William J. Binder, MD, FACS—pushing facial aesthetics into the future
PSP Plastic Surgery Practice – January, 2011

With careful technique, cosmetic surgeons have been using botulinum toxin (BTX-A) to primarily treat frown-line wrinkles for several years. However, it is now being shown to treat not only wrinkles, but also migraine headaches. For wrinkle treatment in the brow area, BTX-A is injected into specific sites in the upper third of the face, creating temporary, controlled paralysis of those specific facial muscles. This usually lasts 4 to 6 months, when re-injection is necessary. While working with BTX-A on patients in 1992, cosmetic surgeon Dr. William Binder noticed a correlation between its use and alleviation of pain for his patients with migraine headache symptoms. The patients reported decreased or eliminated migraine pain following the BTX-A in both the acute and prophylactic management of migraine headaches and related symptoms. The results of that study found “that the majority of migraine headache sufferers and those seeking wrinkle treatment share a similar demographic – females 30 to 50,” said Dr Binder.

Over 17% of women and 6% of men suffer from migraines. Of the 96 patients treated in the study, 49 had complete improvement; 27 had partial improvement; and 20 had no response. The benefit remained for just over three months. Adverse effects were limited to transient local pain and bruising at the injection site. The authors have concluded that BTX-A is safe, effective and therapeutic for the treatment of migraine headache disorders. A full, clinical trial is currently underway.