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Plastic and Reconstructive Surgeon, San Francisco, CA Dr. Brunno Ristow, American Society for Aesthetic Plastic Surgery
Modern Plastic Surgery
Dr. Ristow Biographical Profile
Before & After Photos of Reconstructive and Plastic Surgery

Contact Dr. Ristow by phone 415.202.1507, San Francisco, CA
Dr. Brunno Ristow, renown Plastic Surgeon
Aesthetic Plastic Surgeon Dr. Brunno Ristow, San Francisco, California Diplomate of the American Board of Plastic Surgery
Brunno Ristow at age 17 with his
mother Ally Odette von
Buettner Ristow.

Heritage and Youth

Dr. Brunno Ristow was born Brunno von Buettner Ristow in Brusque, a small town in Santa Catarina, Brazil to a German-Brazilian family. His mother’s family immigrated to Brazil in 1858 from Cracow, then located in Galicia, a northern province of the Austro-Hungarian Empire. His father’s grandfather emigrated from Pomerania, a province of the Kingdom of Prussia bordering the Baltic Sea, in 1872, as part of a wave of German immigrants invited to colonize and develop the southern states of the Empire of Brazil. By 1900 Brazil had a German population of approximately 300,000.1

Dr. Ristow’s maternal great-grandfather, Edward von Buettner, founded one of the oldest textile manufacturing concerns in Brazil in 1889, and his paternal great-grandfather worked for the Imperial postal service. Both Dr. Ristow’s mother, Ally Odette von Buettner, and his father, Dr. Arno Ristow, were educators. Dr. Arno Ristow (M.A., Peabody College, Nashville TN, 1956) founded the College Consul Carlos Renaux in Brusque and has published two noted books on education in Brazil.

Dr. Ristow’s home was musical and richly intellectual. His first piano lessons started at age five. As a boy he started to draw and collect birds, abundant in the tropical forests around his birthplace. His first experiences in the medical field came at age 14, courtesy of the only surgeon in his town, Dr. Carlos Moritz, who taught the young Dr. Ristow to hold his retractors.

Medical Education

After graduating from the Colegio Julio de Castilhos, Padrao do Estado, RS, Dr. Ristow served in the Brazilian Army Medical Corps (1959-1960). Subsequently he was admitted to the National School of Medicine of the University of Brazil, today the Federal University of Rio de Janeiro. In 1966 he graduated summa cum laude and received the prestigious School of Medicine Award. That same year he married pharmacist Rosiris Arruda Sombra, the daughter of Jose Pinto Sombra, General of the Brazilian Army, and granddaughter of a prominent congressman from the state of Santa Catarina. His initial training in Brazil was with renowned plastic surgery innovator Ivo Pitanguy.

Setback and Recovery

Dr. Ristow in 1969
Dr. Ristow in 1969

In early 1967 Rosiris Sombra Ristow was diagnosed with Leukemia. At the time, the best treatment was available at Sloan Kettering/Ewing Hospital in New York City. The Ristows came to Manhattan where Mrs. Ristow was treated. Dr. Ristow, determined to stay by his wife’s side, was awarded a scholarship from the Governor of Santa Catarina, Dr. Ivo Silveira, and worked part-time at the Brazilian Mission to the United Nations while he prepared to revalidate his MD license in the United States. After his license was revalidated in February 1968, Dr. Ristow applied and was accepted at The New York Hospital - Cornell Medical Center's General Surgery Program for his residency.

In July 1968, Mrs. Ristow suffered a recurrence and died. After a trip to Brazil for the burial, Dr. Ristow returned to his residency at Cornell (1968-1971) and, later, did his plastic surgery residency at The Institute of Reconstructive Plastic Surgery, New York University (1971-1973). During this time Dr. Ristow was mentored — and helped through his personal tragedy — by some of the best surgeons of the time, including Drs. Cranston Hollman and Samuel Moore (both at NYH-CMC) and Drs. John M. Converse and Thomas D. Rees (both at NYU). Dr. Rees, arguably the best aesthetic surgeon in the US during this period, became a life-long friend.

In 1975 Dr. Ristow was certified by the American Board of Plastic Surgery.


Dr. Ristow in his first offices, 1977
Dr. Ristow in his first offices, 1977

In July 1973 Dr. Ristow moved to San Francisco, CA, where he opened his private practice at the Presbyterian Pacific Medical Center (now known as The California Pacific Medical Center, or CPMC). In 1974 he was elected Chief of Plastic Surgery by the committee of Presbyterian Pacific Medical Center, a position he held until 1992. Over a period of 40 years he achieved some of the world’s finest results in facial rejuvenation and pioneered new techniques, many of which have become standard practice in the field today.

His emphasis was on producing natural and elegant results, yet with a remarkable component of rejuvenation. Detectability of his surgical interventions is exceedingly difficult. Dr. Ristow's approach to facial rejuvenation was based on the repositioning of ptotic tissues and restorations of volumes to their original youthful anatomical contours. Replenishing lost volume at the base of the nose and embracing judicious (small amounts) of live fat transfers to the face became standard procedures.

-  Restoring Lost Volume to the Face

By the 1970s, experts recognized that facelift results did not appear natural. The available techniques did not lift the drooping corners of the mouth and the re-draping of the slacked skin imparted a flattened mid-face (a wind tunnel look). At first, internal suspensions improved the corners of the mouth and supported the malar fat pad.2 Nevertheless, volume was needed for a natural result. Dr. Ristow, in the mid 1980s, initiated the replacement of volume, utilizing transfers of readily available SMAS and dense fibrous fat from the face to three distinct places:

1. At the base of the alae, an anatomically specific region later named Ristow's Space.3
2. To the bulk of the malar fat pad.4
3. To the lips (begun in 1990 by transferring SMAS strips to upper and lower lips).

The vast majority of these grafts appear to survive intact indefinitely.

For a selection of Dr. Ristow’s results, please see the Photo Gallery page.

To read letters from Dr. Ristow’s patients, please see the Testimonials page.

For a more detailed explanation of Ristow’s Space please click here.

Dr. Ristow in 2011
Dr. Ristow in 2011


In 1981, Dr. Ristow bought a small valley of volcanic, sandy ground on the eastern slopes of the Napa Valley, just south of the Stags Leap Appellation. The property's huge rocks were crushed, the new vineyard drained, and Cabernet Sauvignon grapes planted. The third vintage of Ristow Estate wine, released in 1997, won a score of 94 by Jim Laube, senior editor of "Wine Spectator." 5

Personal Life

Ristow at Bryce Canyon 2013
Dr. Ristow at Bryce Canyon 2013

Dr. Ristow has raised four children with his wife Urannia Ristow. The Child Fund (formerly The Christian Children's Fund) is also an abiding passion for him. For over 41 years he has sponsored 25-35 children per year in his native Brazil, providing food, medical care and education for those less fortunate. He speaks five languages and plays the piano.

Textbooks & Selected Publications

For a complete list of Dr. Ristow’s Presentations to Professional Societies, Films and Teaching Courses, please click here.

  • Brunno Ristow, M.D., Rejuvenation of the Aging Neck: 40 Years Experience. Clinics in Plastic Surgery Journal, Vol. 41 Issue 1, 2014.
  • Brunno Ristow, M.D., Rejuvenation of the Mid-Face (Chapter). International Textbook of Aesthetic Surgery. Verduci Editore, 2012.
  • Arno von Ristow, M.D., Marcos Areas Marques, M.D., Brunno Ristow, M.D., Doenca Tromboembolica: Fundamentos Principios Gerais (Chapter). Textbook of Aesthetic Surgery. 2012.
  • Brunno Ristow, M.D., Preoperative Use of Alpha Tocopherol Does Not Increase the Risk of Hematoma in the Face Lift Patient: A Preliminary Report. Plastic and Reconstructive Surgery: The Journal of the American Society of Plastic Surgeons, November 2009.
  • Rod Rohrich, M.D., Joel Pessa, M.D., Brunno Ristow, M.D., The Youthful Cheek and the Deep Medial Fat Compartment. Plastic and Reconstructive Surgery: The Journal of the American Society of Plastic Surgeons, June 2008.
  • Brunno Ristow, M.D., A Personal Technique For Facial Rejuvenation. Aesthetic Surgery Journal, July/August 1989.
  • Brunno Ristow, M.D., Milestones in the Evolution of Facelift Techniques (Chapter). Re-Operative Aesthetic Surgery of the Face and Breast. Quality Medical Publishing, Inc., 1995.
  • Brunno Ristow, M.D., Forehead Lifts (Chapter). Mastery of Surgery: Plastic and Reconstructive Surgery. Boston and Toronto: Little, Brown and Co., 1993.
  • Brunno Ristow, M.D., Transconjunctival Blepharoplasty (Chapter). Mastery of Surgery: Plastic and Reconstructive Surgery. Boston and Toronto: Little, Brown and Co., 1993.
  • Brunno Ristow, M.D., The Sequence in Rhinoplasty (Chapter). Aesthetic Plastic Surgery. Boston and Toronto: Little, Brown and Co., 1993.
  • Brunno Ristow, M.D., Aesthetic Plastic Surgery of the Upper Face (Chapter). Surgical Technology International. London: Century Press, 1992.
  • Brunno Ristow, M.D., Eyebrow and Forehead Lifts (Chapter). How They Do It: Procedures in Plastic and Reconstructive Surgery. Boston and Toronto: Little, Brown and Co., 1990.
  • Brunno Ristow, M.D., Eyebrow and Forehead Lifts (Chapter). Male Aesthetic Surgery. St. Louis, Toronto, London: C.V. Mosby Co., 1989.
  • Brunno Ristow, M.D., Forehead Lifts (Chapter). Current Therapy in Plastic and Reconstructive Surgery. Toronto and Philadelphia: B.C. Decker, Inc., 1988.
  • Robert Beasley, M.D., Brunno Ristow, M.D., Cancer of the Hand (Chapter). Cancer of the Skin. Saunders, 1976.
  • John M. Converse, M.D., Byron Smith, M.D., Brunno Ristow, M.D., Severe Scarring Secondary to Chickenpox a case report. British Journal of Plastic Surgery. 1973.
  • Holon Farr, M.D., M.D., Brunno Ristow, M.D., William O'Grady, Resection of Large Skin Carcinoma of Neck; Coverage With A Deltopectoral Flap. Plastic and Reconstructive Surgery: The Journal of the American Society of Plastic Surgeons. May 1972.

Positions held

Honors & Awards

    Physicians Recognition Award in Continuing Medical Education
    American Medical Association
    Awarded annually 1971 — retirement

    Named Leading Physician in America in "Best Doctors in America"
    Steven Naifeh and Gregory W. Smith
    1992 — retirement

    "The Best Doctors in America"
    Castle Connolly Medical, LTD.
    2001 — retirement

    Visiting Professor of Surgery
    Federal School of Medicine, Porto Alegre, Rio Grande do Sul, Brazil

    Visiting Professor (Plastic and Reconstructive Surgery)
    The University of British Columbia, Canada

    Marquis Who's Who in America
    Biographical outline

    Simon Fredricks Award
    Best Panelist at the ASAPS/ASERF annual meeting
    American Society of Aesthetic Plastic Surgeons

    Marquis Who's Who in the World
    Biographical outline

    The Order of St. John of Jerusalem, Knights of Malta, U.N. NY
    April 1981

    The Venerable Order of St. Hubertus
    November 1979
    Bestowed at Grace Cathedral, San Francisco, CA

    Special Diploma
    University of Brazil, National School of Medicine (upon graduation)

1 Edmund Morris, Theodore Rex (New York: Random House, 2001, 179.)
2 Skoog Tord, M.D. Plastic Surgery, Page 134. W.B. Saunders. Philadelphia, London, Toronto, 1974.
3 Rod Rohrich, M.D., Joel E. Pessa, M.D., Brunno Ristow, M.D. (June 2008). "The Youthful Cheek and the Deep Medial Fat Compartment". Plastic and Reconstructive Surgery: The Journal of the American Society of Plastic Surgeons 121 (6).
4 Brunno Ristow, M.D. Trattato Internazionale di Chirurgia Estetica. Vol 2, page 909-926. Scuderi, N., M.D., Toth, B.,M.D. Editors. Verduci Editori-Roma, 2012.
5 James Laube (January 2008). "Retrospective: 1997 California Cabernets". Wine Spectator.