Why choose a plastic surgeon for headache surgery?

While most migraine headache patients do not typically consider plastic surgeons as their first choice, plastic surgeons are able to deliver a unique and more specific approach to headache surgery.

These surgeons have detailed knowledge of the nerve complexes that contribute to migraine headaches. In addition, they have significant experience working with the courses of these nerves throughout the head and neck, as they see and work around these nerves every day during aesthetic and reconstructive surgery.

Plastic surgeons can approach troublesome nerve complexes with well-hidden incisions that are often used in aesthetic surgery. Their experience and increasing interest in headache relief have significantly contributed to the field of migraine relief treatment.

Our Surgeon Dr. Lowenstein

Dr. Lowenstein is a certified surgeon by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgery. In addition, he has served on the Board of Directors of the American Society of Plastic Surgery. As with all aspects of surgery, Dr. Lowenstein encourages patients to be informed about the qualifications and expertise of their surgery providers. He believes that his extensive microsurgical experience provides the optimal care needed for migraine surgery patients. Dr. Lowenstein has trained with experts and pioneers in the field of migraine surgery. His extensive experience allows his patients to benefit from meticulous techniques and excellent outcomes that result from an emphasis in these specialized procedures.

More About Dr. Lowenstein


How will my migraine headache be treated?

In the workup of your particular headache syndrome, Dr. Lowenstein will use temporary nerve blocks to target various nerve complexes, assessing the degree of response and relief provided by each of these nerve blocks. This process is called the Targeted Injection Mapping protocol (TIM).

Targeting these nerve blocks are common and familiar to experienced plastic surgeons such as Dr. Lowenstein because he utilizes many of them during other types of head and neck surgery. Dr. Lowenstein then uses meticulous techniques to access the nerve complexes that affect your headache with individualized care.

Do neurosurgeons perform migraine surgery?

While some neurosurgeons perform peripheral nerve decompression surgery, most operate primarily on the brain and the spine. However, most migraines only require outpatient peripheral nerve surgery, in which the small nerves in the face and neck that are typically associated with migraines are decompressed. In this scenario, plastic surgeons are the most experienced.

Why do plastic surgeons perform microsurgery?

Plastic surgeons have pioneered surgeries such as the first kidney transplants, the first burn care surgeries, and the first migraine surgeries which require microsurgical techniques. In migraine surgery, microsurgery is an advanced surgery that requires magnification of the operating field and allows surgeons to operate on structures that are barely visible to the naked eye.

Microsurgery requires high precision and skill by the surgeon. Plastic surgeons typically specialize in tiny blood vessels and nerves due to routine reconstructive surgeries, making them expert microsurgeons.

How is migraine surgery done?

Migraine surgery is typically done in four steps:

Step 1: Anaesthesia is administered to the patient.

Due to the positioning and need for patients to be very still, patients will be under general anesthetics during headache surgery.

Step 2: Incision and surgery is done.

Nerves and blood vessels that contribute to migraine headaches are released. Because these vessels are very delicate structures, it’s important to operate using special magnifying glasses and very fine instruments. It’s also important to ensure that the tools used to stop bleeding, called a cautery, are precise to minimize damage to the nerves and blood vessels.

Step 3: Closing the incisions.

Surgical incisions need to be closed and are done so with meticulous techniques to minimize scarring.

Step 4: Recovery.

Around 90% of patients who had undergone surgery will experience an improvement or elimination of their migraine headaches. However, these results would may several months to materialize. While some patients awaken from the surgery completely pain-free, others take a few months for the relief of migraine surgery to manifest.

Can a pain doctor perform these operations?

While pain doctors are experienced in procedures such as injections and implantation of nerve stimulators, they often work by targeting the general regions of the nerves instead of the exact nerve which is causing the migraine. Migraine surgeons such as Dr. Lowenstein directly visualize the nerves and can locate and target their exact location, resulting in a high success rate of migraine surgery.

Do neurologists perform migraine surgery?

Typically, two types of doctors can manage a patient’s health issues – a “medical” doctor that prescribes medications and a “surgical” doctor that performs operations and procedures.

While some neurologists are able to perform minor procedures, specialized operations such as migraine surgery are best done by a migraine surgeon such as Dr. Lowenstein. However, it’s recommended that you have a neurologist involved in your care before surgery, as Dr. Lowenstein will use the information regarding the medical evaluation of your migraine to perform your surgery.

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