With the discovery that some of his brow lift patients were relieved of their previous migraine headache symptoms, plastic surgeon Dr. Guyuron Bahman who is a mentor of Dr. Lowenstein pioneered peripheral nerve decompression for the treatment of chronic migraine headaches. Further investigation by Dr. Guyuron and other plastic surgeons provided detailed descriptions of specific nerve complexes that contribute to and in many cases cause chronic migraine headaches. Plastic surgeons have detailed knowledge of 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 interested in headache relief have been able to develop and improve anatomic approaches to these nerve complexes via well-hidden incisions that we often use in routine aesthetic surgery.

In the work up of your particular headache syndrome, Dr. Lowenstein will use temporary nerve blocks to target various nerve complexes, assessing the degree of response and relief that each of these nerve blocks provides. This process is called the Targeted Injection Mapping protocol (TIM). These nerve blocks are common and familiar to experienced plastic surgeon such as Dr. Lowenstein because he utilizes many of them during other types of head and neck surgery. With a plastic surgery oriented individualization of care, Dr. Lowenstein then uses meticulous techniques to access the nerve complexes that effect your headache.

What about Dr. Lowenstein?

Dr. Lowenstein has been certified by the American Board of Plastic Surgery, and is also a member of the American Society of Plastic Surgery. In fact, Dr. Lowenstein 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 become educated about the qualifications of their surgery providers. He has extensive experience in the microsurgical techniques needed to provide optimal care to migraine surgery patients.

FAQs: WHY A PLASTIC SURGEON?

  • Do neurosurgeons perform migraine surgery?

    While some neurosurgeons perform peripheral nerve decompression surgery, most operate primarily on the brain and the spine. When it comes to microsurgery of the type used in decompression of the small nerves involved in migraines, plastic surgeons are the most practiced in these types of techniques.
  • Why do plastic surgeons perform microsurgery?

    Stemming from the first organ transplants of kidneys which were pioneered by plastic surgeons, the surgery on very small blood vessels and nerves have been the specialty of plastic surgeons.
  • What are microsurgical techniques?

    Blood vessels and nerves are very delicate structures. When releasing the nerves that contribute to migraine headaches and occipital neuralgia, it is important to use very fine instruments and operate using special magnifying glasses or even microscopes. Even the tools used to stop bleeding, called cautery, are different in their configuration to make sure that any manipulation of tiny structures does not damage adjacent nerves and blood vessels.
  • Can a pain doctor perform these operations?

    While pain doctors are often well versed in procedures such as injections and sometimes even implantation of nerve stimulators, they work by targeting the general regions of the nerves instead of the exact anatomy of the nerve where Dr. Lowenstein performs migraine surgery. It is because of this difference, that migraine surgery works many times in patients that have had no success with pain management doctors. Migraine surgeons such as Dr. Lowenstein directly visualize the nerves and know their location much better than pain doctors or neurologists, and as such even the nerve blocks and Botox injections performed by Dr. Lowenstein are more likely to work than nerve blocks or Botox from other doctors.
  • Do neurologists perform migraine surgery?

    There are usually two types of doctors for health issues- a “medical” doctor that uses medications to manage things, and a “surgical” doctor that performs operations and procedures. While some neurologists do small procedures, the more involved operation used for migraine surgery is done by a migraine surgeon such as Dr. Lowenstein. Having a neurologist involved in your care is essential however, as the medical evaluation of your migraine prior to surgery is very important and that information is used by Dr. Lowenstein to manage you surgically.

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