Can The Occipital Muscle Be Removed for the Treatment of Migraines?
Q: Dr. Eppley, I am writing this mail to inquire viability of surgical removal of occipital muscles.
I have viewed multiple posts by Dr.eppley regarding temporalis removal for various reasons, one of which was of my interest, headache.
I am wondering if the similar removal surgery can be done occipitalis. It might lead to the loss of ability in raising eyebrows for facial expression, but I am nonetheless interested in the surgery.
Living outside US, currently I am receiving Botox treatments from a local clinics, it helps but the effect wears off faster.
Regardless of whether removal of occipitalis in effect assuages my symptoms, I wish to have a try and am asking if occipitalis can be removed by such surgery as can temporalis.
A:If the goal of treating the occipitalis muscle for the purposes of migraine relief, which I assume is what the Botox injections were for, that can be done but not in the exact way that you describe. (surgical removal of occipital muscle) The occipital muscles are very large and go way under the nuchal ridge of the occipital skull bone, thus large segments of the muscle can not be removed. But the occipital muscle can be released from the nuchal ridge with some muscle removal with decompression of the greater occipital nerves as they pass through it. That is a very typical approach in the surgical treatment of occipital migraines.
Dr. Barry Eppley
World-Renowned Plastic Surgeon