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Medical condition · Chadds Ford | Glen Mills, PA

Botox for chronic migraines.

Botox isn’t just cosmetic. The same molecule that softens forehead lines is FDA-approved for the prevention of chronic migraines — and many of our patients use it as their primary headache prevention strategy.

How the treatment works

The mechanism — plain language.

The Botox migraine protocol uses 155 units distributed across 31 specific injection sites in the head, neck, and shoulders — a precise pattern established in the PREEMPT clinical trials.

Botox works by blocking the release of acetylcholine and pain neurotransmitters at the targeted muscle and nerve endings — interrupting the cascade that triggers migraine attacks before they start.

This is a preventive treatment, not an acute one. It’s not for stopping an in-progress migraine. It’s for reducing the frequency and severity of migraines over months.

Clinical evidence

What the research shows.

In the PREEMPT clinical trials, patients receiving Botox for chronic migraine reported an average of 8–9 fewer headache days per month after 24 weeks. Real-world clinical experience consistently mirrors this — most patients see significant reduction by their second treatment cycle.

Is this right for you?

Who qualifies.

  • Adults age 18+
  • Chronic migraine: 15+ headache days per month, at least 8 of which are migraines
  • Migraines that have not responded adequately to oral preventive medications, or where oral preventives caused intolerable side effects
  • No contraindications to botulinum toxin (no active neuromuscular conditions, no allergy to formula)

Not the right approach if:

You have episodic migraines (fewer than 15 days per month) — the FDA indication is specifically for chronic. You have an active neuromuscular condition. You’re pregnant or breastfeeding. Note: medical insurance often covers Botox for chronic migraine when criteria are met — we’ll help you understand whether your plan covers it.

Medical oversight

Reviewed and supervised
by a board-certified plastic surgeon.

This is medical care — not cosmetic. Every plan at Contoured is reviewed and approved by Dr. Benjamin Lam, DO, a board-certified plastic surgeon and clinical associate professor at PCOM. That oversight isn’t standard at most medspas. It is here.

Dr. Benjamin Lam, medical director Medical Director · Plastic Surgeon

Dr. Benjamin Lam, DO

Board-certified plastic and reconstructive surgeon. Past-President of the Plastic & Reconstructive Surgery Section of the American College of Osteopathic Surgeons. Director of the Plastic & Reconstructive Surgery Fellowship at the Philadelphia College of Osteopathic Medicine.

Read Dr. Lam’s full bio →

Amy Litz, founder and owner Founder · Lead Provider

Amy Litz

Twenty years inside the injectable and body-contouring industry — first as a sales rep and CoolSculpting trainer, now as the lead provider at Contoured. Personally performs the majority of medical-application treatments under Dr. Lam’s oversight.

Read Amy’s full story →

Common questions

What patients ask before starting.

Is Botox covered by insurance for migraines?
Often, yes. Many major medical insurance plans cover Botox for chronic migraine when the FDA criteria are met (chronic migraine with 15+ headache days/month, prior trial of oral preventives). We can help you understand what your plan requires. Note: insurance coverage is for the medication only — clinic visit fees may apply separately.
How is migraine Botox different from cosmetic Botox?
Same molecule, different protocol. Cosmetic Botox treats 3–5 specific facial muscles (20–40 units total). Migraine Botox uses 155 units across 31 specific injection sites in the head, neck, and shoulders — a pattern established in the PREEMPT clinical trials.
How long until I notice fewer migraines?
Most patients see meaningful reduction after the second treatment cycle (about 6 months in). Some respond after the first. A small minority don’t respond and we re-evaluate after two cycles.
Will I still need my acute migraine medication?
Probably, but less often. Botox is preventive — it reduces frequency and severity over time. Your acute medications (triptans, NSAIDs, etc.) remain available for breakthrough migraines.
Are there side effects?
Most common: temporary neck pain and mild headache for 1–2 days after injection. Less common but more concerning: temporary weakness in neck muscles. Rare: drooping eyelid (eyelid ptosis) which resolves over weeks.
Does Dr. Lam supervise this?
Yes. Migraine Botox is a medical procedure and falls firmly under Dr. Lam’s physician oversight. Every patient is evaluated and the dosing plan is reviewed and approved before treatment.
How long do the effects last?
About 12 weeks per cycle. Treatment is repeated every 12 weeks indefinitely for ongoing prevention.
Treatment used for this

The clinical pathway.

Physician-supervised. Conservative. Reviewed.

Ready to discuss treatment?

Text us or call. Every first visit is a free 30-minute consultation where we evaluate whether this treatment is right for your specific case.

Text us Schedule online Or call (610) 787-9154