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Q&A with Dr. Guyuron: Migraine Surgery

Jun 4, 2018, 12:00 PM by Valerie Clark

I’ve done Botox for migraines. Why would it be beneficial for me to move beyond it?

Botox is an injection of a toxin that paralyzes, weakens or relaxes nerves and muscles where it is injected. It can be a quick fix for migraine sufferers, but the effects are temporary. Therefore, the injections must be repeated every 3 to 12 months. If you experience frequent migraines, you may be a candidate for a treatment option that can permanently reduce or eliminate migraine headaches.

Migraines are caused by inflamed or irritated nerve endings which is referred to as a trigger. Migraines can also be triggered by stress as well as seasonal and food allergies.  Migraine surgery eliminates the trigger point by decompressing the nerve permanently. The biggest benefit is eliminating or greatly reducing migraines for good, which means less time dealing with a debilitating migraine and more time enjoying life.

What about surgery for migraines?

Dr. Bahman Guyuron, through his experience in plastic surgery, discovered the connection between a forehead lift and the reduction or elimination of migraines in some patients. He developed the technique now known as migraine surgery, which was born from plastic surgery, and he teaches his technique to surgeons around the world.  For migraines that occur in the forehead area, the surgery involves removing a muscle in the forehead (which is used for frowning), which, in turn, decompresses the nerve that is known to trigger a migraine in this area.

In most cases, the surgery is minimally invasive and requires only small incisions that will heal quickly with little or no visible scaring.  This is done as an outpatient procedure and can take less than one hour to complete. Most patients return to work and normal lifestyle within a day or two.  The risk of complications and infection is very low for this surgery.

Over 17 years, and 40 studies performed, 90% of Dr. Guyuron’s patients report significant reduction or elimination of their migraines.  Dr. Guyuron continues to improve upon his technique and discover more about what causes migraine headaches.  He can perform migraine surgery to target migraine triggers in the forehead, temples, behind the eyes, sinuses, and back of the head. Thanks to Dr. Guyuron’s continued effort, we know more about what causes migraines than was known 15 years ago.

What are the benefits of surgery over medications?

Medication does not work for every migraine sufferer, and it only works if it is taken as prescribed. Also, there can be unwanted side effects to the medication.  The benefits of medication are short-lived and often do not provide enough relief, especially for severe migraines. Surgery can permanently eliminate or greatly reduce the severity and occurrence of migraines.  Most patients report that if they do get a migraine after surgery, it is mild enough to be treated with regular ibuprofen.

What is the next step for a more permanent solution? 

The next step would be to schedule a visit with the American Migraine Center in Lyndhurst. At the Center, they will evaluate your symptoms and potential trigger sites.  If you do not have an official diagnosis, then you can be seen by Dr. Roda, a board-certified neurologist, who is trained to diagnose migraine headaches. Dr. Guyuron only operates on patients who have diagnosed by a neurologist.

A consultation with Dr. Guyuron can be arranged via skype for out-of-town patients or in-person for local patients. He will take the information provided by the American Migraine Center together with your medical history of migraine symptoms. He will work with you to identify where your migraines start and understand how they affect your life.  If he determines that you are a candidate for migraine surgery, then you will create a treatment plan to end your migraines once and for all.  His goal, together with the American Migraine Center, is to help patients find a solution and long-lasting relief.

Do you have a question for Dr. Guyuron? Please submit your question on the Zeeba Clinic website at

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