Botox is a great option for treating migraines. It can be used in a number of ways, including in conjunction with other medications or as a standalone treatment.
Botox is injected into the muscles around the head and neck to help reduce muscle spasms, which can cause headaches and migraines. The procedure takes just a few minutes and only requires local anesthetic. You should feel comfortable after the procedure and be able to return to work within 24 hours. If you’re interested in botox for migraines, talk with your doctor about how it works and whether it’s right for you!
Read on to learn more about What To Expect Botox For Migraines, Brow Lift Recovery Headache
What To Expect Botox For Migraines
While most people associate Botox with its ability to smooth out facial wrinkles, it’s also been approved to work as a powerful treatment for migraines.
Migraines affect about 10% of people around the world and are about three times more common in women than men. Chronic migraines, which are defined as migraine episodes that occur more than 15 days out of any given month, affect about 1% of people.
Chronic migraines can greatly impact daily life due to the pain and other symptoms they cause. Fortunately, Botox has been shown to be an effective treatment for reducing migraine-related pain. In one study, patients reported experiencing 50% fewer headache days while receiving Botox treatment.
To shine more light on this promising migraine treatment, Florida Medical Clinic neurologist Dr. Carrie Downey explains some of the benefits of Botox for migraines, and what patients can expect during a typical Botox treatment.
How Botox Works for Migraines
Botox works by reducing muscle contractions and stopping neurotransmitters from sending pain signals to your brain. This can help reduce the pain caused by migraines and lets many patients enjoy daily life without interruption.
The effect is only temporary, so patients will need to receive ongoing treatment. The most common treatment timeline involves an injection every 12 weeks, or four times per year. It may take several weeks to experience migraine relief after an injection. Your doctor may adjust this timeline according to your individual needs.
What is Botox? Is it safe?
Botox is created from botulinum toxin. While the idea of being injected with a toxin may sound scary, Botox actually contains such a miniscule amount of toxin that there is little chance of dangerous side effects. Since 2010, the FDA has recognized Botox as a safe treatment for migraines when administered by a licensed medical professional.
Who qualifies for treatment?
Dr. Downey says that not everyone who struggles with migraines may be eligible to receive Botox treatments. Botox is only recommended for people who fit the following criteria for chronic migraines:
- Experience headaches for more than 15 days a month where at least 8 days involve migraines that last at least 4 hours each
- Struggle with the above for at least 3 months
- Are at least 18 years old
Depending on your symptoms, your doctor may recommend you try other medications or treatments before trying Botox.
What’s the difference between a headache and a migraine?
Botox is an approved treatment for those who struggle with headaches for more than 15 days per month and experience migraines for at least 8 of those days. But what’s the difference between a headache and a migraine?
Headaches can cause pain in different parts of the head according to their cause.
- Some headaches may be caused by physical or psychological stress (tension headaches)
- Others are caused by sinus pressure (sinus headaches)
- Cluster headaches refer to particularly intense headaches that tend to happen around the same time each day
On the other hand, migraines often involve other symptoms aside from head pain. They may include dizziness, nausea, sensitivity to light or sound, as well as severe fatigue (tiredness). Migraines may occur in different phases, which may involve symptoms and signs like blurred vision, mood disturbances, and trouble with speech.
What to Expect During the Procedure
Botox appointments are very quick and can be done right in your doctor’s office in about 15-30 minutes. You don’t need to do anything to prepare, but your doctor may ask you to stop taking certain medications a few days prior to the injection. You should also inform your doctor if you’ve had a Botox injection in the past four months, even if it wasn’t an injection for migraines.
During your appointment, your doctor may numb your skin with a topical anesthetic. You may receive several shots during the procedure in the areas on your head and neck where you feel pain. The shots may feel like a slight pinch.
After the procedure, you’re welcome to go home immediately. It’s safe to drive yourself home, but you may want to bring someone along just in case.
Note: Injections should ONLY be given by a licensed health care provider who has been trained to administer Botox for migraine treatment. There is a high risk for complications when injections are performed by unlicensed or untrained individuals.
Side Effects of Botox for Migraines
Side effects are generally mild and will typically go away within a day or two. They may include:
- Headaches or sore neck
- Pain, swelling, or redness at the injection site
- Drooping eyelids or eyebrows
- Temporarily blurred vision
- Dry eyes or excessive tearing
Your doctor will discuss these side effects with you during your appointment, including what over-the-counter medications you can take to ease the discomfort.
More serious side effects are rare, but possible in patients with muscle or nerve conditions or breathing-related problems. For this reason, it’s important to see a board-licensed neurologist so that they can determine if Botox is a safe migraine treatment for you.
Brow Lift Recovery Headache
“Beauty is pain,” as the saying goes — but modern cosmetics experts are proving that beauty can relieve pain rather than causing it. Surgeons have found that brow lifts can alleviate migraines, thanks to a few key elements of the surgery. Migraine headaches affect millions of Americans each year, according to the Migraine Research Foundation, and up to 90% of migraine sufferers experience pain severe enough to affect normal functions like driving, working or conversing. In addition, migraines are a chronic illness; that is, they don’t simply strike once fleetingly, but those who struggle with migraines experience them on a recurring basis and even for days at a time. There is also no known cure for migraine headaches. While there are some preventive measures as well as medications that can help manage the pain of a migraine flare-up, many people struggle to find a solution to keep their headaches at bay.
WHAT IS BROW LIFT SURGERY?
Brow lifts, sometimes called forehead lifts or upper facelifts, focus on diminishing the appearance of wrinkles on the forehead and around the eyes. These surgeries can address horizontal forehead lines, worry lines between the brows and crow’s feet. They are also commonly combined with eyelid surgery, or blepharoplasty, to correct sagging or drooping eyelids. Depending on the extent of your lines and wrinkles, your surgeon can perform brow lift surgery using one of three techniques: an endoscopic brow lift, a temporal brow lift or a coronal brow lift.
Endoscopic brow lifts have become increasingly popular in recent years because they are the least invasive option. Your surgeon uses small incisions through which they insert a thin, flexible tool with a small camera attached — they can view and manipulate the tissues underlying the skin of your brow without lifting the skin completely.
Temporal brow lifts involve slightly larger incisions than endoscopic lifts, positioned at the edges of the temples. This type of lift is the current industry standard for clients who require more work than an endoscopic lift can accomplish, and is usually the type of brow lift performed when a client is interested in an eyelid surgery as well.
Coronal brow lifts are the most invasive, using an incision that spans the full length of the brow from temple to temple along the hairline. This technique is somewhat outmoded and is currently only used in special cases.
No matter which type of brow lift is right for you, there is one distinguishing factor — unlike full facelifts, which often focus on removing stretched or excess skin causing an aged appearance, brow lifts focus on facial muscles. The main cause of forehead wrinkles is overworked facial muscles; when you make a certain facial expression particularly often, your muscles will become somewhat stuck in their tensed position, leaving behind the furrows or crinkles of a worried look or squint. During a brow lift, your surgeon removes and repositions some of your brow muscles to release this tension and smooth your brow to a more youthful, relaxed position.
Migraines aren’t like the headaches you get when you’re tired or dehydrated. They are characterized by intense, throbbing pain that often results in nausea; sensitivity to sounds, smells and light; dizziness and even temporary sight impairment. While the pulsing pain initially led doctors to believe that migraines were caused by dysfunctional blood vessels, today’s understanding is that migraines are primarily neurological. The sensory effects of migraine attacks suggest that the headaches stem from the brain and nerves, and indeed, the most common and often effective medications for migraines treat the headaches using this principle.
Brain scans of patients experiencing migraines show a burst of activity in parts of the brainstem, an area known for processing mood and pain. In addition, a network of neurons responsible for transmitting pain around the eyes, teeth, forehead and sinuses are particularly active during a migraine. Scientists also believe that this particular network of nerves releases inflammatory chemicals as a response to specific stimuli, which contributes to the throbbing and puts even more sensory pressure around areas already sensitive from a migraine.
HOW A BROW LIFT CAN HELP
The nerves associated with migraines are located in the same areas as the muscles that cause forehead wrinkles. The added tension in the forehead not only makes migraine pressure worse but can even start to pinch some of the facial nerves and trigger migraines more frequently. When your surgeon uses a brow lift to release or remove these tensed muscles and open up more space in the tissues of the forehead, the nerves in the area are also freed from constriction and are less likely to cause shooting migraine pain.
Research also shows that minor muscle tension in the brow can cause non-migraine headaches or generalized forehead and temple pain, only serving to worsen the symptoms of migraines. Restoring relaxation to your upper face with a brow lift can go a long way toward relieving that daily dull ache as well as the debilitating discomfort of a migraine. The brow lift’s effectiveness at smoothing unwanted lines and wrinkles combined with its tension-relief benefits gives this cosmetic surgery the ability to improve your life in more ways than one — the confidence of a reflection you love and the relief of reduced head pain and tension.
Despite the apparent benefits, opinions are mixed amongst plastic surgeons, as well as The American Board of Plastic Surgery. For those reasons, we do not perform brow lifts to help treat migraines, but your primary physician can provide you with more comprehensive information about if this procedure has the potential to help you.
Endoscopic brow lift complications
A brow lift is usually performed by a plastic surgeon.
A brow lift is an aesthetic surgical procedure to correct the loss of soft tissue elasticity in the upper third of the face. Excess sagging skin around the forehead causing drooping (ptosis) of the brows and wrinkling of the forehead is removed by repositioning the underlying muscle and tissue. It creates a more refreshed, youthful appearance in the upper third area of the face. It can also be combined with a facelift. A brow lift is usually performed by a plastic surgeon.
Endoscopy is the insertion through a surgical incision of a flexible tube with a lighted camera and surgical instruments. The endoscope is now used in a variety of reconstructive and cosmetic surgical procedures. Endoscopic brow lift surgery has gained widespread acceptance, is minimally invasive, and heals faster than traditional brow lift surgery.
Why do people seek endoscopic brow lift surgery?
Aesthetically, the face is divided into three equal parts, of which the forehead (from the top of the eyebrow to the anterior hairline) occupies the upper third. In males this area averages 7 cm and in females it averages 5 cm.
The male eyebrow is less arched than the female eyebrow. The top of the eyebrow lies approximately 2.5 cm from the mid pupil. With aging, these parameters may shift. A lesser distance denotes eyebrow drooping (ptosis).
Loss of forehead skin elasticity from genetics, sun damage, and gravity causes eyebrow drooping, with resultant upper eyelid drooping and dissatisfaction with the appearance.
Aging causes depletion of the subcutaneous fat. This leads to forehead wrinkling, the direction of which depends upon the underlying muscle.
Why is endoscopic brow lift surgery done?
- Aged appearance: Patients may worry they have a tired, surprised, worried, or an annoyed look, appearing older than their actual age
- Eyebrow drooping: Patients may feel an uncomfortable weight of tissue on their eyes
- Forehead wrinkling
- Eyebrow elevation
- Improve eyebrow symmetry
- Change eyebrow shape
- Decrease the function of muscles causing brow wrinkling
When should endoscopic brow lift surgery be avoided?
Endoscopic brow lift surgery should be avoided with:
- Conditions causing dry eyes
- Excessive brow elevation after upper eyelid surgery
- A tendency for keloids or thick scarring
- Psychological instability
- Unrealistic cosmetic expectations
- Poor general health and systemic conditions
What happens during the endoscopic brow lift procedure?
Before the procedure
- Routine blood and radiological investigations will be done.
- Patients may be advised to shampoo their hair with antibacterial soap/shampoo the night before or morning of surgery.
- Hair does not need to be shaved.
During the procedure
- An endoscopic brow lift is performed under general anesthesia or with intravenous (IV) sedation and local anesthesia.
- Multiple small incisions are made just behind the hairline (most surgeons make 3- to 5-cm incisions), through which the endoscope and instruments are inserted.
- Brow tissue is gently released and elevated.
- Excess tissue is removed.
- The muscles are elevated, pulled up and anchored to the bone using anchors made of titanium which look like small screws of 2 mm width. They may be temporary or permanent and do not cause permanent damage.
- The incisions are sutured and dressed.
- A small surgical drain may be inserted — a clear tube is inserted through a small incision below the main incision.
After the procedure
- Post-operative pain can be managed with painkillers.
- Antibiotics may be necessary.
- Patients are advised to rest with their head elevated for two weeks.
- Patients are usually discharged the same day or 24 hours after surgery.
- The drain may be removed after 24 hours.
- The dressing may be removed after 48 hours.
- Patients can shower and wash their hair after 48 hours, using mild shampoos prescribed by the surgeon.
- The surgeon may prescribe medicated ointments to apply to the wounds.
- Patients should not use any hair products for at least seven days.
- Depending on the type of suture used, the surg