Mariclaire Buckley, 34, is a mother of four, but until a year ago, her migraine headaches often left her caring for her young boys.
"I've done physical therapy and the chiropractor," said Buckley. "I've taken every new drug when it comes out."
When nothing worked, she tried a surprising solution, plastic surgery; a brow and forehead lift to be exact.
"In many patients, these effects are lasting," said Dr. W.G. Jay Austen, Chief of Plastic and Reconstructive Surgery at Massachusetts General Hospital.
Nerve decompression surgery is only an option for migraines that are thought to be caused by nerves in the forehead that are compressed by tissue or muscle. When those nerves are freed, the headaches may permanently disappear.
The surgery involves removing tissue from the brows and forehead, providing access to those nerves, and possibly removing wrinkles at the same time.
"My life has changed entirely since doing it," said Buckley. "I am able to go anywhere, go out and have fun."
Firstly, doctors try Botox injections in specific areas of the forehead as a test run for surgery. It relaxes the muscles surrounding those nerves.
"Before we did operate on her, we did treat her with Botox, and she did report significant improvement," said Dr. Austen. "All this together made her an ideal candidate for migraine surgery."
If Botox does not work, then having surgery will probably not work either. Migraines are probably not caused by the nerves in the forehead.
Even if Botox does work, surgery should still be a last resort option. If the surgery goes wrong, permanent nerve damage could occur, which could cause headaches that are worse or even death.