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Jeffrey Janis, MD, FACS: Most people have the question of why are they seeing a plastic surgeon for migraine headaches? It doesn't make much sense because most people see their primary care physician or family physician or a neurologist for migraine headaches.

The story really goes back to the year 2000 where a plastic surgeon in Cleveland, Ohio, Dr. Bahman Guyuron had patients, two of them, as a matter of fact, that he did cosmetic brow lifts on. Now, these patients came back to see him after their surgeries and were incredibly pleased with the cosmetic results, but were even more happy that their migraine headaches were gone.

Dr. Guyuron and I did these anatomic studies in order to understand the nerve and its location and how it might be compressed, and out of that designed a way to do Botox and also to do surgery to treat this condition. There's been a tremendous amount of data produced and published about this technique. It's effective, it's safe, and it works for many patients.

So these patients come in to the practice in either using Botox or using nerve blocks, we figure out where is the pain coming from? What are these trigger points? And based on this roadmap, we're able to design a specific individualized surgery to decompress these nerves and help relieve these patients of their migraine symptoms, oftentimes eliminating these symptoms entirely.

That is the concept of what we're trying to do here at Ohio State University and the Department of Plastic Surgery in combination with our colleagues from neurology and neurosurgery so that we can take care of these patients in a comprehensive fashion and help bring them the relief that they're looking for.

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