The decision to use botox for migraines is a serious one. The procedure is safe, but its effects are lasting and irreversible. Before you decide to undergo the procedure, you should know what to expect. Botox injections are used to treat migraines in a variety of ways: by reducing inflammation, preventing muscle spasms that can trigger headaches, and relieving pressure on nerves responsible for pain. Botox is most commonly injected into the forehead, but injections can also be administered in other areas of the head and neck where muscles are prone to spasms or tension headaches.
Botox can take several weeks before its full effect is felt, so you may need more than one round of injections to achieve optimal results. You may notice some side effects right away, like temporary drooping of the eyelids or eyebrows (this will go away within two weeks). Other possible side effects include pain at injection sites, redness or bruising around injection sites (these will go away within one week), and headaches (usually mild).
Read on to learn more about What To Expect From Botox For Migraines, Brow Lift Recovery Headache
What To Expect From Botox For Migraines
When you think of Botox, you probably imagine cosmetic injections meant to smooth fine lines and wrinkles. While that is the primary use for Botox, it’s also become a popular treatment for chronic migraine.
If you have migraine attacks for 15 days or more every month, your doctor may have suggested Botox as a treatment. However, there are some side effects of Botox injections for migraine, including neck stiffness and muscle weakness. Other side effects are less common but can occur.
This article discusses possible side effects of Botox for treatment of chronic migraine.
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What are the possible side effects of Botox?
Botox is well-tolerated by most people and is considered very safeTrusted Source if you go to an experienced practitioner. Still, there are some possible side effects that you should know about if you start using Botox to treat migraine.
Common side effects
Common side effects of Botox for migraine include:
- redness, soreness, or swelling at the injection site
- bruising
- chills
- fatigue
- dry mouth
- neck stiffness
A 2014 studyTrusted Source showed that neck pain was the most common side effect, affecting 4.3 percent of study participants. Injection site pain, drooping eyelids, and muscular weakness was reported in 2.1 percent of people.
In general, these side effects are simply the effect of injecting a foreign substance into your body. They typically go away after a day or two.
Longer-term side effects
However, there’s also the possibility of longer-term side effects. These may include:
- muscle weakness
- eyebrows that appear to “droop” or look uneven
These side effects are from the Botox treatment itself and may take several weeks to subside.
Serious side effects
In the studyTrusted Source noted above, serious side effects from Botox for migraine were uncommon, and were rarely severe enough for people to stop treatment.
However, there are cases when serious complications do occur from Botox. You should seek immediate medical help if you notice any of the following symptoms after your treatment:
- blurry vision
- swelling of your tongue or throat
- difficulty speaking or swallowing
How does Botox work in treating migraine?
Onabotulinumtoxin A, also known as Botox-A, was approved in 2010 by the FDA for the treatment of chronic migraine.
Botox is injected into specific areas of your head and neck involved in migraine pain. The effect lasts for about 3 months.
Botox injections were developed to block neurotransmitters that tell your muscles to contract. By blocking these signals between your body and your brain, Botox diminishes the appearance of wrinkles.
However, blocking neurotransmitters is also a way to prevent migraine attacks. Botox blocks the release of these chemicals from reaching your nerve endings and causing pain.
Migraine attacks are typically best treated right at the very beginning of an attack — but it can really difficult to do that.
If you try to treat a migraine with oral medication, you can end up taking too much of it. This can result in medication overuse headache and sometimes even trigger more migraine attacks.
Botox can work as a preventive treatment that keeps your brain from receiving the initial migraine signals, without the risk of “rebound headache” that comes with many oral medications.
Is Botox right for treating my migraine attacks?
If you’re thinking about Botox treatment for your migraine attacks, here are some questions you might consider and talk with your doctor about:
- Are your migraine attacks chronic? Chronic migraine is defined as taking place 15 days (or more), on average, out of every month. If your migraine attacks aren’t chronic, it’s unclear whether Botox would be helpful for you.
- Are you okay with multiple treatments? Botox might not be effective to treat migraine after your first treatment, and even when it works, it isn’t permanent. You’ll need to plan to get regular Botox treatments every 3 months if Botox becomes your long-term treatment plan.
- Will your insurance cover it? Your insurance may only cover Botox for migraine if you can document that you’ve already tried other treatments. Even then, you may have a hard time getting approval from some insurance providers. If you don’t have insurance, Botox can become costly, especially when you add up the cost of multiple treatments.
Who is not a good candidate for Botox treatment?
There are some people who should not get Botox for migraine attacks or for any other reason.
You aren’t a good candidate for Botox if any of the following apply to you:
- known sensitivity or allergy to botulinum toxin (or a history of botulism)
- signs of infection at or near the injection site
- neurological conditions that make you more prone to muscle weakness, such as amyotrophic lateral sclerosis (ALS) or myasthenia gravis
- you’re pregnant or breastfeeding
Other frequently asked questions about Botox for migraine
How long does a Botox treatment take?
With an experienced provider, a Botox treatment will take about 20 minutes. Your first treatment might take a little longer to fill out paperwork and to speak with your provider about concerns and questions.
How many injections will I have to get?
More than you might think. If you’re getting Botox for migraine treatment, expect to get 30 or so injections, all in targeted areas in your forehead and neck. These areas are different than the targeted areas where you’d have Botox for a cosmetic treatment, like smoothing out your forehead.
How much does Botox hurt?
People with different pain tolerance (and different expectations) may answer this question differently. Botox needles hurt as much as any injection would, and the experience is over quickly. Be prepared for it to feel a little uncomfortable, and have an ice pack on hand to soothe inflammation or pain afterward.
How often will I have to get Botox for migraine?
Treatments are recommended once every 12 weeks. The effect of Botox may start to wear off before that, but getting the treatment more often than that is not recommended.
Will Botox work to treat my migraines?
Individual results may vary, so there’s no way to know for sure. But there’s strong reason to believe that it might.
Multiple studiesTrusted Source have shown that treating chronic migraines with Botox means fewer headache days each month when compared with placebo. It may take 10 to 14 days for the result of the Botox to start to take effect.
Some people don’t respond to this type of treatment for migraine, and it typically takes two treatment cycles to figure out if you’re one of them.
The bottom line
Botox for migraine can cause some uncomfortable side effects, like muscle weakness and a stiff neck. Fortunately, most of these side effects are mild and temporary.
Severe side effects are extremely rare, but they can happen. Only you can decide if the risk of these side effects is worth it to treat your chronic migraine.
If you’re curious about this treatment, find an experienced provider to help you determine if it’s right 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.
UNDERSTANDING MIGRAINES
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