As reported last summer, there’s hope and help from the world of cosmetic surgery for those who suffer migraines. Today, there’s news that may make the future even brighter for those crippled by the devastating headaches.
It all started with the discovery by Dr. William Binder in the early 1990’s that Botox injections were effective in alleviating migraine pain and preventing headache recurrence for many patients. Since then, Binder has been treating migraine patients successfully with Botox, albeit by using the neurotoxin in an “off label” treatment. This means that the U.S. Food and Drug Administration has not yet approved Botox for this particular use.
News from the United Kingdom this month gives even more reason for migraine patients to be optimistic about the future: Botox has received approval in the U.K. as a treatment for migraines. U.S. patients and doctors can now hope that FDA approval won’t be too far behind.
Estimates of the number of migraine sufferers in the U.S. run from the low 20 millions to the high 30 millions. Many find little to no relief with traditional medications. In a news release this week, Dr. Binder points out that even when patients find a drug like Imitrex that helps ease their pain, the medication does nothing to slow migraine occurrence rate. For many patients, Botox helps with both factors.
Noting that Botox injections placed strategically seem to do the trick for many migraine patients, and knowing that the effect of Botox is to paralyze muscles temporarily, such as those that cause forehead lines, some surgeons are taking treatment a step further. Growing numbers of plastic surgeons are offering migraine sufferers permanent help with a one-two punch of Botox and surgery.
Surgeons who offer treatment for migraines first administer Botox injections to various sites to determine a patient’s precise trigger spots. When success is noted, the surgeon learns two things: one, that the patient is a good candidate for surgery, and two, which areas to target. Most people end up having a procedure that’s similar to a forehead lift that smoothes the wrinkles that result from muscle action.
The American Society of Plastic Surgeons (ASPS) put out a news release almost exactly one year ago about the exciting results of a study by Dr. Bahman Guryon, a plastic surgeon practicing in Cleveland. Through a clinical trial involving a control group, Guryon and colleagues found that more than half the patients who had the real surgical procedure suffered no more migraines. Others found their occurrence rate cut in half.
Surgical treatment for migraines is still new, and not without controversy. Some physicians note that treatment, especially the aggressive Botox injections, can result in temporary side effects. Others say the success rate from surgery is high enough to be suspect.
Even so, more plastic surgeons are starting to offer the treatment pioneered by Guryon. Dr. Kevin Rose, a plastic surgeon in Utah who studied under Guryon, is one of them. He says his success rate is “phenomenal.” His hope is that as insurance companies began to see the tremendous benefit for their customers—and potential positive effect on their bottom line—they will begin to cover the procedure.
Plastic surgeons who offer the Botox-forehead surgery combination can be found in other corners of the U.S. as well. Texas, Maine, Indiana and a few other states are home to plastic surgeons who offer this treatment.
The usual caveats about elective surgery apply here, of course. There are risks and complications to consider carefully. Ironically, one common side effect of forehead surgery is a brutal headache in recovery. But, if there’s a decent chance that it’s the last debilitating headache for someone who has suffered for years, there will be plenty of takers.