Peled Surgery

Peled Surgery Ziv M. Peled, MD is a plastic and peripheral nerve surgeon specializing in relieving chronic head pain from compressed nerves.

ON & TN are often unhelpfully diagnosed as migraines. Dr. Peled's mission is to educate patients about their options. People often ask me, 'How did you get involved with peripheral nerve surgery after a plastic surgery residency at Harvard?' The answer comes in two parts.

I was recently asked about whether or not decompression works in other parts of the body, and the answer is most certain...
03/16/2026

I was recently asked about whether or not decompression works in other parts of the body, and the answer is most certainly, YES. These first two illustrations demonstrate an example of that success in the frontal region above the eye. In the first illustration, the green arrow to the right points to what appears to be the supraorbital nerve compressed by bone (black arrow) and the supratrochlear nerve coming out under the bone toward the left side of the image (other green arrow). The next illustration shows this same anatomy now following decompression. The two green arrows to the right and in the center of the image point to multiple branches of the supraorbital nerve that have now been decompressed by removal of a small piece of bone (between the two black arrow tips). The green arrow to the left of the image now points to the true supratrochlear nerve more toward the nose. These images therefore demonstrate not only significant compression of the supraorbital nerve, but a branch of that nerve that was bent around the bone prior to decompression. The last two images show the actual intraoperative photographs of this same anatomy. Headaches improved!!!!

03/12/2026

RFA for occipital neuralgia sounds like it should work. But there’s a fundamental mismatch.

ON is mechanical—something is physically compressing your nerve. RFA doesn’t remove that compression. It just changes how your nerve sends pain signals for a while.

When the ablation wears off, the compression is still there.

Surgical decompression actually removes what’s causing the problem.

03/10/2026

Your body has a built-in alarm system that works faster than you can think. When you touch something hot, your nerves fire at 250 mph—pulling your hand back before your brain even registers pain.

During traditional mastectomy or top surgery, this alarm system is often removed along with breast tissue. Thousands of nerve endings, gone. And without them? You can’t feel burns. You can’t feel when an implant is causing damage. You lose the early warning that keeps you safe.

This is why we focus on sensation-preserving techniques—not just for how it feels, but for what it protects.

What questions do you have about nerve-sparing surgery? Drop them below, I’m here to answer. 👇

Today, we celebrate the strength, compassion, and resilience of women everywhere. For me in particular, one woman who ha...
03/08/2026

Today, we celebrate the strength, compassion, and resilience of women everywhere. For me in particular, one woman who has taken difficult moments and transformed them into hope for others. She leads with courage and heart, constantly turning adversity into purpose and continuing to profoundly help so many others. It’s an honor to share this life with you❤️❤️❣️🫶🫶

There are still so many misconceptions about mastectomy—and they matter more than people realize. Take a moment to liste...
03/06/2026

There are still so many misconceptions about mastectomy—and they matter more than people realize. Take a moment to listen to these two incredible women discuss some of the most common misconceptions about mastectomy and why understanding your options can make such a meaningful difference. .mckeon

So proud!! No words!!! 🫶🫶🫶🫶🫶🙌🙌🙌Check it out in the link in bio.....you will learn so much❣️❣️❣️🤗🤗🤗 .mckeon
03/06/2026

So proud!! No words!!! 🫶🫶🫶🫶🫶🙌🙌🙌
Check it out in the link in bio.....you will learn so much❣️❣️❣️🤗🤗🤗
.mckeon

03/05/2026

Every case is different—some nerves do require resection. But understanding what’s happening inside your foot helps you make a truly informed decision with your peripheral nerve surgeon.

03/02/2026

Sometimes, seemingly small anatomical details can have significant clinical consequences. In the case of a Morton’s “neuroma,” that principle is especially relevant.

In this first of two videos, I’ll walk through exactly what I mean and why these nuances matter.
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02/26/2026

Do you want to know why your chronic headaches seem to be getting worse with stress? And what about the connection between all this stress and nerve compression or irritation? Watch the video and click on our link in bio to learn more.

Ever wonder how sensation can be preserved or restored to the ni**le-areolar complex (NAC) during sensation-preserving t...
02/21/2026

Ever wonder how sensation can be preserved or restored to the ni**le-areolar complex (NAC) during sensation-preserving top surgery? This illustration shows the incision partially closed and the future NAC graft site prepared (deepithelialized). The intercostal nerves—responsible for ni**le sensation—are carefully identified and preserved for a good length. These nerves are then microsurgically connected to the underside of the NAC graft site to help restore meaningful sensation over time.

Once the nerve connections are complete in the operating room, the incision is closed in a more refined, aesthetic manner and the temporary staples are removed. The second image shows this exact process IRL.

Bonus: Additional intercostal nerves visible near the lower portion of the incision are also preserved fo3 some length and connected to the chest wall, further optimizing the potential for sensory recovery.

Restoring sensation isn’t accidental or random — it’s intentional, meticulous, and rooted in nerve-focused surgical technique. I’d love to hear your thoughts or questions in the comments below.

02/14/2026

What happens when the MRI doesn't show anything?!? Find out why this might happen and what it means in the video. Has this happened to you?

Address

2100 Webster Street
San Francisco, CA
94115

Opening Hours

Monday 7am - 6pm
Tuesday 7am - 6pm
Wednesday 7am - 6pm
Thursday 7am - 6pm
Friday 7am - 6pm

Telephone

+14157510583

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Our Story

People often ask me, 'How did you get involved with peripheral nerve surgery after a plastic surgery residency at Harvard?' The answer comes in two parts.

First, many people don't realize that plastic surgical training involves work with many types of soft tissues including, skin, muscle, fat, bone and yes, nerves. We would often get called upon to re-attach limbs that had been amputated in accidents and as part of those procedures, we would repair the injured nerves in order to restore function and sensation.

Secondly, in deciding what type of surgeon I would become and what I would do following my training, I happened upon a colleague and friend who was doing some interesting surgical work with patients suffering from diabetic neuropathy. I spent some time with him and did several operations with him during my Chief Residency year and after that experience knew that I had found what I would ultimately do with my life. After a whole additional year of training focusing on and learning how to operate on peripheral nerves, I landed in the Bay Area and knew I had found my new home, where I ultimately founded Peled Migraine Surgery.

Given my passion for peripheral nerve surgery, I expanded my practice to include chronic headache patients, many of whom suffer from nerve compression very similar to that which I have been treating for many years in other parts of the body. The results for chronic headache patients have been wonderful and have mirrored those published in the literature. The benefit I often see in these headache and other nerve patients have validated my career decision. I genuinely feel that I make positive and substantive changes in peoples lives on a daily basis and this feeling is the reason I became a physician in the first place.