More than 38 million Americans will experience the debilitating effects of migraine headaches this year. A staggering number by any standard, this statistic is all the more startling as it represents a nearly 36 percent increase in the incidence of migraines across the United States since 1999.

Fortunately, as the prevalence of migraines has increased significantly over the past two decades, the number of efficacious treatment options for those who endure the painful and life-altering symptoms of migraine headaches has also grown.

It is well-known there are common migraine triggers, or lifestyle and environmental factors, that precipitate these pervasive headaches. These include stress, a lack of quality sleep, hormonal changes, the consumption of caffeine or alcohol, dehydration, loud noises, bright lights and seasonal allergies, among other causes.

What may be less known is there are areas in the head that trigger migraine headaches, including sites in the forehead, temples, sinuses, behind the eye and in the back of the head. Fortunately, plastic surgeons have the capability to perform an innovative procedure known as migraine surgery to permanently deactivate these internal triggers.

During this procedure, the surgeon makes small incisions to remove muscle or vessels surrounding the nerve at the migraine trigger site. The nerve itself may also need to be adjusted or removed occasionally in order to completely eliminate migraine headaches originating from that site. Migraine surgery is safe and typically performed on an outpatient basis. Patients may experience temporary numbness following the procedure, but post-operative infection and other complications are extremely rare. 

In the two decades since the procedure was first performed, many independent, international studies, including Harvard University in Cambridge, Mass., have shown the surgery to be highly effective, significantly decreasing or completely eliminating migraine headaches in 80 percent to 90 percent of the individuals who have opted to treat their migraines through surgery.

Over time, the basic principles of the surgery have remained the same, but myself and fellow surgeons have continued to simplify the procedure to minimize risk and downtime for patients through these studies, in addition to developing new techniques for addressing rare trigger sites.

Advances in research have also continued to yield landmark discoveries, such as the findings of one study that demonstrated patients with migraine headaches have a genetic deficiency in the myelin sheath that typically insulates the nerve. Although not considered a cure because it does not eliminate the pathology, or genetic component, behind the migraines, migraine surgery effectively protects the nerve from the sources of irritation that contribute to the onset of migraine headaches.

Dr. Bahman Guyuron is a plastic surgeon who practices at Zeeba Clinic in Lyndhurst. 

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