New Surgery for Migraines

For people who suffer from migraine headaches, relief may be a surgical procedure away. Ahmed Afifi, MD, UW Health plastic and reconstructive surgeon and assistant professor at University of Wisconsin School of Medicine and Public Health, is now offering surgical decompression of the peripheral sensory nerves around the skull to treat migraines.


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Surgery for migraine headaches was first discovered in Cleveland when a plastic surgeon noticed patients were reporting migraine relief after undergoing cosmetic browlift surgery. Research later showed that release of the supraorbital nerve, which is commonly done during browlift surgery, was the reason for this improvement.

Patients must have been diagnosed with migraines by a neurologist, as not all headaches are migraines. Candidates for consideration include patients who have not responded to medical or pharmacological therapy and patients who have responded to local injections to identify trigger nerves.

The supraorbital nerve as visualized from the endoscopic view after removal of the corrugator muscle."We use Botox® or local anesthetics as a diagnostic test preoperatively. For example, if injections in the corrugator muscles in the supraorbital area alleviate the headaches, then the patient is a good candidate for resection of the corrugator muscle and decompression of the supraorbital nerve." says Dr. Afifi.

Surgery is performed as an outpatient procedure under local or general anesthesia and usually takes one to two hours. Swelling is typically gone within two weeks and often patients are able to return to their usual activities in the same time frame.

"A prospective study of patients over a five year period has found that more than 70 percent had a significant improvement in their quality-of-life, headache intensity and frequency, with complete elimination of migraines in roughly a third of the patients," says Dr. Afifi.

To schedule a patient consult, please call (608)265-2535.