Lexington, Kentucky Sep 15, 2026 (Issuewire.com) - A separate track for a different kind of patient

Dr. Theodore L. Gerstle, a plastic surgeon at Lexington Plastic Surgery in Lexington, Kentucky, treats migraine headaches alongside his busy facelift, breast, and body contouring work. Knowing the financial burden these headaches have on patients' lives, he is now setting aside dedicated consultation time each week for patients who come in specifically for migraine treatment, rather than folding those visits into the general cosmetic schedule.

The change is administrative, not medical. But Dr. Gerstle says it matters because migraine patients arrive with different questions and a different history than someone coming in for facial rejuvenation.

"Someone who has had debilitating headaches for ten years needs time to explain what they have already tried," Dr. Gerstle says. "They are not shopping for a look. They are looking for relief and improved quality of life."

What the consultations cover

Dr. Gerstle offers a range of options for migraine patients, from conservative approaches to surgery:

• Nerve blockade
• Neutotoxin
• Surgical nerve decompression, aimed at long-term reduction or resolution of symptoms

The dedicated slot gives him room to walk through all three with a patient before recommending a path. He starts with the least invasive option that fits the person in front of him.

"I don't begin with surgery," he says. "I begin with what has already been tried, what worked for a while, and what stopped working. Surgery is one tool, not the first one."

Why this needed its own hour

Cosmetic consultations at Lexington Plastic Surgery often run on a set structure: goals, options, recovery, cost. Migraine consultations do not fit that shape. Patients frequently bring records from neurologists, prior Botox logs, or notes on trigger points that took years to identify.

Dr. Gerstle says trying to compress that history into a slot built for a facelift consultation shortchanged the patient.

"A headache history is not a five-minute story," he says. "If I only have twenty minutes, I am going to miss something that matters."

The new structure gives migraine patients a full consultation slot built around their timeline, not a cosmetic template.

Who this is for

The dedicated track is for patients who have already tried standard migraine management, such as medication or a neurologist's care, and are exploring whether nerve decompression or another surgical approach could help. It is also open to patients who want to understand Botox or nerve blocks as a next step before considering surgery.

Dr. Gerstle says he is not trying to position surgery as a cure-all.

"Not every migraine patient is a surgical candidate," he says. "Part of the consultation is figuring out, honestly, whether surgery is even the right conversation to have."

A commitment to keep the option open

Dr. Gerstle says the practice will keep the migraine consultation track in place going forward, as a standing part of how Lexington Plastic Surgery operates, not a trial.

"This isn't a program with an end date," he says. "It's how I think this part of the practice should run."

He points to his own path into plastic surgery, through the Harvard Combined Plastic Surgery Residency program, as part of why he treats migraine surgery as its own discipline rather than an add-on to cosmetic work.

"Reconstructive training teaches you to think about nerves and tissue in a functional way, not just a cosmetic one," he says. "Migraine surgery draws on that side of the training."

To read more, visit the website here.

About Dr. Theodore L. Gerstle

Dr. Theodore L. Gerstle is a plastic surgeon at Lexington Plastic Surgery in Lexington, Kentucky. He has been in private practice there since 2014. Dr. Gerstle trained at the United States Military Academy at West Point, the University of Louisville School of Medicine, and the Harvard Combined Plastic Surgery Residency program. His practice includes facial rejuvenation, breast surgery, body contouring, reconstructive surgery, and treatment for migraine headaches.

Contact:

[email protected]

Media Contact

Theodore Gerstle

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http://drtheogerstle.com