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Cosmetic Eye Procedure May Ease Migraines

Eyelid surgery may help treat severe headaches, but not everyone's convinced

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Cosmetic eyelid surgery involving specific nerves may do more than improve your looks -- the procedure may also provide migraine relief for some, according to new research.

The technique involves making incisions in the upper eyelid to deactivate so-called "trigger" nerves. This process also lifts the lid, a technique known as blepharoplasty.

The new approach is an alternative to another surgery sometimes used to treat migraines. That one approaches the nerves under the skin but starts at the scalp.

Both procedures are known as trigger-site deactivation surgeries. Some neurologists and others who care for people with migraines view the procedures as unproven.

But when the surgery is used in appropriate patients, migraine improvement is common, said study researcher Dr. Oren Tessler, an assistant professor of clinical surgery at the Louisiana State University Health Sciences Center New Orleans School of Medicine.

"Ninety percent of our patients had over 50 percent improvement in their migraines," he said. "After a year's time, 51 percent had no migraines."

"As a bonus they got an upper eyelid surgery," added Tessler, who is also director of plastic surgery at University Hospital, New Orleans.

Not everyone agrees that this surgery is helpful, or even that freeing trapped nerves gets to the root of what causes migraines.

"I think it's conceivable at least in principle that a nerve could be trapped," said Dr. Vincent Martin, co-director of the headache and facial pain program at the University of Cincinnati School of Medicine in Ohio.

Martin said that while entrapped nerves may worsen migraines, he's not convinced that they're a cause of migraines.

In addition, "There are weaknesses in the way the study was designed," he said, citing the lack of a control group. All 35 patients had the surgery so they couldn't be compared against a "sham" surgery group, a common method in scientific studies.

"There's a huge 'placebo effect' from surgical procedures," Martin explained. In other words, they may think they feel better simply because they received treatment.

The study, published online recently in Plastic and Reconstructive Surgery, included 30 women and five men. Their average age was 46.

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