JUNE 2019 • LONGISLANDPRESS.COM 39
HELP FOR
MIGRAINE SUFFERERS
Nearly 45 million Americans suer from
migraines, a debilitating headache oen
accompanied by nausea and sensory burden
that can cause signicant pain for hours or even
days.Although pharmacological advances have
been made for the treatment of migraine
headaches, medications may have side eects
and create dependence. As patients seek out the
dierent modalities that can successfully relieve
migraine symptoms, more and more patients
are turning to expert plastic surgeons for
innovative surgical solutions.
e latest approach to treating migraines
involves Botox which was approved by the FDA
last year for the treatment of this condition.
Botox is injected into ‘trigger points’ including
the forehead, temples, the back of the head, neck
and shoulders that can temporarily relax the
muscles which constrict nerves and lead to
migraines. Another approach employed by pain
specialists involves the use of nerve blocks with
an anesthetic and a steroid. ese treatments
may provide relief to the irritated nerve and
temporarily suspend migraine symptoms. e
success of these treatments for a patient will
indicate their candidacy for migraine surgery.
For some patients, taking the next step to
surgery to reduce migraine symptoms is a life-
changing event, even bringing a permanent cure
from their symptoms. Migraine surgical
solutions will vary from patient to patient
depending on the oending muscles identied
through injectable treatment methods. A highly
specialized plastic surgeon can release the
compression of the muscles causing the nerve
constrictionin the targeted trigger sites. In the
case of forehead muscles, a small segment of
facial muscle over the nerves is removed
through small hidden incisions near hair
bearing skin. is procedure will also smooth
the forehead. In the case of temple muscles, the
nerves are detached but not removed. In the
back of the head, muscles that encapsulate the
nerves may also be removed. When a deviated
septum contributes to migraine pain, a
septoplasty, or straightening of the septum, is
performed along with removal of the turbinates
in the nose. Overall, migraine surgery requires
one to two hours per site and is done on an
outpatient basis with near immediate relief of
symptoms if done successfully.
Importantly, migraine surgery is best
performed by Board Certied plastic surgeons
that have had formal training on complex
peripheral nerve surgery and a deep
understanding of the anatomy and function of
the so tissue and muscles of the face.
Choosing a skilled surgeon will optimize the
results of the surgery and minimize potential
complications.
Dr. Kaveh Alizadeh, MD, MSC, FACS
/LONGISLANDPRESS.COM
