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 migraines.

Migraine Surgery Candidates: What You Need to Know

The Migraine Institute is a leading provider of minimally invasive migraine surgery treatments. We use advanced migraine decompression surgery techniques to address a patient’s migraine triggers and permanently remove faulty nerve signals that cause your migraines.

Are You a Candidate for a Minimally Invasive Surgery?

Not all migraines are created equal, and different migraine sufferers have different underlying causes. Migraine surgery is ideal in treating migraines related to one of several muscular/nerve trigger points. One trigger point is located inside the nose, and the remainder are located around the face, scalp and neck.

Nerve decompression surgery is a complex procedure. Dr. Jonathan Cabin of The Migraine Institute will conduct an in-depth evaluation to determine if you are an appropriate candidate for this approach. Using trigger point confirmation techniques as part of a comprehensive patient assessment, Dr. Cabin gains understanding of each individual’s unique link between a trigger point and migraine pain. This allows a customized surgical plan to be developed for each patient.

What are Migraine Trigger Points?

A migraine trigger point refers to a specific sensory nerve on the face, scalp or neck that, when irritated, sets off a domino effect that can lead to a migraine. With effective migraine trigger point confirmation, a patient can appreciate the link between a specific trigger point and the migraine pain that he or she experiences.

The most important tools in confirming trigger points is the use of a detailed patient history, migraine log and in-office examination. Frequently, other techniques will be required including doppler testing and/or BOTOX®/nerve block injections. Depending on the trigger point(s) involved, a CT scan or course of medication (like nasal steroid spray) may also be required for further confirmation.

A doppler is a special device that uses sound waves to detect blood vessel pulsations. It is particularly helpful in localizing arteries that may be irritating trigger point sensory nerves. These arteries can be treated to eliminate the migraine trigger.

BOTOX® injections relax muscles around a nerve (some new studies suggest that it may actually work directly on the nerve, as well). It takes BOTOX® about 3-5 days to start working and 2 weeks to get to its maximal effect.  If BOTOX® treatment in a certain area reduces or eliminates migraine symptoms, this suggests that this may be a trigger point.

Nerve blocks work more immediately by blocking signal transmission for a specific nerve.  This can also help determine whether a particular area is a trigger point, especially if the patient is actively in the early stage of a migraine when the injection is performed.

Steroid nasal spray is administered through the nostrils to shrink the internal lining of the nose. When nasal spray helps to reduce or eliminate migraines, then this can serve as confirmation of a nasal trigger point.

Is Migraine Surgery Effective?

Migraine surgery is custom-tailored to your specific triggers and is designed to permanently eliminate a particular nerve irritation. In most patients, surgery dramatically reduces the duration, intensity and frequency of migraines. Roughly half of all patients have no migraines after migraine surgery.

Set Up a Consultation with Dr. Cabin at The Migraine Institute

A consultation with Dr. Cabin is available for those who are interested in migraine decompression surgery and other interventional migraine treatments.

To schedule a consultation with Dr. Cabin and The Migraine Institute team, please contact us today at 310.461.0303 or fill out our online form.

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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