Since high school, Michael Calderone's migraine headaches have been so crushing that life his life would just stop.
"I would come home in the summer after working and go pass out in a dark room with a headache so bad I would lose the rest of the day," said Calderone, a 52-year-old who runs a building electronics company in Cleveland. "I was totally dysfunctional until I passed out."
The headaches only got worse as he grew older.
"If it hit in the morning, I would lose a whole day and the next day until it would cycle down," he said. "No bright lights, no stress, no activity at all -- just not to agitate your head so it would not get worse."
That was until he met Dr. Bahman Guyuron, chair of the department of plastic and reconstructive surgery at University Hospitals Case Medical Center.
Guyuron had pioneered a surgical technique that he had discovered by accident while doing cosmetic surgery on women.
In July 2008, Guyuron gave Calderone a forehead lift, freeing entrapped nerves behind his eyes that had caused chronic and excruciating pain on the left side of his face.
And today, the migraines are gone.
"At one point I was getting them every day --- I was incapacitated," said Calderone. "Now, I feel like I have my life back."
According to the Migraine Research Foundation, an estimated 36 million Americans -- about 10 percent of the population, suffer from migraines. They are not just headaches, but an array of neurological symptoms that can include throbbing head pain, nausea and visual disturbances.
Migraine ranks in the top 20 of the most disabling medical conditions. Three times as many women as men are afflicted, according to the foundation, which funds research and provides medical resources for patients.
Migraines tend to run in families. Both Calderone's 21-year-old daughter and his niece have them.
Attacks can last between four and 72 hours and may include nausea, vomiting, as well as extreme sensitivity to sound, light, touch and smell. Tingling or numbness can also occur in the extremities or face.
But now, plastic surgeons, many of whom have been trained under Guyuron, are offering nerve decompression surgery. He theorizes that 90 percent of all migraines are caused by irritation of the peripheral branches of the trigeminal nerve.
Guyuron first discovered the connection between migraine and nerve compression by muscles, vessels and bone 12 years ago.
"A surgeon's wife had a forehead lift and came for a follow-up with me," he said. "She told me she was not only happy with the way she looked, but she hadn't had a migraine for the previous six months."
"I thought it was a coincidence, but another patient told me the same thing," said Guyuron.
So he investigated 314 patients who had undergone forehead lifts over the previous decade, revealing that 31 of 39 who reported migraine headaches saw "significant improvement."
"That was the beginning," he said.
A Guyuron-led study published in the journal Plastic and Reconstructive Surgery in 2009, found that nearly 85 percent of patients who underwent the nerve decompression surgery had a 50 percent reduction in migraine.
His work suggests that migraine arises from irritation in the nerves, which releases toxins and begins a "cascade of events that end up being a full-blown migraine in the head."
According to Guyuron, there are four common trigger points on the face and four less common ones. Most are on the forehead, temple, back of the head and behind the eyes.
"Each one has a different mechanism and reason for the nerves being irritated, and we have developed a surgical technique for each trigger," he said.