Best Headache Surgery in Los Angeles

Surgical treatment of headaches is an innovative use of peripheral nerve surgery.

What Is Headache Surgery?

This specialty was started by Dr. Bahman Guyuron at Georgetown, who noticed that cosmetic surgery for the forehead sometimes resulted in headache relief. He began to study the nerves entering and exiting the skull.

Nerves exiting the skull have compression points – places where the nerve is in a confined space and can become irritated. Dr. Patel studied directly with Dr. Guyuron so that he could apply microsurgical techniques to help those with chronic headache pain, including relief of migraines and cluster headaches.

Who Is A Candidate For Headache Surgery?

Dr. Patel works closely with his colleagues at the Headache and Neuralgia Center at Keck Medicine of USC to help with the diagnosis and management of headaches. Common treatments for headaches include nonsurgical options, such as Botox or steroid injections.

The ideal candidate for surgery is someone who:

  • Feels some benefit from Botox or steroid injections, but still needs relief.
  • Has tenderness at the point of a known nerve.

Headache Surgery Procedure

Dr. Patel places incisions in hidden areas of the scalp.

  • For frontal headaches at the forehead, the incisions are in the eyelid crease. Sometimes these incisions can be combined with eyelid rejuvenation therapy.
  • For temporal headaches (at the sides) or occipital headaches (at the base of the skull near the neck), the incisions are well hidden within the hair.

Surgeries are outpatient procedures, and lasting from just one and a half to two hours.

Results Of Headache Surgery

About 4 out of 5 patients who come to Dr. Patel through the Headache and Neuralgia Center for diagnosis end up with an improved quality of life. For some, that means fewer visits to the emergency room and less medication. For others, it means complete elimination of headaches.

How Successful Is Headache Surgery?

A small segment of patients doesn’t experience much relief at all. Usually, this is because removing one type of headache (occipital, for example) unmasks another pain point, such as the forehead.

What To Expect During Headache Surgery Recovery

After surgery, patients usually feel some tightness. Patients are encouraged to maintain their full range of motion to relieve the tightness.

Most patients do have some pain after surgery, but it is usually not headache pain.

Some patients feel a temporary numbness in the area of surgery that goes away over time.

Is There Surgery to Stop Headaches?

Dr. Patel performs a type of nerve decompression surgery to help alleviate migraine headaches. This technique was developed by Dr. Guyuron, a pioneer in the area of migraine relief. The particular surgery that Dr. Patel performs involves the accurate identification of the trigger site for migraines. This is often the occipital or trigeminal nerve. The nerve is then carefully removed through a small incision. While some headache surgery procedures may be more involved, all are performed in an outpatient setting. You can expect to return to work and other normal activities as soon as the day following the procedure.

What Does a Peripheral Nerve Surgeon Do?

Peripheral nerves are bridges from the spinal cord and brain to various parts of the body. Disordered peripheral nerves do not send and receive messages efficiently, resulting in symptoms. Dr. Ketan Patel is a respected plastic and reconstruction surgeon who has received specific training in the area of peripheral nerve surgery as well as microsurgery. Peripheral nerve surgery is performed to correct peripheral nerve disorders, such as compression, and improve function and comfort.

What Nerve Damage Causes Headaches?

Most migraines are triggered by the occipital nerves, which pass through the scalp. The occipital nerves may become inflamed or injured through trauma, but often develop symptoms simply due to compression and tightness in the neck muscles. Sometimes, nerve inflammation occurs secondary to an underlying disease. Dr. Patel and the team at the Headache and Neuralgia Center at Keck Medicine of USC work together to accurately diagnose the cause of migraines and other symptoms so that the most appropriate treatment plan can emerge.

I Did Not Respond to BOTOX . Am I Still a Candidate for Surgery?

Botox has become a common non-surgical treatment for migraines and other headaches. It is also sometimes used diagnostically as a type of anesthetic but is technically not a nerve block. It is important to differentiate because Botox and nerve blocks do not work in the same way. Botox prevents muscle contractions in target locations. So, injections of Botox into the muscles around the estimated area of a compressed nerve may work by alleviating that compression through muscle relaxation. Studies suggest that Botox works primarily on the motor nerves associated with target muscle tissue. However, migraines may involve sensory nerves, which do not respond to Botox. This is to say that Botox, while effective in some cases, may not be the most reliable measure of your candidacy for headache surgery. If you received Botox injections for headaches with no improvement, schedule a consultation with Dr. Patel. There are other tests that can be performed to better understand what may be triggering your symptoms.

What Is the Likelihood That the Surgery Will Work for Me?

Most studies on the efficacy of headache surgery indicate that more than half of the patients who undergo this procedure achieve complete pain relief. Ninety percent of the patients who undergo headache surgery report at least 50% improvement in their comfort level.

Will My Insurance Cover the Cost of This Procedure?

Insurance companies are continually updating their coverage details. If you would like to obtain treatment for migraines using your insurance, we suggest that you contact your provider directly for current information regarding pre-requisites for care and coverage amounts. Each insurance company sets its own standards when it comes to coverage. Some cover the majority of headache treatment costs, and some extend no coverage whatsoever. Our staff will do their best to assist you in this area so that you can obtain the care you need to regain comfort and quality of life.

Schedule A Headache Treatment Consultation

If you are considering headache surgery, please contact our office by calling 323-442-7920 or by clicking here to submit an online contact form. Dr. Patel help you understand whether you are a candidate for the procedure, and if it is determined so, you will have the full support and medical expertise of our practice at your disposal.

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What Happens in a Consultation?

  1. Get to know Dr. Patel.

  2. Help him understand you and your goals.

  3. Learn about our services and specialties.

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