WHERE IS THE SURGERY PERFORMED?
The surgery is usually performed as an outpatient operation in a facility adjacent to Dr. Guyuron’s office.
WHAT TYPE OF ANESTHESIA IS USED?
The majority of the procedures are done under general anesthesia and usually the patient spends about half a day in the facility.
WHAT KIND OF POSTOPERATIVE CARE IS NEEDED?
The patient is often discharged home with one or two drain tubes under the scalp that are connected to a small vacuum tube that will be removed in a few days. Someone has to stay with the patient the first night to assist in changing the vacuum tubes and call for assistance in case of an unlikely emergency. There will be a need for application of some ointment on the incisions periodically during the first week. All of the stitches are dissolvable and they do not need to be removed. After a septum surgery, Dr. Guyuron places two tubes inside the nose, instead of packing, that are not visible from the outside. These tubes will be removed in four to seven days after surgery, depending on the type of surgery.
WHO IS A CANDIDATE FOR SURGERY?
Anyone who has at least two or three severe migraine headaches per month that would not respond to over-the-counter medications, those who are tired of taking migraine medications, and those who experience migraine headaches that interfere with their personal and professional lives would be good candidates for this surgery. This is especially true for those who have frequent migraine headaches, do not tolerate migraine medications or have experienced side effects from medications.
WHAT KINDS OF TESTS ARE NEEDED?
Patients will undergo standard testing as outlined in the anesthesia policy. In addition, for patients who have pain behind the eye, a CT scan may be required to document the abnormalities inside the nose and sinuses which are not easily visualized by simple inspection of the inside of the nose.
WHAT IS THE RECOVERY LIKE?
After recovering in the facility, the patient will be transferred home, to a condominium close to the outpatient setting or to a hotel room close to the surgical facility. The drains are usually removed in two to four days. The patient will experience some swelling and bruising which will get worse within 48 hours and then gradually disappear, on average, in eight to 10 days. The patient will appear presentable in about one to two weeks after surgery and can resume social activities at this time, depending on the trigger site. It is recommended that patients avoid heavy exercise for about three weeks. Usually there are no limitations after this period. Patients who undergo septum and turbinate surgery, it may be necessary to irrigate the nose once or twice a day for a period of three to six weeks.
HOW DOES THE PATIENT PREPARE FOR SURGERY?
The patient will be asked to avoid aspirin or aspirin-type medications for three weeks before and one week after surgery and will be provided with a list of medications and food products to avoid. Strict adherence to the instructions from the surgical team will ensure a safer operation and quicker recovery.
WHEN DOES THE PATIENT NOTICE THE IMPROVEMENT?
Depending on the trigger sites, the results could be immediate or may take several weeks or months to observe the improvement, especially when the surgery involves the nose.
WHAT HAPPENS IF MY MIGRAINE HEADACHES DO NOT GO AWAY?
This commonly is the consequence of a trigger site that was not identified because it was dormant or was overshadowed by other, more dominating trigger sites. It is always possible to have surgery on the other trigger sites that were not detected earlier. The pain in the operative site may go away completely and you may develop pain somewhere else, which can be treated.
CAN I TAKE MY MIGRAINE MEDICATIONS AFTER THE SURGERY?
If you have migraine headaches, you can continue with your migraine medications, as long as they do not contain aspirin or aspirin-type medication. However, the need for these medications becomes extremely small.
DOES INSURANCE COVER THIS TYPE OF SURGERY?
It depends on the type of insurance you have. Approximately 50 percent of insurance companies currently cover this surgery. Dr. Guyuron’s office staff will assist you in obtaining the answer from the insurance company.