If you’re one of the 28+ million Americans who suffer from migraine headaches, no doubt you’ve tried every trick in the book to end them quickly and prevent their return. If the standard changes in lifestyle and medications currently available just don’t work well enough for you, here are some resources that may give you new hope.

One option that has been available for several years is treatment with BOTOX® Cosmetic. As reported by otolaryngologist Dr. William Binder more than 15 years ago, the same overworked forehead muscles that cause dynamic wrinkles also contribute to migraines. Relaxing the muscles with BOTOX injections smoothes the forehead and, for many, relieves migraines for several months. When headaches return, most patients find they return gradually, signaling that another treatment may be in order.

In 2002, a Cleveland board-certified plastic surgeon, Dr. Bahman Guyuron, and neurological colleagues teamed up to take treatment one step further. They used BOTOX injections to identify patients who could be helped by targeting forehead muscles for deactivation. Patients were treated with BOTOX as a screening procedure, and 22 of 29 who experienced relief were then chosen for surgery to remove corrugator supercilii muscles—the same ones that cause vertical forehead wrinkles. 21 of the 22 patients reported improvement; almost half of those reporting complete elimination of their migraines.

At the annual American Society of Plastic Surgeons (ASPS) conference in Seattle taking place this week, a paper will be presented that gives even more evidence that the one-two punch of BOTOX injections and surgery can help many migraine sufferers. The paper highlights a five-year study of 100 patients who were first treated with BOTOX. 89 of the men and women reported improvement in their symptoms for at least four weeks; those patients then went under the knife to have the offending forehead muscles deactivated. The ASPS surgeons reported that 22 of the group found their migraines eliminated entirely, 49 patients noted a significant decrease and only 8 experienced no change.

The day after this paper is presented at the ASPS conference, member surgeons will be invited to attend a class on using BOTOX and surgery to help migraine patients. This means the combination treatment will start to be more widely available soon. If this option appeals to you, seek out a board-certified plastic surgeon who’s a member of the ASPS. And visit the ASPS Web site, www.plasticsurgery.org, to follow the news.

If you’re just getting started researching migraines, check out www.migraineheadaches.org. This site, presented in FAQ form, gives a good overview.

For a more in depth look at migraines and other headaches, you may want to get to know, at least electronically, Dr. Randolph W. Evans in Houston. This chief of neurology at Baylor College of Medicine and self-styled “headache specialist” has compiled an amazing body of research on headaches. Visit his site at www.rwevansmd.com and you can learn about “Exploding Head Syndrome,” “Airplane Descent Headache” and even “Orgasmic Headaches.”

If you’re a veteran “migraineur” (a term used by Dr. Evans), it may seem to you that the medical world’s understanding of headaches and discovery of effective treatment have proceeded with a snail’s pace. It appears that may be about to change.