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Migraine Headache Surgery

Dr. Jimmy Waldrop is the first and only surgeon in Chattanooga to offer this particular style of migraine headache surgery which provides patients with long term relief of their migraine symptoms.


If you would like to be considered for migraine surgery, you must first:

  • Be seen by a neurologist and diagnosed with migraine headaches
  • Report side effects or unsuccessful results from other treatment options
  • Obtain a referral from your neurologist for evaluation for surgical treatment

Although this procedure is new to the Chattanooga area and is offered only through The Plastic Surgery Group, it has been successfully performed on thousands of patients throughout the country.


Background

Dr. Guyuron at University Hospitals Case Medical Center has pioneered this procedure after noticing that a number of patients having browlift surgery had resolution of their migraine headaches. Subsequently he has performed multiple research studies and has shown the effectiveness of the treatment.


How does the surgery work?

The basis of the surgery is in the theory that migraine headaches can be caused by irritation of the trigeminal nerve. This nerve has multiple branches in the head and irritation of any of these may lead to migraines. Common causes of irritation are surrounding muscles, bone, cartilage, and blood vessels. Elimination of these irritating entities leads to cessation of migraine headaches. Common “trigger points” include the central forehead, the temples, the back of the head, and the nasal septum.


Where are the incisions?

The surgery is done through small incisions which are placed to hide them from view. For the forehead and temporal areas, which are performed in combination, there are 5 small incisions made behind the hairline. When the back of the head is treated the small incision is made also behind the hairline at base of the skull near the neck. Surgery on the nasal septum is done through the nostrils and the incision is not visible.


What are the risks of the surgery?

As with any surgery there are potential risks but they are usually minimal and are rare. Common to all surgery is the risk of infection and bleeding. More specific to migraine surgery there are risks of temporary or permanent numbness of certain areas of the scalp and rarely minimal hair loss at the incision sites. Potentially the nerves that move the muscles of the forehead may be injured but again this is quite uncommon. Regarding the nasal septum there is the possibility that the nose can become drier after the surgery.


What are the chances of success from the surgery?

Studies performed by Dr. Guyuron demonstrate a success rate of about 80%, meaning a reduction of migraines of at least 50% or more. However, as much as 60% of patients may experience elimination of migraine headaches.


Where is the surgery performed?

The surgery is usually performed in an outpatient surgery facility.


What kind of anesthesia is used?

The procedure is performed under general anesthesia as an outpatient procedure.


Does health insurance cover the surgery?

In some cases health insurance will cover the procedure if criteria are met.


What kind of postoperative care is needed?

When you go home, someone will have to drive you and stay with you overnight in case you need assistance. You will have a small drain tube in place if you had surgery for the back of the head. This drain is usually removed in 2-5 days. All of the sutures are dissolvable and do not need to be removed. You should shower and shampoo your hair daily starting 2 days after surgery.


Who is a candidate for surgery?

People who suffer 2 or more severe migraine headaches a month that do not respond to over the counter medications. Anyone who cannot tolerate the side effects of prescription medications and have uncontrolled headaches. If you are unwilling to take medications or if you experience migraines that interfere with your personal or professional life.


What is the recovery like?

You will experience some swelling and bruising which usually lasts about 7 to 10 days. You can expect to have a post operative headache related to the swelling and surgery for a few days. Most patients are presentable for social interaction by 2 weeks and should avoid heavy exercise for about 3 weeks.


When will I notice improvement?

Depending on the trigger sites that required treatment you may notice immediate improvement or may take several weeks. Often the improvement noticed from the nasal septum surgery may take several weeks.


Can I take my migraine medications after the surgery?

Any medications containing aspirin or ibuprofen should be avoided due to the bleeding risk after surgery. However, if you have a migraine you may take other migraine medications although the need for this should be small.