Background: Over the last decade surgical treatments for migraine involving proposed trigger sites have been described and popularized by plastic surgeons in particular. Various related techniques aim to free up "trigger sites" by removal of small facial muscles or "decompressing" small facial nerves.
Discussion: The basis for migraine trigger site surgery is without merit. There is one positive placebo controlled study with many limitations. Natural history and placebo mechanisms explain the outcomes from migraine surgery. The American Headache Society recommends that the migraine surgery not be performed outside of a clinical trial.
Conclusion: Migraine trigger site surgery should not be performed.
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