Patients who suffer from migraine headaches often find a migraine event incapacitating, totally disrupting their lives until it passes. A cure has been elusive and sometimes it seems as if there have been as many treatments as patients.
What does this have to do with plastic surgery? It begins with a shift in the thinking of the cause of migraines from vascular (blood vessel) changes to muscle tension surrounding the skull. Also, since we began using Botox for the cosmetic treatment of wrinkles between the eyebrows, almost every plastic surgeon has had patients who have found relief from their migraine headaches after injection of the muscles between the eyebrows. Since Botox relaxes the muscle fibers that are injected, this pain relief is consistent with the theory that migraines are triggered by muscle tension.
These findings among others have resulted in a shift in treatment models, and now one of the approved uses of Botox is the treatment of migraines. In fact, many large migraine treatment centers, including the Mayo Clinic, use Botox injections as part of their treatment protocol.
Another link between plastic surgery and migraines is the procedure Endoscopic Brow Lift. In this cosmetic procedure, surgical endoscopes are used to elevate and reposition a sagging brow through small incisions behind the hairline. During a Brow Lift, which may be done with or without a Facelift, many plastic surgeons also perform various techniques to weaken or remove the small muscles responsible for the "squint line", the same muscle targeted in Botox injections. They have found that some patients have gotten relief from their migraines. The effectiveness of this procedure for migraine relief is currently being investigated.
Throughout its' history, the field of plastic surgery has been deeply involved in reconstructive procedures that improve function as well as form, and the treatment of migraines is just the latest example of this rich history of innovation.