A Historical Context
Migraine surgery has been around since about 2000, when Cleveland, Ohio-based plastic surgeon Bahman Guyuron, M.D., pioneered the procedure.
“Dr. Guyuron, who does a lot of aesthetic surgery, was doing cosmetic brow lifts when he essentially tripped on this discovery,” Dr. Janis says.
A few patients commented on how impressed they were by the migraine pain relief they had gotten after their brow lifts. And Dr. Guyuron likened the outcome to what happens when a nerve gets entrapped in the wrist, causing symptoms in the hands, and carpal tunnel release surgery relieves associated symptoms. In a cosmetic brow lift, surgeons might decompress the supraorbital and supratrochlear nerves in the head because those nerves run through the corrugator muscle, according to Dr. Janis.
“The pain relief is not because the brows are higher on your forehead. The pain relief is thought to be because we take out the muscles pinching those nerves,” Dr. Janis says. “That’s why Dr. Guyuron and I started to study nerves around the head and neck. We found that migraine patients tend to have pain in three typical locations: around eye, the temple and the back of the head.”
Based on their research, the plastic surgeons developed approaches to surgically decompress specific nerves, Dr. Janis says.
“Since the year 2000, we have 18 years’ worth of clinical data and experience, published in the peer-reviewed literature to support the fact that migraine surgery is not experimental; it’s not investigational. It has a lot of data and support behind it,” Dr. Janis says.