In 1992, Binder, a facial plastic surgeon in Los Angeles, first noted migraine improvement in a patient he was injecting with onabotulinumtoxinA for wrinkles.At the American Headache Society meeting in 1998, Binder and colleagues presented the first poster on onabotulinumtoxinA treatment in patients with migraine. The author of this month’s expert opinion, Blumenfeld, then started to treat migraine patients at Kaiser Permanente San Diego who were high utilizers of triptans. His preliminary findings of efficacy on 271 patients were published in 2003.