What should I expect during a consultation for migraine surgery?

During your consultation, there are three main components to determine whether or not you are a good candidate for migraine surgery. The first is your medical history, both past and present. This component of the evaluation is critical because it gives the surgeon a window into what has occurred to get to the present and how he or she might avoid repeating some of the same modalities that were not helpful in the past.

Second, you should be prepared for a comprehensive physical exam, but one that is focused on your headache symptoms and the possibility of peripheral nerve pathology contributing to them. Third, diagnostic testing such as nerve blocks or Botox injections to help confirm whether or not peripheral nerve pathology is a factor in your migraine symptoms.

With regard to medical history, during your migraine surgery consultation, you should be prepared to discuss:

• Your surgical goals
• Medical treatments that you have tried in the past to treat the condition your surgeon will address
• Your other ongoing and past medical conditions
• Your drug allergies
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
• Previous operations both related and unrelated to migraine surgery
• Your current work history and overall lifestyle

With regard to a physical examination, your plastic surgeon will likely also:

• Perform an examination of several organ systems
• Perform a focused examination of peripheral nerves in the head and neck

With regard to diagnostic testing, your plastic surgeon will likely also:

• Review any prior imaging studies you've had (MRIs, CT scans)
• Review any prior procedures you've undergone or injections you've had
• Take photographs

At the end of the evaluation process, your surgeon should discuss your options and recommend a course of treatment. He or she should also discuss the likely outcomes of migraine surgery including what the many, published results demonstrate.

The success and safety of your surgical procedure depend greatly on your complete honesty during your consultation and with the results of any diagnostic testing.

Be sure to ask your plastic surgeon questions and make sure these are answered to your satisfaction. It's very important to understand all aspects of your possible operation. It's completely natural to feel some anxiety, whether it's excitement for anticipated relief or typical, preoperative stress.

Don't be shy about discussing these feelings with your plastic surgeon. To help, we have prepared a checklist of some questions you might consider asking your plastic surgeon that you can take with you to your consultation:

• Why do you perform migraine surgery?
• What is your surgical training in this procedure?
• How many such procedures have you performed?
• May I speak with one or more of your former patients who have had a similar procedure?
• What happens if there is a surgical complication?
• What will my follow-up be like after my operation?