Minimally Invasive Migraine Surgery

Our advanced surgery technique is tailored to your specific migraine triggers and is designed to permanently remove the faulty nerve signals that causes your migraine to strike.

Are you a candidate for migraine surgery?

Type of Migraine

Not all migraines are created equal, and different migraine sufferers have different underlying causes. Migraine surgery offers an ideal procedure to treat migraines related to one of four muscular/nerve trigger points. One trigger point is located inside the nose, and the remainder are located around the scalp.

Migraine Trigger Point Confirmation

When a sensitive spot on the body is pressed or palpated, a patient may feel localized pain or “referred” pain elsewhere in the body. With effective migraine trigger point confirmation, a patient can understand the link between a trigger point and the migraine pain that he or she experiences.

There are two types of trigger points:

  • Latent: May be tender when pressed but will not cause pain in other parts of the body.
  • Active: May result in pain in various parts of the body when pressed or palpated.

The three scalp trigger points can be confirmed via BOTOX® injections to these areas. A nasal trigger point can usually be confirmed via the use of nasal spray.

After a BOTOX® injection, the muscles usually will relax and ease the tension that otherwise may lead to migraines. If a BOTOX® treatment minimizes migraine symptoms, then we have discovered your trigger point.

Nasal spray is administered through the nostrils to deliver temporary migraine relief. If the nasal spray alleviates your migraine symptoms, then we have found your migraine trigger point.

Migraine Surgery Effectiveness

Once confirmed, surgery is tailored to your specific triggers and is designed to permanently eliminate an ineffective nerve signal. In most patients, this dramatically improves the duration, intensity and frequency of migraines. Roughly half of all patients are able to stop migraines after migraine surgery.

Surgical Work Up

Surgical Candidates and Work Up

Should I Schedule a Consultation?

In order to be considered for surgery, you must have a diagnosis of migraine headache from a neurologist within the past five years. Surgery is only effective in those suffering from migraine headaches, and many types of headaches can present similarly to migraines.

Additional Considerations

Other considerations in patient selection for surgery include the effectiveness and suffered side effects of your migraine medications, as well as the severity of your headaches. A favorable response to BOTOX® (or nasal spray, for the nasal trigger) will be required to confirm that surgery will be effective. If effectiveness of BOTOX® and/or nasal spray is confirmed from an outside physician, it is typically not necessary to perform this confirmation in our office.

Concurrent Cosmetic Surgery

You may opt to have one or more cosmetic procedures at the same time as your migraine surgery. In many cases, the same incisions can be used to address your migraines and perform aesthetic surgery to the eyes, brows and/or nose.

Pre-Operative Clearance

Before surgery, you will need to complete bloodwork and receive a general medical examination from an outside doctor. You also may need additional medical clearance based on your age and health.

SURGICAL CANDIDACYOverview of Migraine Surgery

Overview of Migraine Surgery

Before Surgery

Two weeks prior to your surgery, you will be asked to stop taking any blood thinning prescriptions or supplements. By doing so, you can reduce the risk of excessive bleeding during the operation. If you are dependent on blood thinning medications due to a severe medical condition, we will need to consult with your managing physician to explore various alternative options. You will be asked to refrain from eating or drinking starting the night before migraine surgery. This will ensure anesthesia can be administered safely and effectively on the day of your surgery.


Depending on the patient and the trigger sites involved, the surgery can be performed after a patient receives local anesthesia. Or, in some instances, migraine surgery will be performed under deep sedation or general anesthesia.

The decision to administer migraine surgery under deep sedation or general anesthesia may vary based on a patient’s trigger points, medical conditions and age. Before migraine surgery, a facial plastic surgeon will conduct an in-depth assessment of a patient and offer anesthesia recommendations. This will ensure anesthesia is administered properly at all times.

Length of Migraine Surgery

Migraine surgery usually takes about one to three hours to complete based on the treatment location and trigger points. A facial plastic surgeon will discuss what to expect before, during and after migraine surgery. By doing so, a migraine surgery patient will know exactly what to expect at all stages of the procedure.

Incisions and Approach

During migraine surgery, a facial plastic surgeon will make incisions within the hair on the scalp or within the upper eyelid creases. These incisions typically heal with no visible scar. During a migraine surgery that involves a nasal trigger point, a facial plastic surgery will make incisions within the nose, completely hidden from view.

Migraine Recovery

Migraine surgery is an outpatient procedure. After the surgery is completed, you will be able to return home immediately.

In one week, all sutures will be removed in the office. Depending on the nature of your work or daily activities, restrictions will be placed on various activities for one to three weeks.

If nasal surgery is involved, stitches may be necessary. However, these stitches will dissolve on their own a few weeks after a procedure is completed.

Surgical Side Effects

After migraine surgery, you may experience swelling and bruising around the eyes. However, these symptoms usually will disappear within one to two weeks. Ice, anti-bruising medication and ointment will be prescribed. There is also commonly itching that occurs near the scalp incisions that very quickly subsides.

Typically, there is minimal pain after surgery, and you will be prescribed pain medications immediately following treatment. You also may receive antibiotics to help minimize the risk of infection.

surgical work upMigraine Surgery Concerns

Migraine Surgery Concerns

Some of the most common migraine surgery concerns include:

  • Scars do not heal properly
  • Loss of hair around incisions
  • Muscle/nerve injury that results in temporary movement problems
  • Dryness around the eyes

In many instances, patients will experience temporary facial muscle weakness following migraine surgery. This issue usually disappears on its own in the weeks after treatment.

Migraine Surgery Concerns Results


Depending on the trigger sites, patients may notice improvement immediately, but it may take weeks or months until the full effect is felt. The majority of patients notice improvement within two-to-four weeks.

Although uncommon, there is a chance your migraines will not significantly improve. This is usually related to additional trigger sites that are now noticeable after the removal of the primary sites, and can usually be treated with an additional procedure. It is very rare for there to be no improvement after surgery.

Results Why Choose The Migraine Institute

Why Choose The Migraine Institute For Your Migraine Surgery?

The Migraine Institute is the first center in Los Angeles that is exclusively committed to helping individuals eliminate migraine pain. We have a team of migraine specialists who are pioneers in the field of migraine surgery and will do whatever they can to assist patients. From the first moment you step into The Migraine Institute, our top priority is to take care of you so you can start enjoying life again!

Find out if you are a candidate for migraine surgery.

Put an end to sitting inside while your friends and family are out enjoying life! Contact The Migraine Institute today to learn more about life-changing results migraine treatment can provide.

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Have you been diagnosed with chronic migraines by a neurologist?
Have you tried BOTOX® for your migraines before?