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Brunno Ristow, M.D., F.A.C.S
2100 Webster Street, Suite 501
San Francisco, CA 94115
Tel: (415) 202-1507
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Facial, Breast, Abdominal and Nose Plastic Surgery, by Dr. Brunno Ristow, M.D., F.A.C.S.
All the following procedures are performed at our private surgicenter at the The Pacific Clinic, in San Francisco, CA
Facial Surgery: Aesthetic, Cosmetic, Restorative
Face Lifts
Today, facelifts are truly beautiful procedures, which produce lovely results.
Incisions are concealed in areas very difficult to detect; add to this Doctor Ristow's supreme care in suturing and they become practically invisible.
A Face and Neck Lift, which is a frequent combination, does the following:
- Elevation of the malar fat pad over the cheekbone. (Placed where it was in your youth.)
- Diminishes greatly the neck bands caused by muscles
- Contours the jaw/neck line as defined as when many patients where in their twenties.
- Supports the corner of the mouth.
- Smoothes the deep nasolabial folds
- Generates results that are natural, youthful and extremely pleasing to patients.
No other methods in facial rejuvenation can achieve such lovely, natural and lasting results.
It is very gratifying to see the great happiness that a patient feels following a well-done facial rejuvenation.
Many cannot stop smiling and it appears that a marked optimism has taken hold of their demeanor.
We recommend an overnight stay in our private clinic following a face lift.
Face lift plastic surgery or cosmetic surgery before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Mini Lifts
These procedures do not show any incisions.
The sutures are hidden inside the temporal hairline.
Best to elevate corners of the eyelids and rejuvenate the upper part of the face.
There may be minute sutures in the upper part of the ear.
Recuperation is fast.
The patients go home and possibly, with a little make-up, can attend social functions in 48 hours.
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Mid Face Lifts (Malar Lifts)
These are, by almost any measure, as good as a mid face rejuvenation can get.
It includes lifting the deeper layers of the face (SMAS) and has profound effects on the resulting youthfulness of the mid face.
The procedure affects in various degrees, the upper neck as well (the area under the chin).
Sutures are removed between the fourth and sixth day. Patients my choose to go home or stay overnight in our private clinic.
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Injectables
An astounding progress has been made in injectables for rejuvenation.
Most current ones such as Restylane, Juvederm, Cosmoderm and Cosmoplant are not of animal origin and do not require prior testing.
Please realize the enormous and totally different way injectables rejuvenate the face; while surgical procedures in general "lift" sagging tissues, injectables "fill", add volume to faces in areas depleted of volume.
So, they fill lines, plump depressed or deficient areas.
Injectables are the single most used esthetic procedure in the United States.
We offer these modern volumizers and wrinkle diminishers to all our patients.
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Eyelids
Eyelid surgery is extremely popular in our practice. The recuperation is fast and the results are gratifying. Scars, after a few days, can be successfully camouflaged with make-up, and soon, they just blend in with the surrounding tissue. Facelifts commonly include eyelidplasties. The operation to correct eyelids is actually two procedures. It frequently involves upper eyelids and lower eyelids. Eyelid operations make the person look younger, fresher and more alert.
Eyelid plastic surgery before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Corner Lip Lifts
In many patients the corners of the lips turn downward, conveying an impression of sadness, constant bad humor or anger. This can be improved with an operation known as "corner lifts." Corner lip lifts can be done at the same time as a facelift. Corner Lip Lifts can be done alone and the recuperation is immediate. You are allowed to drive home, go to work, have lunch, etc.
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Lip Augmentations
Women recognize that the plump lips of a youthful face thin out mercilessly with aging. Millions of dollars are spent annually to correct this problem, by using collagen, fat injections or various temporary fillers.
Facelifts, which do not correct thinned out lips, do not explore the full potential available. We have a good procedure to restore fullness to aged and thinning lips. We have eighteen years experience with increasing volume of the lips with the person's own living collagen, which gives permanent lip augmentation results. We are extremely pleased with this breakthrough. If lip augmentation is done as the sole procedure, you may go home after the operation.
Lip augmentation before and after images:
   
For results that combine multiple procedures, please visit our Photo Gallery.
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Eyebrow or Forehead Lift
Forehead aging causes a low, unnatural position of the eyebrows. This drooping of the eyebrows may be addressed prior to the facelift. Technically, in this sequence, the forehead takes some of the facial "slack" and therefore the facial incisions are shorter.
I have developed a technique that gives very satisfactory results. Not only are the eyebrows correctly repositioned, but "worry lines" across the forehead, "scowling lines", and also that unusual thickness of the upper part of the nose caused by loose skin are markedly improved. This technique delivers long-lasting results and is a substantial improvement over previous surgeries where these lines frequently recurred. The results of this operation give the person a rested, non-judgmental and serene look. If patients wish, they may go home after this procedure. You may shower the following morning.
Eyebrow or forehead lift before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Dermabrasion
Wrinkles around the mouth (jowls and nasolabial folds) are improved by a facelift. The upper and lower lip wrinkles, however, do not improve significantly because they cannot be undermined from the facial skin. Such a maneuver is not surgically possible; it would damage the muscles of expression of the mouth.
For these lip lines, our procedure of choice is DERMABRASION. This has many advantages over chemical peels and lasers. The recuperation is faster and more comfortable. Skin color changes which is the standard for chemical peels or lasers, are very rare following dermabrasions. We recommend this procedure to some patients who are having facelifts, because a smooth face and neck is not harmonious with a wrinkled mouth. If dermabrasion is done alone, you may go home shortly after the procedure.
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Fat Transfers to the Face
In patients where a loss of volume is present, fat transfers to the face may offer a more youthful look.
Since fat responds to its genetic code of the location in the body, (for example, hips will behave as hips in weight gain) I prefer to use, in the face, fat that originates from the face, neck or SMAS.
Many need just repositioning of the fat volume; some can use a measured increase in volume provided by a fat transfer.
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Protruding Ears
The correction of protruding ears can be a simple or a complex procedure. When the entire anatomy of the ear is correct (the delicate little valleys and folds are present) but the angle in which the ear protrudes from the head is too "open", the angle may simply be reduced from the back (or front) of the ear by attaching the ear closer to the head.
If the protrusion is caused by improper development of the anatomy, the ³folds² must be created and the operation is more complex. Seventy-five percent of protruding ears fall into this latter category. In this case, the correction is done from behind the ear. North European immigration to the Northeast Coast of the United States made this procedure common in that geographical location where I did my training. In Northern California, the operation is more rare. However, I have never lost my great interest in performing these procedures.
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Rhinoplasty Surgery or Cosmetic Nose Surgery
Rhinoplasty
Attentive studies to facial harmony show that good-looking noses are not the same but that their measurement stays within known parameters. Certainly, I have studied extensively and with great dedication the proportions of a beautiful nose. Normally one listens to the desires of the patients and if they can be achieved, and the result will be in harmony with the face, I proceed. Sometimes, patients desire an aesthetic evaluation of their nose by the surgeon, and jointly, they reach a consensus of the desired goal. All will be amply discussed with you during the consultation. I have taught numerous courses in Rhinoplasty. You may go home after the procedure.
Rhinoplasty surgery or cosmetic nose surgery before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Corrective Rhinoplasty
Great strides have been made in correcting badly deformed noses, either by accidents or, most commonly, by inexpert surgery. We now use cartilage grafts routinely for this purpose. These grafts are obtained from the patient's nasal septum or from the back of the ear. These grafts survive and solve many problems, which were impossible to overcome in the past. No overnight stay is needed for this procedure.
Corrective rhinoplasty surgery before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Body Enhancements: Breast Lift Augmentation and Abdominoplasty Surgery
Breast Lifts and Breast Lifts with Reduction
Few operations are met with such overwhelming satisfaction by the patients.
Having a large or pendulous breast that is lifted to its ideal position creates immense happiness.
Briefly, small lifts can be done with very small scars, either just below the aureola (tissue around the nipple), around the aureola or around the aureola and down to the fold. The larger the breast to be lifted or reduced, the longer the suturing necessary on the fold level. The techniques that I prefer preserve most, if not all, nipple sensation. Patients have the option to stay with us overnight or to go home.
Breast lifts with reduction before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Abdominoplasty
For someone with a flabby abdomen, perhaps covered with stretch marks from pregnancy, this procedure is truly gratifying and is among the most desired operation by women, second only to facial rejuvenation. The operation diminishes or flattens the bulges that will not go away with exercise.
During your consultation, I will carefully examine you and clearly show you where incisions can be placed (you have choices). Mini abdominoplasties have low incisions and frequently preserve the original umbilical scar (belly button). Mini abdominoplasties may go home but standard procedures require an overnight stay.
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