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Peripheral Nerve Surgery For Your Los Angeles Headaches

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Migraine headaches have traditionally been thought to begin within the central nervous system (i.e. the brain and/or spinal cord) and then produce symptoms elsewhere such as throbbing in the back of the head, forehead or temples. There are many theories as to what exactly within the central nervous system is causing these chronic and often debilitating headaches. Some of these theories include pathologic blood vessel dilatation and constriction (loosening and tightening), abnormal firing of neurons within the brain, and abnormalities of various biologic substances (e.g. serotonin, calcitonin gene-related peptide). The fact that no one theory has been proven correct is likely one of the many reasons that there are so many different methods for the treatment of chronic headaches like migraines. In fact, from a medication standpoint alone, there are not only dozens of medications used to treat migraines, but dozens of classes of medications such as triptans, anti-depressants, muscle relaxants, blood pressure medications, narcotics, anesthetics, ergotamines, and so on. Fortunately, a different perspective on chronic headaches has produced remarkable results that have been previously unheard of.

This different school of thought suggests that peripheral nerve irritation (i.e. irritation of nerves outside of the brain and spinal cord such as those within the scalp or forehead) can cause irritation within the central nervous system thus leading to the perception of and symptoms of a headache. If this mechanism were in fact the culprit, then identifying and correcting the cause of such irritation could produce relief from the headache symptoms. Plastic surgeons have been doing exactly that with a common nerve irritation problem known as carpal tunnel syndrome. In this syndrome, a nerve within the wrist is compressed (i.e. pinched) and surgeons decompress (i.e. un-pinch) it thereby relieving the symptoms of pain with a greater than 90% success rate. Recent research has demonstrated that just like at the wrist, there are nerves within the head and neck that are compressed and that decompressing them, can produce significant or even complete relief that can be permanent.

Peled Migraine Surgery of San Francisco has emerged as a leader in the development of peripheral nerve surgery as a migraine relief technique. Ziv M. Peled, MD* is a Board-Certified plastic surgeon trained to perform the full spectrum of aesthetic and reconstructive plastic surgical procedures. He completed his medical school training at the University of Connecticut School of Medicine where he earned honors in multiple surgical disciplines. He subsequently completed four years of rigorous general surgical training at the University of Connecticut during which he also completed an additional two-year, post-doctoral Basic Science Research Fellowship at Stanford University under the tutelage of Dr. Michael T. Longaker, a pioneer in the field of scarless wound healing. During that time, Dr. Peled not only helped establish Dr. Longaker’s laboratory at Stanford, but was also awarded a 5-year NIH grant for his work in keloid biology and scarless wound repair. Ziv then completed a prestigious and highly sought-after plastic surgical residency at Harvard University. While there, he was awarded an “Excellence in Teaching” award from the Harvard medical students. Dr. Peled continued to hone his specialty skills with an additional year of training in peripheral nerve surgery at the Dellon Institute for Peripheral Nerve and Plastic Surgery. He is Board-Certified by the American Board of Plastic Surgery, which means that he graduated from an accredited medical school, completed numerous years of residency training, and successfully passed a series of comprehensive written and oral examinations. The American Board of Plastic Surgery is one of only a select few specialty boards recognized by the American Board of Medical Specialties (ABMS) and is the only ABMS board which certifies candidates in the specialty of plastic surgery of the entire body. Dr. Peled is also a member of the California Society of Plastic Surgeons and the American Society of Peripheral Nerve PN) - the leading society of peripheral nerve surgeons.

In addition to his cosmetic and reconstructive work, Dr. Peled helped to found a perpiheral nerve surgery institute here in San Francisco. In that institute, he served as Director and Chief Plastic & Peripheral Nerve Surgeon. His specific training enables him to perform a unique set of surgical procedures designed specifically to restore sensation and minimize/eliminate pain in patients suffering from migraines as well as neuropathy due to diabetes, chemotherapy and thyroid disorders. He has also treated many patients with various forms of nerve trauma as well as many other types of nerve disorders. Dr. Peled has authored and co-authored over 40 manuscripts and book chapters on all aspects of plastic surgery and has presented his work at numerous national meetings. He has performed several hundred peripheral nerve procedures of various kinds. Ziv is an Active Member of the American Society of Plastic Surgeons and was also recently elected as a member of the American Society for Peripheral Nerve. This honor recognizes and highlights Dr. Peled's breadth of work with peripheral nerve patients suffering from migraines and diabetes as well as his published work on peripheral nerve surgery.

Visit http://peledmigrainesurgery.com today for more information, and to make an appointment to relieve your migraines.

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What Are The Long-Term Effects Of Botox?

My name is Dr Ziv Peled. Welcome to the blog for my practice, Peled Migraine Surgery. My work as a Plastic Surgeon at Peled Migraine Surgery.has given me the experience needed to treat nerve and migraine issues here in San Francisco.
Several people have recently asked about the long-term effects of Botox treatment.  Happily or unhappily (depending on your perspective) this will be a relatively short post as very little is known about the long-term effects of repeated Botox injections.  There are likely a number of reasons for this fact. First, keep in mind that Botox is used for many different clinical conditions such as chronic headaches, blepharospasm (spams of the eyelid - the condition for which Botox was first developed and studied), spastic paresis in cerebral palsy and of course for cosmetic reasons. Secondly and because of the first reason, Botox is used in many different doses, places and frequencies making its long-term effects hard to study.  Even for chronic migraines, there are many different treatment algorithms (i.e. dosages and patterns of injection) amongst clinicians using Botox. Third, there are now three FDA approved versions of botulinum toxin type A (Botox® made by Allergan, Dysport® made by Ipsen, and Xeomin® made by Merz) each with slightly different formulations and hence clinical properties.

Botox InjectionOne of the few truly long-term follow-up studies I have found regarding botulinum toxin type A (in this case Botox®) was out of Jordan, Turkey and the University of Cincinnati.  In this study, chart reviews were performed on 32 patients who were being treated for hemi-facial spasm and blepharospasm and had had at least one Botox injection annually for at least 10 years (some patients had been treated for 20 years).  The findings demonstrated a need for a slightly higher dose of Botox to be effective over time and a decrease in the number of adverse effects (i.e. complications) over time. No life-threatening or systemic complications were reported, only localized ones likely relating to the function of the drug at the site of injection. Several other studies with follow-up between 6-15 years have found similar results.  The latter finding is likely a function of greater experience treating patients after many years and improved injection techniques.  The former finding can be related to a number of potential causes.

Prolonged treatment with botulinum toxin type A has been shown to result in the development of neutralizing antibodies which are thought to decrease the efficacy of the toxin.  Risk factors for the development of such antibodies are the formulation of the toxin, the frequency and dosage of the injections and the conditions for which the injections are being used.  Decreased efficacy (and hence the need for higher doses) may also be a reflection of the progressive nature of the disease being treated.  In other words, if the nerves are progressively injured by the disease process, they may require higher doses of Botox for clinical effectiveness. The take home message would be that Botox appears to be relatively safe and effective in long-term use although very few studies have been done to test this concept formally and none with occipital neuralgia.  Therefore, in my hands botulinum toxin type A remains a diagnostic test which, if effective, means that no more botulinum toxin type A needs to be injected - the patient is a candidate for decompression.  After all, in ON we are talking about a mechanical compression of the nerve(s) by a physical structure (muscle, fascia, blood vessels) and no amount of medicine will make that go away.

For more information on the effects of Botox, and how Migraine Surgery can help relieve Migraine symptoms and pain, visit www.peledmigrainesurgery.com today, and call (415) 751-0583 for an appointment.  Contact the author at This email address is being protected from spambots. You need JavaScript enabled to view it..

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WHAT’S THIS TRIGEMINAL NEURALGIA THING?

Several people have recently asked about trigeminal neuralgia (TN) and how it may relate to chronic headaches.  Trigeminal neuralgia is classically thought of as being caused by compression of the trigeminal nerve (root) near the pons (a part of the brain) or the trigeminal sensory ganglion (its sensory component) in the middle cranial fossa (another part of the inner skull) near another part of the brain.  The primary cause of TN is thought to be compression of the trigeminal nerve by an abnormal blood vessel inside the skull.  There is sometimes another term used, trigeminal neuropathy, which usually relates to TN caused by issues other than blood vessel compression such as herpes zoster, post-traumatic pain, or other space occupying lesions such as brain tumors, benign or malignant. Hence this problem is typically thought of as a central nervous system issue.  Again, the central nervous system to doctors simply means brain or spinal cord.

The symptoms of trigeminal neuralgia are very narrowly defined and include severe, unilateral, paroxysmal, electric or stabbing attacks that last a few seconds to a few minutes, in the distribution of one or more divisions of the trigeminal nerve and in the absence of other identifiable neurologic disorders.  In this regard, TN is very much like occipital neuralgia whose symptoms are defined in extremely specific ways.  These two disorders thus stand in sharp contradistinction to other headache disorders like migraines, cluster headaches and tension headaches whose symptoms are often generic, quite varied and hence overlap significantly.  It is for this reason among others that I feel ON and TN are extremely misunderstood and underdiagnosed.

So how does TN relate to headaches?  Well, the trigeminal nerve is the primary sensory nerve to the face, forehead and temporal scalp.  Therefore, injury to this nerve can cause facial pain, or frontal/temporal pain, the latter often perceived as forehead or temporal headaches. The supraorbital, supratrochlear, auriculotemporal and zygomaticotemporal nerves are all branches of the trigeminal nerve. The first two are responsible for sensation to the forehead and above/between the eyes and the latter two for sensation to the anterior and posterior temporal scalp.  Hence compression or irritation of these sensory nerve branches can cause pain in their distributions.  For example, as I have posted before (photos included), the auriculotemporal nerve is often compressed by the adjacent superficial temporal artery.

Hence there can be compression both in the central nervous system as noted above and in the peripheral nervous system as in the example just cited, but both involving the trigeminal nerve.  The former requires a neurosurgeon because in order to access the compressive element (blood vessel or tumor) near the brain, the skull must be cut and the compressive element removed.  This compression usually involves the entire trigeminal nerve or a large part thereof. The latter doesn’t require anything be done to the skull and is performed on the tissues (e.g. nerves, blood vessels, connective tissue) external to it, addressing one or more trigeminal nerve branches. Therefore, I believe the more precise term for compression/irritation of these peripheral nerves should be trigeminal branch neuralgia and it is these compression syndromes that I and Drs. Guyuron, Ducic, Hagan, Janis, etc. treat with our decompression procedures.

One last point: several people have wondered whether these peripheral nerve decompression procedures are “minimally invasive” and the answer is, “It’s all relative”.  I guess compared with using a saw to remove part of the skull and exposing the brain and other nerve roots, the answer is yes. That type of procedure is done in a hospital and often requires a multi-day hospital stay.  However, even though the peripheral nerve decompression procedures noted above are outpatient cases and are performed at accredited surgery centers, they are real operations and are not to be taken lightly.  They require skill and experience as the nerves are quite small peripherally.  They require general anesthesia because the patient must be positioned carefully and be perfectly still because the nerves are so small. And they require incisions, so compared with an MRI or trigger point injection, they are invasive.  Having said that, like the procedures for ON, they can be very effective with relatively low complication rates and risks.

For more information about peripheral nerve surgery, and migraine surgery in San Francisco, CA, visit www.peledmigrainesurgery.com today, and call 415-751-0583 to schedule an appointment.

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WHAT TO LOOK FOR WHEN CHOOSING A “HEADACHE SURGEON”

My name is Dr Ziv Peled. Welcome to the home page for my practice, Peled Migraine Surgery.: www.peledmigrainesurgery.com I live in San Francisco, CA and work as an Plastic Surgeon at Peled Migraine Surgery.

1. One of the first things to assess is whether your surgeon has significant and specific training in peripheral nerve surgery. Since the operations for chronic headaches/neuralgia potentially involve many nerves within the peripheral nervous system, the person performing such operations should have had focused training on the workup, evaluation and management of patients with any number of peripheral nerve problems (chronic headaches included). Because peripheral nerve surgery is performed on all parts of the body (e.g. arms, legs, trunk and head), your surgeon should ideally have experience and training with many of these types of nerve procedures because they provide the procedural foundation now employed in the operations designed for chronic headaches. A sample question that a patient might ask is what percentage of the surgeon’s practice is focused on peripheral nerve surgery. Dr. Peled has operated upon numerous patients involving many nerves in the forehead, temple and occipital regions with great success. Approximately 60% of his practice is devoted solely to peripheral nerve surgery.

 

2. Another important thing to ask your surgeon is how many of these procedures they have performed. In addition to the specific number of cases s/he has performed, the surgeon should also have experience with the wide breadth of peripheral nerves that are known to be potential causes of chronic, severe headaches. These include nerves within the forehead, temple and occipital regions.

3. Is your surgeon a member of the American Society for Peripheral Nerve (ASPN)? This society is the leading academic society for peripheral nerve surgeons. Its mission is to stimulate and encourage study and research in the field of neural regeneration, to provide a forum for the presentation of the latest research and relevant clinical information and to serve as a unifying authority on all areas of neural regeneration and restorative neuroscience. In order to become a member there are a number of qualifications that a surgeon must meet.  For example, a candidate has to be nominated by two of their peripheral nerve surgical peers and have published at least one scholarly, peer-reviewed paper on some aspect of peripheral nerve surgery. Looking for ASPN membership can serve as an objective vetting factor in deciding between several surgeons.  It also demonstrates a true commitment to the study of peripheral nerve problems and a genuine interest in advancing the field. Look for the ASPN logo on your surgeon’s website or communication forms. Dr. Peled has been a member of this Society for several years and has published several papers about various aspects of peripheral nerve surgery.  He is also currently involved in additional studies to advance the field which will hopefully be published in the near future.

4. Your surgeon should also be able to provide you with references for the type of procedure(s) he or she is recommending.  Not only does this give you the chance to speak with someone who has gone through what you will likely experience, it demonstrates that the surgeon has actually performed the procedure at least once before.

5. Finally, you should choose a surgeon with whom you have the best rapport.  This is the hardest concept to describe or discern.  While there are so few of us who perform these operations, realize that there still may be several qualified surgeons technically capable of performing the right operation for the correct indications.  However, just like every patient is different, so too is every surgeon.  Is their office staff professional and pleasant?  Does the doctor answer your questions in a manner that you can understand and make you feel at ease that they understand your particular situation?  Do they spend time actually listening to you and your symptoms?  Are they realistic in setting your expectations for what will happen before, during and after your procedure?  These factors can make the difference between simply a good outcome and a good outcome with a good experience along the way.

For more straight talk about how surgery can help you, contact Peled Migraine Surgery at 415-751-0583 and visit www.peledmigrainesurgery.com today.

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WHY DOES IT HURT SO MUCH AFTER THE INJECTION?!?

WHY DOES IT HURT SO MUCH AFTER THE INJECTION?!?

I’ve heard from so many people over the years who consistently tell me that they had worse pain AFTER their injections - whether it is Botox, a local anesthetic (such as is used in nerve blocks) and/or steroids. Remarkably, despite numerous queries to their treating clinicians, their physicians have never had a good answer for them as to why this problem happens. Actually, the answers are quite simple. Worse pain after injections such as those done to diagnose ON can occur for several reasons.

One reason is that the injections done for ON are performed within muscle. Injections into muscle cause a little muscle inflammation/swelling no matter what you inject (even saline) and this inflammation causes discomfort. Anyone who has ever had a tetanus shot into the shoulder muscle (deltoid) knows exactly what I’m talking about. Their shoulder can be sore for 7-10 days afterwards. Fortunately, the discomfort is temporary and only lasts a few hours or days as the inflammation/swelling subsides.

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Neuroma 101

Neuroma 101

First of all, what is a neuroma? A neuroma can be defined in one of two ways. One, as a tumor composed of nerve tissue such as an acoustic neuroma. Almost overwhelmingly, these tumors are benign. The more common usage of the term neuroma means a mass of nerve tissue consisting of regenerating nerve fibers that have been previously severed or injured somehow. When a nerve is injured, it tries to re-grow - that’s what nerves do. If that nerve re-grows into the scar at the skin, it can cause exquisite pain even with light touch in the area. This situation would be akin to having a cavity (which hurts because the nerve at the root of the tooth is exposed) and eating ice cream - ouch! So if a nerve is severed or injured in some other way, how do you prevent a neuroma from occurring?

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Medication Overuse Headache (MOH) or ‘Rebound Headaches”

Medication Overuse Headache (MOH) or ‘Rebound Headaches”

I have been asked recently to write a little something about so-called “rebound headaches”.  This topic can be quite confusing, and as you will read, is not very well understood.  The precise medical term for this disorder is Medication Overuse Headache (MOH) or analgesic rebound headache.  The prevalence of this problem is about 1% in the general population and as with many types of headaches, is higher in women than in men.  The underlying mechanisms for MOH are unknown, but as with many medical problems, are oftentimes multifactorial.  It is known that there can be a genetic predisposition to MOH.   In addition, long-term exposure to opiates is known to cause changes in the nervous system through increased expression of specific cytokines (chemicals, e.g. Calcitonin Gene-Related Peptide) and increased activity of certain neural pathways felt to modulate the sensation of pain.  Some people also feel that addictive personality disorders are associated with MOH. Interestingly, migraines are the thought to be the most common “primary headache disorder” that has been linked to MOH. The bad news is that just about any medication used to treat chronic headaches has the potential to lead to MOH.

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BLOCKS & STIMULATORS & DECOMPRESSION, OH MY?!?

BLOCKS & STIMULATORS & DECOMPRESSION, OH MY?!?

I’ve noted that there has been some confusion lately over the roles of nerve blocks, nerve stimulators and nerve decompression in the treatment of chronic headaches. To be sure, there will be variations in how each clinician may use these modalities, if only because each patient presents a unique clinical dilemma.  While I certainly can't speak to the ways in which others utilize these modalities, I can offer general guidelines as to how I use them in my practice.  Hopefully this information will also provide some insight into the advantages and disadvantages of each.

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HOW MANY HEADACHES IS TOO MANY?

HOW MANY HEADACHES IS TOO MANY?

Over the past year or so, I’ve noticed that many patients are being told by their other treating “headache doctors” that they shouldn’t consider surgery for their problem because their headaches are “not bad enough”.   Patients are often so struck by these remarks that many wonder whether this statement represents actual medical fact and repeat it to me as if it were empirically true. They then ask me if I agree with that concept.  My answer is always the same, “The only person who can say whether the pain you’re having is too much, is YOU.”

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What If I Still Have Headaches?

What If I Still Have Headaches?

Over the years, as I have operated on more and more patients with chronic headaches, my impression of this problem has changed somewhat. Time and again, I would see patients who had severe, frequent, long-lasting headaches who underwent surgery with me and did extremely well. Their headache frequency, severity and duration decreased significantly after their procedure and they were extremely happy.  However, many patients still experienced severe headaches from time to time and the question that was posed to be on many occasions was, "What does it mean that I still have some severe headaches after surgery?" As I have talked with numerous such patients on many occasions and drilled down on their remaining symptoms and their treatment of these symptoms, an interesting observation occurred to me.

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Restoring Anatomy and Nerve Regeneration

As awareness of “migraine surgery” increases, I have often been confronted by the question of whether the nerves that are involved need to be cut for the procedure to be effective. The answer to this question is “sometimes”, but let me elaborate in the next few sentences. There generally seems to be two perspectives on how to deal with "smaller" sensory nerves, in other words those with relatively small areas of sensory distribution. One approach would postulate that cutting the nerve oftentimes leaves a small area of numbness which is easily tolerated or is not even appreciated by the patient and therefore is a relatively good trade-off for relief of pain. Another perspective is that if the nerve is viable as noted during surgery, then leaving it intact will hopefully allow good relief of pain and preservation of sensation. Each of these approaches has its advantages and its disadvantages. Cutting the nerve can lead to immediate relief, but often leaves a noticeable area of numbness. Leaving the nerve intact requires the nerve to heal, recover and/or regenerate from the compression/irritation which was present as the cause for the surgical procedure. This process often requires several months depending on the longevity and severity of the compression/irritation, but if successful should lead to decreased pain and a preservation of some degree of sensitivity. Both procedures carry a small risk that nerve recovery will not occur and pain may persist. In the case of a cut nerve, the proximal (upstream) nerve end may remain persistently sensitive thus leading to a "phantom limb" type of sensation despite numbness in the former area of distribution. In the case of a decompressed nerve, the nerve may not regenerate again leading to persistent discomfort. Moreover, both procedures carry a small risk of neuroma formation although I personally believe that this risk is slightly less when nerves are left intact as compared to when they are cut.

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Peled Migraine Surgery Helps Eliminate Walnut Creek Migraines!

Migraine headaches have traditionally been thought to begin within the central nervous system (i.e. the brain and/or spinal cord) and then produce symptoms elsewhere such as throbbing in the back of the head, forehead or temples. There are many theories as to what exactly within the central nervous system is causing these chronic and often debilitating headaches. Some of these theories include pathologic blood vessel dilatation and constriction (loosening and tightening), abnormal firing of neurons within the brain, and abnormalities of various biologic substances (e.g. serotonin, calcitonin gene-related peptide). The fact that no one theory has been proven correct is likely one of the many reasons that there are so many different methods for the treatment of chronic headaches like migraines. In fact, from a medication standpoint alone, there are dozens of medications and medication classes used to treat migraines.

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Pain in the Neck - Understanding Occipital Nerve Compression Treatment

As the surgical treatment of migraine headache evolves, plastic surgeons are learning that this modality actually represents a series of procedures designed to relieve pressure on specific peripheral nerves throughout the head and neck.

Occipital neuralgia or cervicalgia relates to occipital-generated headaches that stem from the greater (C2) and least (C3) occipital nerves. The occipital trigger sites are the most common trigger points of headache pain.

All patients presenting with chronic daily headaches should be evaluated by a neurologist or primary care physician who is familiar with International Headache Society guidelines for these disorders. Once this evaluation is complete, a thorough history focused on identifying peripheral nerve compression should be performed. The history should quantify the subjective complaints of pain by using the Migraine Disability Assessment Tool (MIDAS) or other reliable instruments such as the migraine headache index (MHI). Once the severity of disability has been stratified, it is important to ask where the pain consistently starts and radiates, whether there is a history of trauma such as whiplash, and if there are any previous cervical surgery/pathology and/or any other issues specific to the occipital region.

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The Difference Between Cervicogenic Headaches and ON - Is There One?

I recently read a comment from a patient asking a very interesting question - “What is the difference between occipital neuralgia (ON) and cervicogenic headaches (CH)?”

Unfortunately the answer to this question is not a straightforward one. It has been postulated that pain in the head/neck region can be referred from problems in the bony or soft tissues of the neck, but there is still some controversy as to whether cervicogenic headache constitutes a distinct clinical entity. The upper-most cervical nerves and their branches are the most commonly cited sources of CH with the most common source being the C2/C3 levels. The actual definition of cervicogenic headaches is also not firmly established. One accepted way of defining this disorder is by its clinical characteristics. Specifically, it is a unilateral pain of variable severity that is not stabbing and radiates from posterior to anterior. It doesn’t shift from side to side, is brought on by unusual head position or neck motion and may be associated with shoulder or upper extremity pain on the same side. The biggest issue with this definition is that it overlaps with many of the characteristics of other headache disorders such as tension headaches and migraines without aura. Another way of defining CH is by demonstrating a cervical source of pain and confirming that source with a nerve block.

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Is it true that because I’ve had RFA to my occipital nerves, that I’m not a candidate for surgery?

This statement represents a common misconception. First of all, let’s define ‘RFA’ or radiofrequency ablation. Simply put, this treatment modality uses radio waves at a high frequency to ablate a structure, in this case a nerve. The term ‘ablation’ actually means to surgically remove a body part or organ, but since RFA is performed with probes through the skin (i.e. percutaneously) it essentially means to destroy the nerve. The probe tip is hopefully placed close enough to the nerve in one or more places such that when the radio waves are passed through it, the tip heats up and completely destroys the nerve which theoretically should be equivalent to surgically excising the nerve.

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Can Botox Cure My Chronic Headaches?

Can Botox Cure My Chronic Headaches?

Many potential chronic headache patients have asked if they are not surgical candidates because they have not responded to Botox® in the past. The answer is, “Not necessarily.” and the reason is because it depends on how and in what doses the Botox was used. The primary way in which Botox® is used by most neurologists and pain management physicians is based upon the PREEMPT protocol (see attached). It calls for using 155 units over 31 injection sites every three months in an effort to reduce the symptoms associated with chronic migraine headaches. There are several problems with this approach. 

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What To Look For When Choosing A Migraine Surgeon

What To Look For When Choosing A Migraine Surgeon

Dr. Ziv Peled explains how to choose a peripheral nerve surgeon, what qualifications to look for and how to decide who is the best fit for you!

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How To Fix a Gummy Smile

How To Fix a Gummy Smile

How can Botox help you with a smile that shows too much of your gums?  Is it an easy process, or does it require surgery? 

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Migraine Solutions Discussed in USA Today

Dr. Ziv Peled, Peripheral Nerve and Plastic Surgeon, was recently asked to sit down and answer some questions about migraines and migraine relief.  Here is a transcript of the interview.

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Dr. Peled Named To Young Plastic Surgeons Steering Committee

Dr. Peled Named To Young Plastic Surgeons Steering Committee

Another exciting honor for Dr. Ziv Peled!

Dr. Ziv Peled was recently asked to serve on the Young Plastic Surgeons (YPS) Steering Committee of the American Society of Plastic Surgeons (ASPS). This Committee is comprised of several up and coming thought leaders in the field of Plastic Surgery and is in charge bringing information on the ASPS/PSF (Plastic Surgery Foundation) to residents and young plastic surgeons and to encourage their professional development through membership in the ASPS. Members also act as liaisons between plastic surgeons in the early stages of their careers and established ASPS Member Surgeons.
The YPS Steering Committee works proactively to convey information about ASPS/PSEF to residents and young plastic surgeons and encourage their professional development through membership in ASPS. Participation on this subcommittee is an opportunity for young members to become actively involved in the Society and Educational Foundation; the committee also promotes a YPS auditor program that invites young plastic surgeons to audit committees of interest.
The YPS Steering Committee also develops the programming for the Annual Meeting's Residents Day and provides input to the Practice Management Education Committee on programming for the annual Senior Residents Conference. In addition, the committee has responsibility for the Breakfast of Champions event and the Fresh Faces panel presentation during the annual meeting.

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Testimonials

  • Thank you very much! Carson is happier than he has been in over a year! We are so thankful that you do what you do.

    D and P

  • Cary Anne and Dr. Peled, I want to thank you both for all your help in making my life so much better! In SO many ways. Again thank you for making my life something I treasure and look forward to daily.

    Victoria

  • Dr. Peled is the real deal. His technical skills should be seen as elite. My headaches and neck pain are gone as a result of the surgery.

    PJHCali Mar 1st, 2013

  • I visited Dr. Peled and he fixed my terrible migraine problem! This surgery was excellent, and he is so knowledgable, he put me completely at ease!

    TF

  • Dr. Peled gave me my life back! Before my nerve surgery I was having headache/migraines amost every day for almost 15 years. After my surgery I am now only having headaches twice a month.

    R.J.

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