If you are reading this page, you have probably already tried more than most people could imagine: painkillers, preventive tablets, maybe Botox, maybe diets and sleep routines and every piece of advice anyone ever gave you. And perhaps, somewhere along the way, you were told, kindly or otherwise, that migraine is simply something you will have to manage for the rest of your life.
We want you to hear this clearly: for many people, that is simply not true. Migraine surgery is a small, superficial operation that treats a physical cause of migraine, a sensory nerve, just under the skin of the face or scalp, that is being squeezed by a muscle, a blood vessel, or a band of tissue. When we free that nerve, the trigger for your attacks is gone.
The key question is: where does your pain start? Not where it spreads to, but the very first spot you feel it. If each attack begins at the same place, and you can point to it with one finger, there is a good chance a compressed nerve is involved. The five places we see most often are:
If you already have a diagnosis of migraine from your own neurologist, you are welcome to come to us directly. If not, our neurologist will see you first to confirm the diagnosis and make sure nothing else is being missed. Then, at your consultation with Dr. Sarhane, we do something very simple: a small injection of local anaesthetic, the same numbing medicine a dentist uses, exactly at the spot where your pain begins. If your headache melts away within minutes, we have found your trigger. This test is almost painless, takes a few minutes, and tells us with good confidence whether surgery will help you. We will never recommend surgery without it, your trust matters more to us than anything.
This is a day-case: you come in the morning and go home the same day. The operation takes between 30 and 75 minutes depending on the trigger zone. It can be done under general anaesthesia or under local anaesthesia with sedation, you choose, after we talk it through together. Through a small incision hidden in the eyelid crease, in the hairline, or inside the nose, Dr. Sarhane gently frees the nerve from whatever is pressing on it. Nothing goes inside the skull, and nothing touches the brain.
Most people describe the first few days as mild soreness rather than pain, easily managed with simple tablets, and many tell us it was far easier than they had feared. Desk work is usually possible within 3-7 days and all normal activities within 4-6 weeks. The nerve needs time to settle, so your migraines typically improve gradually over the following weeks, with the full benefit clear by 3-6 months. Our nursing team stays in touch with you throughout, so you are never left wondering.
Migraine surgery is covered by most insurance companies. Our team will help you with the approval process so that you do not have to worry about it.
We understand that the word "surgery" can be frightening, especially when it concerns your head. Many of our patients felt exactly the same before they came to see us. So let us be very clear and very honest about what we actually do:
The nerves we release lie only a few millimetres below the surface. This is gentle, superficial surgery.
We never open the skull. This is not neurosurgery.
You come in the morning and you sleep in your own bed that same night, with your family around you.
Under general anaesthesia or local anaesthesia with sedation, whichever you prefer, after discussing it with us.
In the eyelid crease, the hairline, or inside the nose. Once healed, most people cannot find the scar themselves.
Supported by more than two decades of published research and thousands of patients worldwide.
And most importantly: the years you have spent in pain were never "normal", and you do not have to accept them as the rest of your story. If your migraine starts from one of the five trigger zones, there is a real chance, a very real chance, that we can help you get your life back.
Learn About Our Migraine Surgery Techniques
Dr. Karim Sarhane explains how we approach migraine surgery to help patients find lasting relief from chronic headaches.