Migraine Surgery: Cost, Risks, Recovery
Overview
Migraine surgery reduces or eliminates headache frequency, duration and pain. Surgery releases compression and irritation of sensory nerves and vessels around your head, reducing the severity of migraines.
Sites of nerve compression are also known as trigger points. You may have one or several trigger points depending on your symptoms. The most common and main trigger sites include:
- Frontal (pain above your eyes and/or your forehead)
- Temporal (pain over your temples)
- Rhinogenic (pain inside your nose that can extend to behind your eyes)
- Occipital (pain on the back of your head that can radiate across your skull to your eyes or behind your eyes)
Candidates
A good candidate for migraine surgery includes:
- Have been diagnosed with migraines or occipital neuralgia
- Have tried several therapies (behavioral, medications) without success
- Physically healthy
- Have realistic expectations
Cost
The average cost of migraine surgery is $5,000-15,000, according to an informal survey of the most prominent headache surgeons in the United States. The American Society of Plastic Surgeons has not yet provided formal statistics.
Migraine surgery costs may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anesthesia fees
- Prescriptions for medications
- Post-surgery garments
- Medical tests and X-rays that may be required
A surgeon’s cost varies based on experience, geographic location, the number of nerves being dealt with and other parameters.
Since insurance coverage is unpredictable, a transparent discussion about the treatment plan is necessary. Many plastic surgeons offer financing plans for migraine surgery in instances where health insurance does not cover it, so be sure to ask about this option in advance.
Risks
The possible risks of migraine surgery include:
- Bleeding that requires a transfusion
- Infection
- Poor healing of incisions
- Hematoma
- Anesthesia risks
- Fluid accumulation
- Skin loss
- Permanent numbness or other changes in skin sensation
- Skin discoloration and/or prolonged swelling
- Unfavorable and/or visible scarring
- Fat necrosis
- Deep vein thrombosis, cardiac and pulmonary complications
- Asymmetry in muscle functions
- Suboptimal aesthetic results
- A possible need for secondary procedures
- Persistent pain
Preparation
You may be asked to do the following things in preparation:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Stop smoking
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Migraine surgery is typically performed in a hospital or outpatient surgery setting. If your surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
Surgical steps
Anesthesia
Medications are administered for your comfort during the surgical procedure. The available choices include local anesthesia, intravenous sedation and general anesthesia.
The incision
The type of incision varies based on the location of your trigger site(s) and your surgeon’s preference.
Your surgeon will either use an endoscopic or an open approach at the frontal trigger site. If your surgeon prefers an endoscopic approach, you will have three to five small (1.5cm) incisions in the hairline above your forehead. If you undergo an open procedure, the incision will be in your eyelid crease.
At the temporal trigger site, surgeons who choose an endoscopic approach will make two small incisions in the hair-bearing temple. If the temporal trigger site is addressed at the same time as the frontal trigger site, your surgeon may use the same upper eyelid incision to address both sites. Another option is to make a separate, small incision at the temple.
At the occipital trigger site, an incision is made either vertically along the midline or horizontally across the back of your head. Both types of incisions are in the hair-bearing area of your scalp.
Incisions at the rhinogenic trigger site are individualized based on your specific intranasal findings.
If you feel painful at a less common trigger site, the surgeon will perform the incision in different areas.
Closing the incisions
The surgeon will use sutures, skin adhesives, tapes or clips to close the skin incisions.
Recovery
You will have minimal dressings after the migraine surgery. Controlling swelling and incision care are important. Sometimes the nerves can be irritated so it requires pain medication. In more rare cases nerve modulator medications may be used as well. Healing will continue for several weeks, as swelling decreases.
Your surgeon will offer you instructions and advice. Attend follow-up visits on time.
Keyword: migraine surgery.
Related posts:
What Are the Treatments of Migraine Headaches For Adults?
What Are the Top Migraine Triggers?