Frequently Asked Questions


How Did Migraine Surgery Develop?

About 12 years ago, plastic surgeons began to observe that patients who had Botox injections for cosmetic purposes and patients who underwent brow lift surgery were reporting a significant reduction of their migraine headaches. The patients who received Botox injections noticed that around the time that the Botox wore off, their headaches would return. Patients who had eyebrow lift surgeryindicated that their headaches ceased and some patients' even said their headaches were eliminated completely.


How Does Botox Work To Reduce Or Eliminate Migraine Headaches?

Botox results in temporary weakening of the muscles that compress or impinge on nerves in the areas that may trigger migraines. Dr. Weinzweig will use small injections in low doses into the muscle area that has been identified as the patient's specific migraine trigger zone. This can be in either the frontal, temporal or occipital areas. The Botox will block the release of the chemical that causes these muscles to contract and will allow it to relax, taking the pressure off any irritated nerves. This will raise the migraine patient's threshold for developing another attack as well as make the patient more resistant to triggering factors in the future.


Is Botox Safe For Treating Migraine Headaches?

Botox is FDA approved for the treatment of migraine headaches and is a safe and effective treatment in experienced hands. It has been used for over 25 years and Botox Cosmetic has also been shown to be effective for treatment of migraine headaches, excessive underarm sweating, certain muscular spasm disorder, in addition for cosmetic purposes.


What Is A Botox Treatment Like?

Botox injection for migraines is a quick and minimally invasive procedure consisting of a few tiny injections. Dr. Weinzweig will use your medical records, migraine headache diary and physical exam to determine your particular migraine trigger zone. The frontal and temporal areas are cooled with an ice pack prior to the procedure to help reduce any discomfort so no anesthesia is needed. In rare cases, if the patient is highly sensitive, our physician may choose to numb the area with an anesthetic cream before. A combination of Botox, local anesthetic and steroid injections may be used in patients with occipital zone migraines. The actual Botox injection treatment lasts just one to three minutes depending on the number of areas being treated. There is no downtime afterward and discomfort is minimal and brief. Many patients return to work the same day. You should not rub the area that has been injected for 72 hours.


Who Should Perform Botox Injections For Migraines?

We believe board certified Plastic Surgeons who have had additional training on the use of Botox for migraines and are the ideal medical professionals to treat patients with Botox. Plastic Surgeons have the most extensive knowledge of the anatomy and physiology of all the facial muscles involved in facial expression and therefore are the most qualified to perform Botox injections. In addition, board certified plastic surgeons have been awarded the highest qualifications by the American Board of Plastic Surgery through extensive evaluations and residency requirements. Dr. Weinzweig is a board certified Plastic Surgeon who has had detailed training in facial anatomy with extensive experience with Botox for migraine patients


How Can I Be Sure I'm Getting Real Botox Cosmetic?

Allergan, Inc., maker of Botox Cosmetic, is the only source for healthcare professionals to purchase the product, and each FDA-approved label has the "Allergan Cosmetic" hologram. When injectables are offered at bargain prices, patients and physician's offices need to be cautious because they may have been purchased through web sites or offshore. At these types of places the practice to assure purity, content, and proper handling and storage may be lax or may result in purchase of counterfeit products.

At the Headache Response Center we only use Botox Cosmetic, which has been manufactured, stored and shipped in the United States and purchased directly from Allergan in the US. Offshore suppliers often have poor quality control on how the product is shipped and handled; there is no assurance that the Botox will not sit in a warm warehouse or dock and allowed to warm, which decreases the efficacy of the product. Since Botox is temperature sensitive, it should be shipped on dry ice.

If you want to insure your provider is using Botox Cosmetic purchased in the US, ask to see the bottle. The word Cosmetic is a hologram on the bottle. Botox from Europe or Canada is usually not Botox Cosmetic; the bottle typically will just be labeled Botox. Also, every bottle has a lot number for identification to insure it was sold in the US.

 

Why Do Some Patients Treated With Botox ® For Cosmetic Purposes Look Unnatural?
We have all seen photos of celebrities who have been treated with Botox and have unnatural appearances ranging from brows lifted too high to a face that appears frozen. The effect of Botox Cosmetic used in the facial areas (frontal or temporal), whether for cosmetic or migraine purposes, is primarily dependent on three important factors:

  1. The qualification and experience of the person providing the treatment. (See "Who Should Perform Botox Injections")

  2. The dose of Botox that is injected – the amount of muscle contraction weakness depends on the amount of Botox that is administered into the particular treatment area.

  3. If the dose has been injected correctly into the appropriate treatment area

    to achieve the desired effect

When performing Botox Cosmetic injections for cosmetic purposes, the goal is to provide the most natural-appearing result as possible to meet our individual patient's goals in a realistic manner. These same goals are adhered to whether the patient is having Botox injections purely for cosmetic reasons or for migraine relief and migraine diagnostic purposes.


With Dr. Weinzweig'spatients are very pleased with their natural, rested, refreshed appearance. He avoids the over-treated appearance that you can get by either using too much Botox in an area or not completely understanding the anatomy of the facial muscles and inappropriately injecting Botox in an area that may cause an unnatural look.


Who Should Not Take Botox Cosmetic
You should not be treated with Botox Cosmetic if you:

  • have allergies to any botulinum toxin product including Myobloc or Dysport
  • had any side effect from any botulinum toxin product in the past
  • are allergic to any of the ingredients in Botox or Botox Cosmetic
  • have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or
    Lambert-Eaton syndrome)
  • have a skin infection at the planned injection site
  • have bleeding problems
  • have a breathing problem, such as asthma or emphysema
  • have swallowing problems
  • have weakness of your forehead muscles, such as trouble raising your eyebrows
  • have drooping eyelids
  • have any other change in the way your face normally looks
  • are pregnant or plan to become pregnant. It is not known if Botox Cosmetic can harm your unborn baby
  • are breast-feeding or plan to breast feed. It is not known if Botox Cosmetic passes into breast milk

How Do You Determine If I Am A Candidate For Migraine Surgery?

Because Botox temporarily inhibits muscle contraction, usually for about three months, it can be used as a "trial test" to see if a patient's migraine headaches go away or become less intense following a Botox injection. Botox is used as a diagnostic test to determine what trigger point(s) is causing your migraine. It also can determine if you will benefit from a more permanent surgical solution. Botox is used to pinpoint which of exact muscles in the forehead, back of the head or temple areas may be serving as "trigger points" to compress, irritate or entrap nerves that could be causing the migraine. If a Botox treatment is successful in preventing migraines or lessening their severity, then surgery to remove the triggering muscle is likely to achieve the same result, possibly permanently.


What Is The Chance That Botox Injection Will Help My Migraine Headaches?

Botox has been shown to be an excellent predictor of migraine surgery success.Trigger sites in the frontal, temporal and occipital areas can be identified by injections of Botox. It has been shown that in these three areas, Botox causes the muscles to weaken for 6 - 12 weeks resulting in over 50% improvement in frequency, severity and duration of migraines in 70-80% of patients undergoing Botox injections. A positive response to Botox predicts a 90% success rate for migraine surgery resulting in complete elimination of the migraines or a significant permanent reduction in migraine frequency, severity and duration.


What Is Migraine Surgery?

Migraine surgery is a surgery performedfor the ultimate goal of reducing or eliminating migraine headaches. Migraine surgery is an option to explore after failure of traditional migraine medications and medical treatments. The specific surgery that is performed is based on individual's specific trigger sites or migraine zone that is involved: frontal, temporal, occipital or nasal. The actual surgical technique performed is specific to the anatomical migraine zone.


Where Is Migraine Surgery Performed?

Migraine surgery is aninnovative and proven approach for the treatment of migraine headaches. It has provided migraine relief for chronic migraine sufferers for the past decade. Dr. Weinzweig is the first plastic surgeon to bring this advantageous surgical treatment to the Chicago area. Dr. Weinzweig is one of a handful of surgeons in the United States who perform Botox injections as a diagnostic tool to determine migraine trigger points that are amenable to surgery.

 

Is Migraine Surgery Covered By Insurance?

Since it is an FDA approved treatment, many insurance companies now cover most of the cost of the Botox injections. Many insurance companies now also cover most of the costs of several of the migraine decompression surgeries. It has been shown that migraine surgery patients experience, on average, a health care savings of over $6,000 a year. Please contact our office at (800) 807-8781 for further information.


Where are you located?

The Headache Response Center has three accessible locations in the Chicago area. We have locations in Lincoln Park, Highland Park, and Downtown Chicago on Michigan Avenue. We are actively working on expanding the Center to offer a Headache Response Center even closer to you.


Do you accept insurance?

Yes. We accept insurance and are in network for most major insurance plans.


What are your hours?

We operate during normal business hours- Monday to Friday 9am to 5pm. We have Saturday appointments one weekend a month in our Highland Park location.


New patients are encouraged to call during normal business hours so you can speak with a clinical coordinator who will be able to schedule you for your first visit.


Please note that once you book an appointment, you will be sent an email. The email will give you an access code that will enable you to fill out your medical forms online. In order to give your provider an opportunity to review your medical history before your first appointment, please fill out the medical history at least 24 hours before your scheduled visit.

What should I bring to my first appointment?

Bring any diagnostic testing you have had in the last year including any MRIs, blood tests, or CAT scans. Bring an accurate and complete list of any medications, supplements, or herbs that you have been taking. If possible, bring all medications with you to your appointment.

 

Where can I find patient forms?
Please note that once you book an appointment, you will be sent an email. The email will give you an access code that will enable you to fill out your forms online. So that your provider has a chance to review your medical history before your first appointment, please fill out the medical history at least 24 hours before an appointment when possible.

How are you different from other headache treatment clinics?

Headache Response Center provides a full spectrum of treatment options for our patients. From physical therapy to surgical intervention, we use an integrated approach towards headache pain management. By using a range of diverse treatment types including pharmacological management, nerve blocks, and surgery, along with physical therapy, biofeedback, and neuromodulation, we provide effective solutions to headaches that provide lasting relief.