Migraine Surgery

Conveniently located to serve the areas of San Diego, CA

Migraine Surgery

Migraine surgery is indicated for patients who are unresponsive to conventional therapies. When successful, patients report an improvement in migraine frequency, duration, intensity, and in many cases complete relief of their migraines.


In the past, migraine headache has been treated exclusively with behavioral and pharmacologic therapies. Although there has been a significant advancement in both fields, many patients remain unresponsive to either therapy. Surgery can help this specific group of patients. Also, migraine surgery can be a solution for patients who depend on Botox for symptomatic relief.  


Patients are referred to our center from their Primary Care Physician, Neurologist or Pain Specialist office. We ask our patients to fill a migraine log/diary form and questionnaires before their consultation with our Plastic Surgeons. During their visits, candidates are carefully evaluated and selected based on their history, symptomatology, failure of alternative therapies/treatment, and risks/benefits of undergoing surgery.


Before Procedure

  1. Patients should have been worked up by their Primary Care Physician, Neurologist, PCP or pain specialist. Alternative (pharmacologic and non-pharmacologic) therapies should have been tried and the patient found to be unresponsive.
  2. Fill out the migraine log and questionnaires before the initial visit
  3. Schedule a consultation at FACES+ for evaluation by our Plastic Surgeons. Out of town patients can schedule a Skype consultation. Concierge Services are available and range from simple recommendations to full VIP services pre-booked for the entirety of your trip.
  4. If you are a good candidate for surgery, all risks, benefits and alternatives of the procedure will be discussed in detail and all your questions answered.

During Procedure

  1. Based on the location of the trigger point and the pre-operative evaluation, the nerve branch responsible for the symptoms is explored and surgically released. Surgery is minimally invasive and is typically done through small incisions that can be placed within the hair bearing scalp so that scars are hidden and minimal.
  2. Depending on the trigger point and risks of anesthesia, procedures may be done with local anesthesia and sedation. You will be evaluated by our Plastic Surgeon and Board Certified Anesthesiologist to help make this decision. Surgery does not remove or go through the skull or the brain.
  3. It can take anywhere from 15 minutes to 1 hour to deactivate each trigger point and release the affected nerve. Migraine Surgery typically takes 1-2 hours to complete, depending on the number of trigger sites.
  4. All surgeries are done on an outpatient basis.

After Procedure

  1. Patients go home the same day
  2. Recovery depends on the location and number of triggers. Slight bruising and swelling may occur, and typically subside within 1-2 weeks. The majority of patients return to work and normal activities within that 1-2 week period.
  3. Most incisions are not visible and are hidden in the scalp or in the upper eyelid.

Additional Procedures

In the early 2000s, it was accidentally discovered that patients who had underwent forehead lift surgery had complete resolution, or significant improvement, in their migraine headaches. Procedures such as facelift, forehead lift, blepharoplasty, rhinoplasty, and neck lift can be done in conjunction with Migraine surgery if indicated.