried injecting lidocaine in this area?

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Have you ever had someone numb these nerve temporarily with an injection of lidocaine or another similar numbing agent? The idea is that if the numbing agent helps relieve your headaches and pain, then there is a possibility that nerve section (cutting the nerve) will help you. if you still have persistent pain despite numbing the nerve with injection, then cutting the nerve will not improve your pain. Another alternative to nerve section is a nerve stimulator.

Dara Liotta, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.