Cosmetic surgery could help ease migraines

May 3, 2010 5:44:54 PM PDT
Some doctors are now performing a version of a face lift to help patients suffering from debilitating headaches. Some patients report relief, but there are plenty of skeptics.

For MaryAnn Niese, just playing outside with her grandchildren carried the risk of crippling pain from migraine headaches.

"It was so bad I was vomiting, I had to go home and the light hurt my eyes," she said.

But after decades of seeing neurologists for her migraines, MaryAnn decided to turn to a plastic surgeon instead. She put her hopes on a procedure that originally evolved from a common type of face lift.

"We're not sure why it works, we just know that it does work," plastic surgeon Dr. Thomas McNemar said.

McNemar began by freezing so-called trigger points around MaryAnn's eyes and temple with Botox to test the effect.

MaryAnn reported temporary relief, making her a candidate for the surgery.

"At that point, we decided that the migraines were starting in an area between her eyes and temple," McNemar said.

The procedure he would ultimately perform uses techniques similar to an endoscopic brow lift. The brow lift involves severing muscles and raising the eyebrows.

But instead of changing MaryAnn's look, McNemar says the migraine surgery is designed to relieve muscle pressure on nerves that can trigger the headaches.

"So if we can decrease the irritation to the nerve, we think we can decrease the amount of migraine the patient has," McNemar said.

Just weeks after the surgery, MaryAnn says her migraines became less frequent.

"I was having 12-15 migraines a month. Now I have three; three or four is the most I've had," MaryAnn said.

Still, some experts are skeptical of the technique, pointing out that other similar surgical strategies have shown limited success.

"I've seen several patients who've had these cosmetic procedures in the font or side. In the long term, I don't think they make a difference," Dr. Peter Goadsby said.

Goadsby directs the headache center at UCSF in San Francisco. He says many migraine patients, particularly women, experience relief in late middle age.

MaryAnn is 63.

"The natural history of migraines is they get worse through the 40s and 50s Then, they go away or get better because of menopause," Goadsby said.

Still, supporters point to a recent study published in the "Journal of Plastic and Reconstructive Surgery," in which eight out of 10 patients in the trial reported relief.

"I think as it continues to evolve, what you will find I think, is that there will be more surgeries in these treatment modalities," McNemar said.

MaryAnn says the early results have given her the kind of hours and days with her grandchildren, she hasn't been able to enjoy in years.

"It was great, it was great to be there without a migraine," MaryAnn said.

The procedure can range from about $3,000 to $10,000. It may not be covered by insurance, depending on the carrier.


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