As human beings who care for other human beings, we are always excited and enthusiastic to explore new treatments and techniques that may improve our patients’ lives and abilities, and take away their pain. But as qualified plastic surgeons with a reputation for honesty and accountability, we always temper that enthusiasm with a reserve of sensible, scientific rigour. We’ll leave claims of miracle cures to others.
So, please forgive us if we present the science behind the treatments we now offer for migraine sufferers. It’s important you know the facts.
There is a growing body of medical literature that indicates that by relaxing or decompressing certain forehead muscles and nerves, it can help to prevent migraines (the medical term for this is ‘migraine prophylaxis’).
To relax these muscles, the patient is injected with purified protein, which is normally used purely for cosmetic purposes to remove frown-lines. The additional benefit for migraine sufferers was discovered quite incidentally (as many scientific discoveries can be). The effect can last for three to six months.
Why this works is still being debated. Here’s where we head, unavoidably, into scientific language, which we’ll try to translate. The most popular hypothesis suggests that prolonged contraction of overactive forehead muscles (the corrugators) leads to nerve compartment syndrome of the supratrochlear nerve, a branch of the trigeminal nerve.
In simplistic terms, constant frowning causes problems. You may not even be aware it’s happening or be doing it consciously. In turn, this blocks the blood flow, causing the local nerves to become anaemic (ischaemia). The nerve fibres then react by releasing neuro-peptides, which inflame the nerve tissue and meninges (the membranes wrapped around the brain and spinal cord).
For many years, researchers have studied the trigeminal nerve as one of the contributors to migraine headaches, but have only recently identified the significance of its role in creating them.
At Adelaide Plastic Surgery, we have a strict protocol we follow to determine how best to help each individual case. We make no presumptions and proceed only when you agree, and it is clear that what we are doing has the potential to benefit you.
First, we would assess you to exclude any organic causes for your headaches, which usually requires a consultation with a neurologist.