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

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.

04/11/2026

Just another example of nerve anomalies, this time in the lower extremity. The first image is a depiction of the nerves below the knee toward the foot. The superficial peroneal nerve is most commonly noted as a single branch in the lateral compartment and highlighted by the black arrow. The following image from the operating room shows a common anomaly with a superficial peroneal nerve branch in the lateral compartment, highlighted by the black arrow, and a superficial peroneal nerve branch in the ANTERIOR compartment highlighted by the green arrow. The blue arrow highlights the remainder of the septum that used to separate these two compartments and had to be partially removed so that the anterior branch could be fully decompressed. Just a few short weeks following the operation, the pain this person was experiencing from this nerve compression has almost completely gone.

04/09/2026

Preserving, repairing or reconstructing nerves isn’t enough.

Patients and their outcomes must be measured. We use a quantitative neurosensory test that precisely measures the ability to perceive light touch. Sensibility is recorded in grams per square millimeter, allowing for results tracking over time. During the test, small, blunt (hence painless) prongs are gently applied to the skin with gradually increasing pressure. The exact threshold at which sensation is detected is captured and displayed digitally, giving us a clear, reproducible way to evaluate nerve function and recovery.

04/03/2026

A year ago, Matt couldn’t lift his foot. He was concentrating on every step, wearing a brace just to walk safely.

This is what peroneal nerve decompression can do-restore the motor function that lets you move through life without thinking about it.

03/31/2026

Decompression surgery addresses every branch at once by releasing the compressed nerve at its source—without destroying function or creating scar tissue.

03/28/2026

So honored to once again be teaching this weekend to another group of pioneering breast and plastic surgeons bringing the next level of care to patients all over the US.

03/27/2026

Every staircase used to be a battle. Now, he runs up and down them without a second thought.

We removed a lesion that had been compressing a nerve in his leg, quietly stealing his mobility. Once it was gone, his body remembered what it was capable of.

03/26/2026

Sensation after top surgery with neurotization can take up to a year to return, and it rarely comes back all at once.
Tingling & zaps that’s the process. That’s your body doing something incredible under the surface.

03/23/2026

Part 2: Why RFA may complicate future options

Radiofrequency ablation works by generating heat vibrating thousands of times per second to create a thermal injury zone. That heat doesn’t just disrupt pain signals. It damages the nerve itself and creates scar tissue in surrounding tissues, restricting normal nerve gliding and potentially worsening compression over time.

If you’re considering RFA, especially before exploring surgical decompression, understanding how it works and what it can and cannot address is essential for making an informed choice.

Every case is different. What questions do you have about RFA or nerve decompression options?

03/22/2026

Could not be a prouder dad watching CRUSH the leading role of Jack Kelly in two performances of Newsies this weekend. Can't wait for the Tony and Oscar ceremonies!!! Love you buddy!!

03/20/2026

“I felt incredibly respected and safe.”

That’s everything. That’s the standard we hold ourselves to every single day.

We’re honored to support patients through some of the most meaningful moments of their lives, and equally honored when they trust us with their care.

Thank you for sharing your experience. 🏳️‍⚧️

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.

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

Website

https://peledsurgery.com/

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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.