Cosmetic Surgery of the Forehead Could Ease Migraine Pain

Surgical deactivation of three common migraine-headache trigger sites via a forehead cosmetic lift could help patients with migraines that are difficult to manage with standard protocols.

Researchers from Case Western Reserve University (Cleveland, OH, USA) conducted a double blind, controlled clinical trial involving 75 patients with moderate to severe migraine headache, who met International Classification of Headache Disorders II criteria. Frontal, temporal, and occipital trigger sites were identified, and the patients were randomly assigned to receive either actual or sham surgery in their predominant trigger site. The patients completed the Migraine Disability Assessment, Migraine-Specific Quality of Life, and Medical Outcomes Study 36-Item Short Form Health Survey health questionnaires before treatment, and again at one-year follow-up.

The study results showed that 57.7% of the control group and 83.7% of the surgery group experienced at least 50% reduction in migraine headache; furthermore, 57.1% of the patients in the surgery group reported complete elimination of migraine headache, compared to only one of 26 patients in the sham surgery group (3.8%). Compared with the control group, the actual surgery group demonstrated statistically significant improvements in all validated migraine headache measurements at one year; these improvements were not dependent on the trigger site. The most common surgical complication was slight hollowing of the temple in the group with temporal migraine headache. The study was published in the August 2009 issue of the journal Plastic and Reconstructive Surgery.

"A certain degree of skepticism is healthy,” said lead author Bahman Guyuron, M.D., of the department of plastic surgery. "But there's no question in my mind we are seeing results, and patients are experiencing an enduring positive response.”

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