Plastic surgeon Dr. Drew Ordon explains how Botox can help relieve migraines.
One of the fun things about working on The Doctors is the information exchange. I know you might think it's about us giving the information and you receiving it, but we doctors are learning every week, too!
Plastic surgeon Dr. Bahman Guyuron was on the show today and shared that he noticed that people who had forehead lifts, who coincidentally suffered from migraines, experienced improvement of their migraine symptoms post-surgery. He began a study with 400 patients to see the effects of a forehead lift on migraine pain. The results are statistically significant and warrant further study.
In my view, there is strong evidence that a forehead lift may be recommended in the future for people who fail medical therapy, but I'd stop short of recommending this surgery for all migraine sufferers. We do not regularly recommend surgery when medication or non-surgical measures may suffice; it is part of the "less is more" and "do no harm" philosophy that we doctors adhere to. But in the future, you never know: we may be operating on migraines!
Currently, we regularly use Botox for migraines, as the advantage is that the paralytic agent acts quickly and carries with it very little risk. Injecting Botox for migraines is an acquired art. Often the patient knows where his or her trigger points are and will tells us, “Inject it here!"
When I examine the patient, I have them bite down to get a sense of which muscles are overdeveloped and spastic. The reason for this is because Botox is used in muscles, not nerves. Then I inject slightly diluted Botox directly into the muscles, massaging the injection site, so as to diffuse the agent and evenly distribute it for maximum effect. The treatment takes about 20 minutes, takes effect in a few days and lasts approximately four months. It works!
~Dr. Drew Ordon