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Plastic Surgery May Stop Headaches Along With Frown Lines

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Conventional migraine medications must be taken daily for long periods to prevent headaches, while injections to abort a painful migraine attack are costly and inconvenient, and often must be given in a hospital emergency room.

"I've been told to use ice bags, go in a dark, quiet room, and even see a psychiatrist," Myers says.. "Suppositories and other medications only gave me temporary relief."

On Feb. 11, 1999, Myers had the forehead lift, which Guyuron had recommended to smooth out frown lines that Myers felt were making him look tired. "As time went on after the surgery, I realized that not only did I look much better, but I also had no more headaches," Myers says.

However, "in my own patient population of over 400 patients, I have not been able to confirm the experience of Dr. Guyuron," says Knize, an associate clinical professor of surgery (plastic surgery) at the University of Colorado Health Sciences Center in Denver. "I don't believe we should act on this as being a treatment for migraine until we can substantiate its effectiveness."

Only five or six of Knize's 400 patients had migraine headaches as defined by the strict guidelines of the International Headache Society, and only one of these patients noticed headache relief after surgery. Knize, Unwin and Diamond suggest that researchers should follow more migraine patients who've had forehead lifts before recommending the operation as a potential migraine treatment.

"Since some patients may have different [triggers] causing their headache, the procedure might not work for everyone," says Guyuron.

Along with a migraine specialist at Case Western, Guyuron is beginning a study of 20 patients with migraines. Before having a forehead lift, each patient will receive an injection of Botox, a medication that temporarily paralyzes the forehead muscle and also smoothes forehead lines. Earlier studies have shown that Botox can prevent migraines, and Guyuron is studying whether patients who get headache relief from the injection are more likely to have permanent relief when the muscle is removed surgically. Seven patients have been enrolled; six have had headache relief with Botox, and one is scheduled for surgery next week.

"If we confirm our earlier findings, this may facilitate insurance coverage for this procedure," Guyuron says."

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