Cosmetic eye procedure may ease migraines, small study says

August 22, 2014 by Kathleen Doheny, Healthday Reporter
Cosmetic eye procedure may ease migraines, small study says
Eyelid surgery may help treat severe headaches, but not everyone's convinced.

(HealthDay)—Cosmetic eyelid surgery involving specific nerves may do more than improve your looks—the procedure may also provide migraine relief for some, according to new research.

The technique involves making incisions in the upper eyelid to deactivate so-called "trigger" nerves. This process also lifts the lid, a technique known as blepharoplasty.

The new approach is an alternative to another surgery sometimes used to treat migraines. That one approaches the nerves under the skin but starts at the scalp.

Both procedures are known as trigger-site deactivation surgeries. Some neurologists and others who care for people with migraines view the procedures as unproven.

But when the surgery is used in appropriate patients, migraine improvement is common, said study researcher Dr. Oren Tessler, an assistant professor of clinical surgery at the Louisiana State University Health Sciences Center New Orleans School of Medicine.

"Ninety percent of our patients had over 50 percent improvement in their migraines," he said. "After a year's time, 51 percent had no migraines."

"As a bonus they got an upper eyelid surgery," added Tessler, who is also director of plastic surgery at University Hospital, New Orleans.

Not everyone agrees that this surgery is helpful, or even that freeing trapped nerves gets to the root of what causes migraines.

"I think it's conceivable at least in principle that a nerve could be trapped," said Dr. Vincent Martin, co-director of the headache and facial pain program at the University of Cincinnati School of Medicine in Ohio.

Martin said that while entrapped nerves may worsen migraines, he's not convinced that they're a cause of migraines.

In addition, "There are weaknesses in the way the study was designed," he said, citing the lack of a control group. All 35 patients had the surgery so they couldn't be compared against a "sham" surgery group, a common method in scientific studies.

"There's a huge 'placebo effect' from surgical procedures," Martin explained. In other words, they may think they feel better simply because they received treatment.

The study, published online recently in Plastic and Reconstructive Surgery, included 30 women and five men. Their average age was 46.

Tessler said patients have to be selected carefully because the surgery is meant for those whose migraines are caused by a compression of nerves as they exit the skull.

"You release the nerve and you remove the irritation," Tessler said.

In his study, the average number of headache days reported by patients declined from 18.5 a month on average to fewer than four a month one year after the surgery.

"There have been no major complications," he said. "Every patient will have some numbness because the is in shock." That numbness usually resolves, but a small amount may remain, he said. His patients tell him it's a small price to pay for migraine relief.

The fees for the surgery, done as a cosmetic procedure, vary by doctor and region of the country. According to the American Society of Plastic and Reconstructive Surgeons, the average physician fee is about $3,000. The fee does not include any charges for the facility and anesthesia.

Tessler said the surgery, sometimes covered by insurance, takes about three hours. An incision is made in the upper eyelid to get to the specific nerves and release them. "It [also] takes away the bulge of the eyelid," he said, giving a more youthful look.

Acknowledging the small study size, Tessler said more research is needed. None of the researchers disclosed financial interests in any of the products, devices or drugs discussed in the study.

Martin also believes more study is needed. This technique is "theoretically plausible, but not proven," he said. "Most neurologists and headache doctors don't think the evidence is sufficient to recommend this at this time."

Explore further: Non-endoscopic migraine surgery provides significant symptom relief

More information: For more information on migraines, visit the U.S. National Institutes of Health.

Related Stories

Non-endoscopic migraine surgery provides significant symptom relief

July 28, 2014
A revised version of a surgical procedure to treat severe chronic migraine headaches led to significant symptom relief more than 90 percent of the time in patients treated at Massachusetts General Hospital (MGH). Physicians ...

Surgery doubted as a migraine reliever

June 27, 2014
(HealthDay)—Migraine surgery is increasingly touted as a potential "cure" for the debilitating headaches, but researchers say the evidence just isn't there to support those claims.

Fat preservation better for lower eyelid blepharoplasty

July 14, 2014
(HealthDay)—Fat preservation and grafting techniques have gained popularity in lower eyelid blepharoplasty, according to a surgical pearls piece published online June 26 in JAMA Facial Plastic Surgery.

Chronic migraine headache relief possible with outpatient surgery

January 4, 2013
When medications fail to eradicate debilitating migraine headaches, surgery could provide relief for certain patients.

Migraines may worsen during menopause

June 24, 2014
(HealthDay)—New research confirms what women with migraine headaches have told their doctors for years: migraine attacks seem to get worse in the years before and during menopause.

Recommended for you

World's first child hand transplant a 'success'

July 19, 2017
The first child in the world to undergo a double hand transplant is now able to write, feed and dress himself, doctors said Tuesday, declaring the ground-breaking operation a success after 18 months.

Knee surgery—have we been doing it wrong?

July 18, 2017
A team of University at Buffalo medical doctors have published a study that challenges a surgical practice used for decades during arthroscopic knee surgery.

New tools help surgeons find liver tumors, not nick blood vessels

July 17, 2017
The liver is a particularly squishy, slippery organ, prone to shifting both deadly tumors and life-preserving blood vessels by inches between the time they're discovered on a CT scan and when the patient is lying on an operating ...

Researchers discover indicator of lung transplant rejection

July 13, 2017
Research by scientists at Dignity Health St. Joseph's Hospital and Medical Center's Norton Thoracic Institute was published in the July 12, 2017 issue of Science Translational Medicine titled "Zbtb7a induction in alveolar ...

New device could make closing surgical incisions a cinch

July 7, 2017
Like many surgeons, Dr. Jason Spector is often faced with the challenge of securely closing the abdominal wall without injuring the intestines. If the process goes awry, there can be serious consequences for patients, including ...

Success with first 20 patients undergoing minimally invasive pancreatic transplant surgery

June 29, 2017
Surgeons at Johns Hopkins Medicine report that their first series of a minimally invasive procedure to treat chronic pancreas disease, known as severe pancreatitis, resulted in shorter hospital stays, less need for opioids ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.