Migraine Surgery — Peripheral Trigger Sites, Nerve Decompression, and Patient Selection

This episode reviews the core principles of migraine surgery, focusing on peripheral trigger sites, patient selection, diagnostic workup, nerve anatomy, and surgical decompression.Topics include neurogenic inflammation, CGRP, trigeminal and cervical nerve triggers, neurologic evaluation, the one-finger rule, Doppler assessment, diagnostic Botox, nerve blocks, CT imaging, and the Big Six trigger sites: frontal, temporal, rhinogenic, occipital, auriculotemporal, and lesser occipital. The episode also covers frontal trigger decompression, corrugator/procerus resection, supraorbital foraminotomy, temporal nerve avulsion, rhinogenic contact points, septoplasty, turbinate reduction, greater occipital nerve decompression, semispinalis capitis resection, occipital artery management, fat wrapping, unmasking of secondary trigger sites, outcomes, recovery, and common pitfalls. Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons.DisclaimerThis podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.SEO / Topic Keywordsmigraine surgery, surgical treatment of migraines, peripheral trigger sites, migraine trigger points, nerve decompression, supraorbital nerve, supratrochlear nerve, zygomaticotemporal nerve, greater occipital nerve, lesser occipital nerve, auriculotemporal nerve, rhinogenic migraine, neurogenic inflammation, CGRP, one-finger rule, diagnostic Botox, migraine Botox, nerve block, Doppler migraine surgery, supraorbital foraminotomy, corrugator resection, procerus resection, temporal migraine, ZTBTN avulsion, septoplasty migraine, turbinate reduction, intranasal contact points, occipital migraine, semispinalis capitis, occipital artery, nerve fat wrap, nummular headache