Forehead Lift Cures Migraine Patients
But Surgery Only Performed on Hard-to-Treat Migraine Patients
WebMD News Archive
July 31, 2009 - Stacy Porter, 29, can’t remember a time when she didn’t suffer from crippling, relentless migraines before having the surgery that changed her life eight years ago.
“I was diagnosed with migraines when I was 2 years old,” the New Philadelphia, Ohio, marketing executive tells WebMD. “I had about 15 days a month of severe migraine pain.”
Her symptoms included throbbing pain in her temples, nausea, and sensitivity to light so severe she remembers wearing sunglasses to more than one final exam in high school and college.
None of the drugs used to prevent migraines helped, so her only relief came from medications that eased the pain but left her feeling drugged and out of it.
That all changed at age 21 when she had a surgery similar to that typically performed to remove crow's feet.
“After that I never had another migraine,” she says.
Plastic surgeon Bahman Guyuron, MD, of Case Western Reserve University, says Porter’s results are common, and his newly published study backs up the claim.
Forehead Lift Lifts Migraines
Guyuron has treated more than 400 migraine patients with a modified version of a traditional forehead lift over the last decade, and he tells WebMD that the vast majority of them have shown dramatic improvement.
His newly published study was designed to convince critics still skeptical of using plastic surgery to treat migraines.
Guyuron and colleagues randomly assigned 75 patients with migraine trigger sites in just one area to receive either real or sham surgery. The patients were not told which type of surgery they were getting.
In the real surgery group, nerves were cut at specific migraine trigger sites. In some cases, like Porter’s, the nerve was the same one cut to eliminate crow’s feet. In others, the nerve was the same one cut to ease frown lines on the forehead.
The surgery works like Botox injections -- now widely used, though not approved, for the treatment of migraines.
In fact, patients in the active-surgery group got Botox injections first to determine if they were good surgical candidates.
In all, 49 patients had the actual surgery and 26 had the sham surgery.
One year later, 83% of the actual surgery group reported at least a 50% reduction in migraines, compared to 57% of the sham surgery group.
Even more surprising, 57% of actual surgery patients reported complete elimination of migraines, compared to just 4% of sham surgery patients.
The study appears in the August issue of the journal Plastic and Reconstructive Surgery.
“You don’t see results like this in migraine studies,” Guyuron says. “Even the most skeptical people will have to accept there is something to this.”
Surgery Not for Everyone
But surgery is not a good option for patients who have infrequent migraines and those who respond to preventive treatments, he says.