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Facial, Breast 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
Facelifts
Today, facelifts are beautiful procedures which can produce astounding results. At The Pacific Clinic, the facelift is our specialty, and we operate at a
standard of excellence and safety that is second to none. Incisions are concealed in areas very difficult to detect. Coupled with Doctor Ristow's supreme
care in suturing, they become practically invisible.
A face- and neck-lift, which are frequently combined, do the following:
- Elevate the malar fat pad over the cheekbone to where it was in your youth
- Greatly diminish neck bands, or "fat rolls"
- Contour the jaw/neck line, for many patients, as they appeared in their twenties
- Support the corner of the mouth to counter sagging
- Smooth the deep nasolabial folds (the creases extending from the nostrils to the corners of the lips)
- Generate results that are youthful, extremely attractive and, above all else, natural
Doctor Ristow is a specialist in creating natural results. A facelift may remove ten or more years of aging, but the patient's natural beauty and
characteristic appearance is maintained. In cases where a patient wants to change one or more specific feature of her face, Dr.
Ristow will work in close consultation with the patient to create new beauty while simultaneously avoiding flashy, unnatural results.
No other method of facial rejuvenation can achieve such lovely, natural and lasting results as the facelift. Dr. Ristow has said, "it is very gratifying
to see the great happiness that a patient feels after a facial rejuvenation at The Pacific Clinic. Many cannot stop smiling, and it appears that a marked
optimism has overtaken them." Please visit our testimonials page to read notes written to Dr. Ristow from some of his patients.
We recommend an overnight stay in our private clinic following a facelift.
Facelift plastic surgery or cosmetic surgery before and after images:
 
For results that combine multiple procedures, please visit our Photo Gallery.
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Minimally Invasive Facelift (MIFL)
The Minimally Invasive Facelift, or MIFL, is a term used to connote either of two related procedures, the minilift or the mid-facelift, which are not as
dramatic as a full facelift but which can achieve striking and beautiful results.
Mini Lifts
These procedures have almost an immediate result. Sutures are very well concealed just within the hairline. Likely you can attend social functions in
48 hours. Also, known as the ÒParis liftÓ in our office in honor of its creator.
Temporal Lifts
This procedure does not show any incisions. The sutures are hidden inside the temporal hairline. This procedure is highly effective in elevating the corners
of the eyelids and rejuvenating 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 immediately and, with a little make-up, can attend social functions after approximately 48 hours.
Mid-Face Lifts (Malar Lifts)
As practiced by Dr. Ristow, a Malar Lift is, by any measure, as good as a mid-face rejuvenation can get short of a full facelift. Dr. Ristow is a pioneer of
this particular procedure. He has delivered numerous lectures and taught many courses on the mid-face lift for the, and for international medical schools.
This procedure includes lifting the deeper layers of the face (SMAS), and has profound effects on the resulting youthfulness of the middle face.
The procedure affects, to varying degrees, the upper-neck as well (the area under the chin). Deficiencies in facial fat volume are frequently corrected with
this procedure by SMAS/FAT transfers as well.
Patients may choose to go home the same evening, or stay overnight in our private clinic. Sutures are removed between the fourth and sixth day.
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Eyelids
Eyelid surgery is extremely popular at The Pacific Clinic, and Dr. Ristow's artistry is unparalleled with this procedure. In fact, the operation to correct
eyelids frequently involves two procedures: upper eyelids and lower eyelids. Eyelid operations make the patient look younger, fresher and more alert. The
recuperation is fast and the results are gratifying. After a few short days, scars can be successfully camouflaged with make-up, and soon they simply blend
in with the surrounding tissue. Eyelidplasties are very commonly combined with facelifts.
The patient may return to activities in six days but nothing prevents them from working at home or conducting walks, shopping, etc. (with dark glasses).
Eyelid plastic surgery before and after images:
 
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Corner Lip Lifts
In some 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 may be done at the same time as a facelift, or they may be done alone.
When performed alone, the recuperation from a corner lift is pretty much immediate. You may 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 lips, do not explore the full potential available. At The Pacific Clinic we have a revolutionary procedure to restore
fullness to aged and thinning lips. We have eighteen years of 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 outstanding 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, alert, friendly, non-judgmental and youthful look.
If patients wish, they may go home after this procedure, or they may choose to stay overnight in our private recovery room.
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.
Changes to skin color, which are standard for chemical peels or lasers, are very rare following dermabrasions. We recommend this procedure to some patients who are having
facelifts, because a wrinkled mouth is not harmonious with a smooth, youthful face and neck.
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 offer a more youthful look. Many patients need repositioning of the fat volume for the best result;
some can benefit from the measured increase in volume provided by a fat transfer. Since fat obeys the genetic code of its original location in the body (for example, fat from
the hips will behave as hips do when it comes to weight gain), Dr. Ristow uses, whenever possible, in the face, fat that originates from the face, neck or SMAS. This ensures
a natural and lasting result.
Dr. Ristow has created a procedure involving relocating redundant fat tissue from the neck to the nasolabial folds (the creases extending from nostrils to lips). This revolutionary
procedure greatly effaces and diminishes the nasolabial folds to restore a youthful, vigorous appearance. Dr. Ristow has lectured on this procedure extensively, and taught it to classes
of the ASAPS (American Society of Aesthetic Plastic Surgery). In July 2007, the editors of
the most important journal in the field of aesthetic surgery, Plastic Surgery, dubbed this specific area of the face the "Ristow Space" in honor of Dr. Ristow's breakthrough
procedure. His procedure has been studied extensively and is now a standard offering at aesthetic plastic surgery clinics worldwide. His initial findings were independently confirmed
by a prestigious group of surgeons in Kiel, Germany and the results published in the
January 2012 issue of Plastic Surgery .
Recuperation from fat transfers is immediate if the procedure is done alone.
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Injectables
Astounding progress has been made in injectables for rejuvenation. Most current products, such as Juvederm, are safe, long-lasting, and not of animal origin. Injectables rejuvenate the
face in a totally different way from surgical procedures: while surgery in general "lifts" and repositions sagging tissues, injectables "fill", or add volume to faces with a moderate
Òlift.Ó We offer these modern volumizers and wrinkle diminishers to all our patients.
Please read Dr. Ristow's letter to his patients on Injectables
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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 "folds" 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. "Northern European immigration to the Northeastern Coast of the United States made this procedure common
in that geographical location, where I did my training," Dr. Ristow has said of ear surgery. "In Northern California, the operation is more rare. However, I have never lost my great
interest in performing these procedures."
Recuperation from corrective ear surgery is 2-3 hours if the procedure is done alone.
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Rhinoplasty Surgery or Cosmetic Nose Surgery
Rhinoplasty
Rhinoplasties, or "nose jobs" as they are commonly known, have been a specialty of Dr. Ristow's for over 35 years. He has taught numerous courses in Rhinoplasty, has delivered
lectures and written scientific papers on this subject for decades. "My studies of facial harmony have shown that beautiful noses are not all the same, but that their proportions
stay within known parameters," explained Dr. Ristow. "Certainly, I have studied extensively and with great dedication the proportions of a beautiful nose."
The nose is one of the most important and characteristic elements of the face. Therefore Dr. Ristow works in close consultation with each and every patient to determine the best
course of action to achieve the desired results. "If the patient's goals can be accomplished, and the result will be in harmony with the face, I proceed," he has explained. All your
options will be amply discussed with you during the consultation.
You go home the same day as 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 or Secondary Rhinoplasty
Great strides have been made in correcting badly deformed noses, either by accidents or, most commonly, by inexpert surgery. At The Pacific Clinic, Dr. Ristow now uses
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 have astounding
longevity 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
Breast Lifts and Breast Lifts with Reduction
Few operations are met with such overwhelming satisfaction by the patients. Having large or pendulous breasts that are lifted to their ideal position creates immense
happiness.
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 utilized by Dr. Ristow preserve most, if not
all, nipple sensation.
Patients have the option to stay with us overnight or to go home after this procedure.
Breast lifts with reduction before and after images:
For results that combine multiple procedures, please visit our Photo Gallery.
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