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.

07/10/2026

For a long time, top surgery felt like an impossible choice. Not because of the surgery itself — but because of what they were afraid it would take from them.
Sensation. Touch. The feeling of being fully present in their own body.
So many patients tell us this same story: they wanted top surgery, but they didn’t want to trade one part of themselves for another.

That’s exactly why sensation preservation techniques exist. This patient didn’t have to choose between gender-affirming surgery and staying connected to their chest. Today, they have both — a body that feels like home, inside and out.
If sensation loss has been the thing holding you back from top surgery, you’re not alone, and you may have more options than you think.

07/02/2026

One of the most common misconceptions about top surgery is that numbness is inevitable. This patient chose sensation-preserving top surgery with nerve reconstruction. Eighteen months later, they have regained full protective and light-touch sensation.
Nerve healing is a gradual process. It happens over months—not weeks—and requires meticulous preservation and reconstruction of the nerves at the time of surgery. While every patient’s recovery is different and outcomes can never be guaranteed, restoring sensation is an important goal whenever it can be be safely achieved.

For many patients, sensation is about far more than touch. It’s about feeling connected to your body, protecting yourself from injury, and improving long-term quality of life.
This is why we believe sensation deserves to be part of the conversation.

Just another example of nerve anomalies, this time in the lower extremity. The first image is a depiction of the nerves ...
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.

Preserving, repairing or reconstructing nerves isn’t enough. Patients and their outcomes must be measured. We use a qu...
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?

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

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