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Migraine Surgery

Gfrerer, Lisa M.D., Ph.D.; Austen, William G. Jr M.D.

Plastic and Reconstructive Surgery: June 2019 - Volume 143 - Issue 6 - p 1808
doi: 10.1097/PRS.0000000000005681
Book and Media Reviews
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Disclosure:The authors have no financial disclosures to report.

As a service to our readers, Plastic and Reconstructive Surgery® reviews books, DVDs, practice management software, and electronic media items of educational interest to reconstructive and aesthetic surgeons. All items are copyrighted and available commercially. The Journal actively solicits information in digital format for review.

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Arun K. Gosain, M.D.

Review Editor

Bahman Guyuron, the father of modern migraine surgery and author of Migraine Surgery, describes his discovery as “prodigious and gratifying, because every time a patient tells me that I have changed his or her life, it is colossally fulfilling.” The reader can sense that his first book on the topic was written with the same drive and dedication that he has shown in conducting the research, developing the surgical techniques, and teaching others how to best care for these suffering patients. Dr. Guyuron summarizes his extensive clinical and research experience in migraine headache over 108 pages, in a clear and concise manner. He takes the reader through all the salient points of surgery for migraine, such that one could achieve a comprehensive understanding of this complex topic and acquire the basic practical tools to care for these patients.

Thirteen chapters cover migraine history, an overview of migraine headaches, detection of trigger sites, evidence of efficacy, anatomy, and surgical treatment at each site (I through VII). A highlight of this book is the description of the surgical procedures, including text, illustrations (80), and videos (eight) written and produced by Dr. Guyuron. The text is a practical guide for the surgeon. Clear illustrations and videos demonstrate every step of each procedure and are easy to follow. Important additional points are made in the text and videos, including patient positioning, markings, instruments, and sutures, making it possible to replicate procedures in detail. Information on postoperative recovery and complications is provided that is critical for preoperative patient counseling.

The surgical chapters are preceded by an excellent summary of surgical anatomy by Jeffrey Janis and Ali Totonchi. These anatomic descriptions significantly add to our understanding of the steps required during surgery as well to avoid complications. These chapters are accompanied by key, high-quality illustrations.

Perhaps the most valuable chapter is “Detection of Migraine Headache Trigger Sites,” written by Dr. Guyuron. It summarizes years of research and practice in order to teach the reader correct patient selection using an algorithm that includes physical examination, history, constellation of symptoms, and the use of adjunct tools such as nerve block, botulinum toxin type A, Doppler, and computed tomography. Importantly, the overview on migraine chapter is written by Hossein Ansari, director of the headache clinic at the University of California, San Diego, who explains the disease from a neurologist’s perspective.

To summarize, this first book of its kind is a practical guide to migraine surgery that is concise, accurate, and without significant gaps. It provides surgeons with all the necessary tools to correctly diagnose patients and treat trigger sites appropriately with well-established surgical techniques. It allows the reader to follow Dr. Guyuron’s procedures step by step. It is well written and illustrated, making it easy to understand for beginners and experts alike. It is not a collection of all that has been written or done in the area of surgery for migraine, nor is it meant to be. It is the definitive guide on migraine surgery as developed by Dr. Guyuron, and should be the first book in every migraine surgeon’s collection.

Copyright © 2019 by the American Society of Plastic Surgeons