What it means for a patient
- If you have migraines and plan a brow or forehead lift, removal of the frown muscle was linked to fewer migraines in this group.
- 8 of 39 migraine patients reported no benefit.
- This is a look-back survey of cosmetic patients, not a trial. Results rely on patient recall.
- Ask your surgeon whether corrugator removal is part of your forehead procedure.
Why this paper matters
It reported a link between corrugator muscle removal during forehead rejuvenation and migraine improvement. The authors state it shows "a strong correlation" for the first time.
Overview
The authors asked whether removing the corrugator supercilii muscle, the frown muscle between the brows, during forehead rejuvenation is linked to fewer migraines. They sent questionnaires to 314 consecutive patients who had the muscle removed during endoscopic, eyelid-incision or open forehead procedures. Answers were confirmed by phone, migraine was defined by International Headache Society criteria, and charts were reviewed.
Findings
- 314 consecutive patients surveyed; 265 (84.4%) responded, were interviewed, or both.
- 16 were excluded; 249 remained.
- 39 of 249 (15.7%) had migraine meeting the Society criteria.
- 31 of 39 (79.5%) noted elimination or improvement of migraine right after surgery (p < 0.0001); benefits lasted over a mean follow-up of 47 months.
- 16 patients improved (mean follow-up 47 months); 15 had complete elimination (mean follow-up 46.5 months).
- Migraine without aura: 29 patients (74%); gone in 11, improved in 13, unchanged in 5 (p < 0.0001).
- Migraine with aura: 10 patients; gone or improved in 7, unchanged in 3 (p < 0.0001).
Terms
- Corrugator supercilii: the small muscle between the brows that pulls them together in a frown.
- Resection: surgical removal.
- Forehead rejuvenation: brow or forehead lift surgery.
- Endoscopic: done through small incisions with a camera.
- Transpalpebral: through an upper eyelid incision.
- Aura: visual or other warning symptoms before a migraine.
- McNemar test: a statistical test comparing before-and-after answers from the same people.