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Migraine surgery

A surgical option for some people with chronic migraine — targeting trigger sites after careful diagnosis and testing

✓ Trigger sites tested before any decision
⏱️
Surgery time
Usually 1 - 3 hours
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Anaesthesia
General, or local with sedation
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Back to work
Usually 1 - 2 weeks
✨
Assessing the result
Over several months

What is migraine surgery?

In some people with migraine, an attack starts at a specific point where a small sensory nerve is irritated by pressure from a nearby muscle, blood vessel or tissue. These points are called “trigger sites”; common ones are the forehead above the eye, the temple, the back of the head and inside the nose.

The operation aims to release the nerve from what is pressing on it, or remove the irritating tissue around it, through small incisions usually hidden in the eyelid crease or within the hairline. The goal is fewer, milder and shorter attacks — it does not replace follow-up with a neurologist.

This surgery is not suitable for everyone with headaches. The path starts with a confirmed migraine diagnosis from a neurologist, then identifying and testing trigger sites with temporary injections before surgery is considered. The doctor assesses each case individually.

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DiagnosisMigraine confirmed by a neurologist
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Pre-testTemporary injection at the trigger site
✂️
IncisionsSmall and usually hidden
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StayUsually same day or one night

Could migraine surgery suit you?

Book a consultation so the doctor can review your diagnosis and attack history and explain whether testing makes sense for you.

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Who is it suitable for?

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Diagnosed migraine

People with chronic migraine confirmed by a neurologist, with ongoing neurology follow-up.

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Not enough relief from medication

Those whose preventive medicines have not reduced attacks enough, or who could not tolerate their side effects.

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Pain that starts in one place

When attacks usually start at a specific site such as the forehead, temple, back of the head or behind the eye.

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A positive test

Those whose attacks clearly improved after a temporary test injection at the trigger site — an important sign of the chance of benefit.

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Who it does not suit

Undiagnosed headaches, medication-overuse headache that has not been treated first, or anyone expecting a guaranteed cure. The doctor will point you to a better-suited option.

Treatment steps

1

Diagnosis and headache diary

Confirming the diagnosis with a neurologist and recording attacks — where they start and how strong they are — for several weeks.

2

Mapping trigger sites

Clinical examination and a review of the diary to identify the site or sites where attacks begin.

3

Test injection

Temporary injections (Botox or a nerve block) at the trigger site, then tracking attacks to judge the response before deciding.

4

Surgery

Releasing the nerve from what compresses it through small incisions, at one site or more depending on the test results.

5

Follow-up

Regular reviews and a headache diary after surgery, with continued coordination with your neurologist.

Recovery stages

Days 1-3

Mild swelling and bruising around the incision and pain controlled with prescribed painkillers; sleep with the head raised.

Weeks 1-2

Stitches usually removed at 7-10 days; most people return to desk work within one to two weeks.

Weeks 3-6

A gradual return to exercise once the doctor agrees; mild numbness of the forehead or scalp may last for a while.

Months 3-12

The effect on attack frequency and severity is assessed with the headache diary; results vary from person to person.

Risks and possible complications

Like any operation, this surgery has possible risks, which the doctor explains in detail before you decide:

  • Numbness, tingling or itching of the forehead or scalp, which usually improves with time
  • Attacks continuing or returning, or a new trigger site that was not treated
  • Bleeding, a blood collection or infection at the wound
  • A scar at the incision or slight hair thinning around it
  • A slight difference in eyebrow movement or symmetry
  • The usual risks of anaesthesia

Frequently asked questions about migraine surgery

Does surgery cure migraine for good?
No patient can be promised a complete cure. Published studies report that many carefully selected patients see a clear drop in how often and how badly attacks come, and some stop having attacks, while others benefit less.
Do I need a neurologist?
Yes. A confirmed migraine diagnosis, and ruling out other causes of headache, is an essential step before surgery is considered, and coordination continues afterwards.
What is the role of Botox before surgery?
Temporary test injections are used to confirm that the chosen site is responsible for the attacks. Clear improvement after the injection is an important sign of the chance of benefit from surgery.
Where are the incisions?
It depends on the trigger site: usually in the upper eyelid crease, within the hairline or at the back of the head, and sometimes through the nose with no outside incision.
Will I stop my migraine medicines after surgery?
Do not stop any medicine on your own. Your neurologist decides on any gradual change depending on how your attacks improve.
When will I know the result?
The effect is usually judged over several months by comparing your headache diary before and after surgery.

Related services

Start with an assessment of your migraine attacks

A consultation where the doctor reviews your diagnosis and attack history, and explains whether a test injection is a sensible next step for you.