Botox for Migraine Headaches Overview
Treats: Patients who have 15 or more migraines each month
Length: 15 minutes
Anesthesia: None needed
Side Effects: Mild swelling around the injection sites possible for a day or two
Risks: Minimal when procedure is performed by an experienced injector
Recovery: Most patients return to regular schedule immediately following the procedure
Duration of Results: 3-5 months
Remarkable Care, Exceptional Results
“Wonderful doctor– very patient, good listener and results from botox are great! Would highly recommend him! Sara on his staff is also very kind and makes you feel welcomed and comfortable. Great office!! I was worried I would have a “frozen” look and in my field that wouldn’t be desirable. The results were perfect- softend the lines by my eyes (crows feet) and left me with a little that looked natural– just what I was hoping for.”
As a facial plastic surgeon in Charlotte, Dr. Kulbersh understands migraines can be a debilitating condition. It can severely impact your quality of life. Migraines affect 1 in 4 households in the United States, and they are the 4th most common reason patients go to the emergency room. The treatment of migraines can be difficult and frustrating. Numerous medications are effective in the treatment of migraines, but many have side effects. For those patients that have not had relief with medications or might have side effects from their medications, Botox is an effective treatment option for chronic migraine headaches.
The top aesthetic destination of the south, Carolina Facial Plastics, is led by double board-certified facial plastic surgeon Dr. Jonathan Kulbersh. With his team of cosmetic experts, a fully accredited surgery center, and a private recovery retreat all located in the heart of SouthPark, Carolina Facial Plastics is known for unparalleled and natural-looking results exclusively for the face.
In the 1990s, a group of patients receiving Botox for aesthetic reasons reported an improvement of their migraine headaches. These reports lead to in-depth scientific research and clinical trials. From this body of data, there is conclusive evidence that Botox is an effective treatment for chronic migraine headaches. In 2010 Botox was approved by the FDA, The Food and Drug Administration, to treat chronic migraines.
Learn more about Botox for migraines at the American Migraine Association.
Botox is extremely effective for the treatment of migraines. At least 70% of patients that suffer from migraines report an improvement in their symptoms after Botox treatments. Most patients report a decrease in:
- The severity of the headache
- The longevity of the headache
- The frequency of the headache
I have many patients who report a resolution of migraines after treatment with Botox, while others significantly improve their symptoms. There remains a small subset of patients that will not benefit from Botox treatments.
There are four areas of the face and neck that have been shown to trigger a migraine. These four areas contain nerves that can become irritated. The irritated nerve can stimulate a series of events that can trigger a migraine. Botox targets three of these four areas:
The frontal area is the region between the eyes and the forehead. A frontal migraine is described as a pain above the eye radiating from the outside in. The nerve associated with frontal migraines is the supraorbital nerve located underneath the end of the eyebrow closest to the nose.
A temporal headache is located on the upper side of the head. Patients typically describe these migraines as starting in the temples and moving behind the ear. The zygomaticofacial branch of the trigeminal nerve is the target for a temporal migraine.
Occipital headaches are migraines in the back of the head that can move down into the neck. The greater occipital nerve is the target of the Botox for the treatment of these headaches.
The fourth area that can trigger a migraine is inside of the nose. A migraine in this area is typically described as pain between the eyes or a sinus headache. The trigger in this area can be secondary to a deviated septum or abnormal anatomy inside the nose. This area is not amenable to Botox treatment. For nasally triggered headaches, a CT scan of the nose is used to investigate the anatomy. If the anatomy is abnormal, then surgery would be an option to improve migraines.
The injection sites for Botox to treat migraines at our office in Charlotte target the nerves responsible for triggering the headache. There are three main areas where Botox is injected:
- The general area between the eyes and above the eyebrow
- The area around the outer corner of the eyes (crow’s feet) and the outer end of the eyebrow
- The back of the head
The injections take about 10 minutes to complete. They are completed with tiny needles and cause little pain or discomfort.
Dr. Kulbersh is a Beverly Hills trained facial plastic surgeon that has an office in the Southpark area of Charlotte, North Carolina. He sees patients from South Carolina, Georgia, Virginia, West Virginia, and all over the east coast. His board-certified physician assistant Heather Bryant, MPAS, PA-C, and board-certified nurse practitioner Courtney Whitley, FNP-C, also perform this treatment in our office. If you are interested in scheduling a consultation, please call (704) 842-3644 or fill out the online contact form on this website.
Frequently asked questions
Botox is approved for chronic migraines, which is defined as 15 or more migraines a month. However, Dr. Kulbersh will determine whether you are a candidate for this treatment based on an in-person examination and a detailed discussion of your symptoms.
Botox injections at our office in Charlotte are very well-tolerated. We take many steps to ensure the comfort of our patients during treatment. As a general rule with injections, the needle’s size directly correlates to the level of discomfort patients will experience. At our office, we use the smallest needle possible for these injections. Additionally, a sharp needle will be better tolerated than a dull needle. For this reason, we will use multiple fresh needles during the injection to limit discomfort.
Botox for migraine treatments in Charlotte are overwhelmingly safe. As with any procedure, there are risks involved. Since Botox is a temporary treatment, any possible complication would be temporary. The possible complications include:
- Drooping eyelid
- Neck pain
The average patient would need to repeat Botox every 3-5 months. I tell my patients to repeat the treatment when the headaches return or begin to increase in frequency or severity.