Frontal Trigger

Frontal Trigger Migraine Surgery in Cleveland, OH

For many patients with chronic migraines, the pain begins in the forehead or just above the eyebrows before spreading throughout the head. This type of migraine is often caused by compression of the supraorbital and supratrochlear nerves as they pass through the muscles of the forehead or, in some cases, through a narrow bony tunnel. Frontal trigger migraine surgery is designed to relieve this pressure by decompressing the affected nerves, helping to reduce the frequency, severity, and duration of migraine attacks.

Board-certified plastic surgeon Dr. Ali Totonchi specializes in advanced migraine surgery techniques and offers both minimally invasive endoscopic and open surgical approaches based on each patient’s unique anatomy. After a comprehensive evaluation of your migraine history, trigger points, and diagnostic findings, Dr. Totonchi develops a personalized treatment plan designed to provide long-term migraine relief while minimizing recovery time.

Frontal Trigger

In this area supraorbital and supratrochlear nerves pass through the frowning muscles and can be compressed by them, occasionally supraorbital nerve passes through a narrow bone tunnel which can act as trigger point. Migraine surgery is done by removing frowning muscles and replacing them by fat to prevent depression in this area, identical surgery is done for cosmetic purposes to eliminate the frowning lines. Surgery can be done with minimally invasive techniques (endoscopically) using few 1 cm hairline incisions or by direct upper eyelid incision. This surgery usually takes about 1-2h based on technique used. Please see following illustration and explanations to familiarize yourself with the incision and technique.

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Does Botox for migraine headache have any side effects?

If Botox injection is administered with proper technique and dose has very minimal side effects, local injection pain may last couple of days and responds to over the counter pain medication, in rare occasions upper eyelid droopiness which is temporary may happen.

Frontal trigger point: Showing supraorbital and supratrochlear nerves passing through frowning muscle group

Endoscopic access for frontal trigger point is the most common access in our practice, it is done by few small incisions in the hairline so after surgery scar is hard to notice since it is hided inside the hair bearing area

In patient with long forehead open approach for frontal trigger point is preferred, incision is made in the upper eyelid fold, since the scar falls in the fold after surgery scar fades nicely and it it hard to notice, upper blepharoplasty can be added to this technique easily.

In both endoscopic and open techniques the goal is to remove the pressure from the nerves by removing the muscle and adding fatty tissue to the area as it is shown in the 2 above illustrations, this technique is routinely used in patients who are undergoing forehead lift so it can improve or eliminate the 11 lines in the forehead area

In some of the patient nerve is compressed by passing through a narrow bony tunnel or under a tight band, it has been shown the releasing this pressure point can improve the response rate, this can be done endoscopically or by open technique

Find Lasting Relief from Frontal Migraines

Living with chronic frontal migraines can affect every aspect of your life—from your ability to work and enjoy time with family to your overall quality of life. If medications, lifestyle changes, and other conservative treatments have not provided lasting relief, frontal trigger migraine surgery may offer a long-term solution by addressing the underlying source of nerve compression rather than simply treating the symptoms.

During your consultation, Dr. Totonchi will carefully review your migraine history, identify your trigger points, and determine whether frontal trigger surgery is the right option for you. Every treatment plan is customized to your unique condition, with the goal of helping you experience fewer migraines and a better quality of life.

Take the first step toward lasting migraine relief. Contact Totonchi Plastic Surgery today at (216) 778-2262 for our Cleveland and Westlake locations or (440) 461-7999 for our Lyndhurst location to schedule your personalized migraine surgery consultation.