Benjamin A. Van Raalte, MD
Benjamin A. Van Raalte, MD, is an ASPS Member plastic surgeon who is board certified by The American Board of Plastic Surgery® and trained specifically in plastic surgery. ASPS members operate only in accredited medical facilities, adhere to a strict code of ethics and fulfill continuing medical education requirements in plastic surgery, including training in patient safety techniques. As your medical partner, Dr. Van Raalte is dedicated to working with you to achieve your goals.
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Meet Dr. Benjamin Van Raalte
Our Values as a cosmetic surgery based business that offers medical grade treatments are as follows: Quality, Ethics, and Compassion.
Our Vision is to be recognized and respected as one of the finest cosmetic surgical facilities and medical spas in the Midwest.
Our Mission is to help people look and feel better about themselves.
To schedule a consultation at Iowa Plastic Surgery with Dr. VanRaalte please call 563- 322-8877.
Our Private Accredited Operating Room
Our office operating room is spacious and designed with safety to meet nationally recognized standards. It is fully equipped, luxurious, and private. Our nurses specialize in plastic surgery. We are approved by the Joint Commission on Accreditation of Health Care Organizations which sets the standards for quality in health care.
For your postoperative recovery we are staffed to provide extraordinary patient care in our onsite recovery area while you are with us after the completion of your procedure. There you will be able to rest and relax until you are ready to go home the same day. Hotel arrangements can also be made for stays in the area.
Dr. Van Raalte also maintains privileges at all area hospitals and can perform surgery at those institutions and at Mississippi Valley Surgery Center.
Breast Implant Removal
Buttock Lift with Augmentation
Chemical Peels, IPL, Fractional CO2 Laser Treatments
Cosmetic Surgery & Computer Imaging
Laser Hair Removal
Male Breast Reduction
Post Burn Reconstruction
Skin Cancer Removal
Spider Vein Treatment
TRAM Flap Breast Reconstruction
Ask a Surgeon
Dr. Benjamin Van Raalte participates in the ASPS Ask A Surgeon service. View responses to public questions below.
Could lip surgery bring my lips closer to the edited photo?Lip Augmentation/Enhancement
The risks outweigh the benefits for your age group. Filler is all that I would recommend. Lip corner operations are generally done either after trauma or skin cancer as there are already scars. For cosmetic purposes I rarely recommend them before age 60 as the scars are too noticeable. There is no way to avoid a scar and it easily could make things worse. Filler has no scars, and is reversible.
Left too bigBreast Reduction
It is soon and things will change. Second, there is no standard bra size. If you are going to Victoria's secret, they're double d is the same as Walmart's C anyway. I also agree that it's sometimes hard to get the exact size based on your body width and the need to preserve blood supply to the tissue. If you need to go down one cup size liposuction can sometimes accomplish that.
T junction breakdown not healingBreast Lift
First of all, this is very common. Probably stop swapping it with an antiseptic and betadyne. Although those kill bacteria, they also kill cells that aid in healing. A. Saline gauze packing might be the best for now or antibiotic ointment. Quite often. It doesn't do much for a couple weeks and then abruptly closes. Things to watch for are increased redness or increasing drainage and then let your surgeon know.
I regret my breast augmentation the next dayBreast Augmentation
Adjustment reactions do happen. Most likely. What is going on is an adjustment reaction. In other words, your brain is giving you mixed signals. Before you wanted it and now that you have it , it wants them out. It could be due to the perioperative pain or the change in your appearance. Over the 35 years I've been in practice. I've had several patients who the first week insisted they wanted them out. All of them I said it would be inappropriate to take them out right away. If you still want them out at 3 months I will do so. All of them at 3 months were very happy. In fact, several wished they had gone larger. Thus, it is too soon to take them out as it would be inappropriate. But be reassured if that is the case later you still can do so. But most likely you are just adjusting in your brain is giving you mixed signals. It could be that it sees it as too large or wrong. It could be the discomfort is telling you to do something.
Symmastia RepairBreast Implant Revision
If the after is the 3rd picture on the right that seems to be a good result
Incision around areolaBreast Lift
It depends on how much droop you have. If the droop is excessive, you will need a lift or you will have a waterfall deformity with the breast tissue hanging over the implant. It would not be a satisfactory appearance naked, although might look okay in a bra. As a rule of thumb, if the distance from the sternal notch to the nipple is greater than 24 cm, it's most likely the lift is needed. Other ways you can correct droop without a breast lift include larger implants, subfacial placement, and in my opinion, a teardrop implant. The teardrop implants are textured and do have an increased risk of anaplastic large cell lymphoma that you have to consider.
Consultation feeBreast Augmentation
I'm going to answer this because I'm not in Arizona. Most surgeons have adopted the model of a consultation fee because it is a consultation, not a sales pitch. Most of the fees are less than the cost of running the office ranging from 100 to $200. A few doctors charge more based on their demand. Compared to the cost of the surgery that's a small fee. It's also much smaller than what other health professionals charge for a consultation. Your question is contradictory. You state your health is very important to you but yet you're reluctant to spend a little bit more to ensure you pick the surgeon you like. A few consultations that you spend money for, is still very little compared to the cost of the procedure. If your health is important to you then spending a small amount more should make you feel comfortable about proceeding.
Open woundTummy Tuck
I disagree with the other postings. This may not need hospital care. The surgeon that is in place can determine whether there are other signs that require more aggressive treatment. Signs such as a fever, chills or palpation of the skin flap all will determine whether there's infection that requires more care than outpatient. Unfortunately this type of complication happens and is not due to any thing the surgeon did wrong. It is always unpleasant to both the patient and the surgeon and does have a longer recovery.
After revisionTummy Tuck
Obviously without the medical records and examination this is a best guess. On the other hand, depending on your preoperative weight, and your current weight this is an average result. Surgery cannot repair the quality of skin and if your quality of skin was changed by pregnancy and weight it will still have stretch marks and not be as tight. Likewise the surgery creates a flap of skin that can have some prolonged or permanent lymphedema. Most importantly the abdominal flap above the thinner groin skin cannot be liposuctioned so thin to match it perfectly. If it were liposuctioned that thin initially it would die. I don't think that belly button can be moved lower nor should it be as it looks appropriate. Moving it lower would lead to a bigger scar. I would work on additional steps of weight loss and exercise first to get more improvement and building your body self esteem, than additional surgery. Then later a small amount of liposuction may be able to finesse the final result.
Abdominoplasty and Belt LipectomyTummy Tuck
There are different codes for the procedures. The pannulectomy is what covers the skin that gets irritated. It amputates the overhanging skin. Many insurance companies have very strict criteria just for the pannulectomy requiring medical treatment and overhanging the pubis by a certain amount. The other two procedures are a cosmetic improvement. However, the cost may be less than you think if done as an outpatient as a cash prepay. Some patients find their copay and deductible and out of network costs for anesthesia more for just the pannulectomy, than the cost of a self pay abdominoplasty. I sympathize with your desire, but unfortunately a lot of people would like an abdominoplasty covered by insurance. That is why a number of years ago the CPT code for pannulectomy which can be an insurance covered procedure, was separated from the abdominoplasty which is a cosmetic procedure. The fraud was excessive.
SAFELipo vs SmartLipo re: anesthesiaLiposuction
There are no differences in outcome by liposuction technique. A controlled study of Smart Lipo on one thigh vs standard lioposuction showed no difference in outcomes, and the SmartLipo had a slightly longer recovery and slightly more complications. The differences are primarily in ease for the surgeon, and some surgeons that are not as strong prefer different machines. In addition, the primary benefit seems to be for marketing the surgeon. The prices you quote are very, very high compared to the midwest. Here liposuction under general anesthesia is $5-8 depending on how many areas, but the maximum safely removed as an outpatient is 5 Liters. I doubt you have that much with a BMI of 23. Cost under local in the midwest would start at $3000 . A small area a noninvasive treatment could be an option starting at $800. You must be in a very expensive area consulting with a very expensive surgeon as I have not heard of costs that high except for 8 hour total body etching.
Breast AugmentationBreast Augmentation
Smooth round implants can slide over time. Aging can also widen the chest width. Another surgery could correct your implants. You could consider a textured implant, which has the slight risk of ALCL but less lateral displacement over time. You also may be now able to have a larger implant if desired. The one implant may have bottomed out. The other option is securing the lateral and inferior fold with suture. You should see a board certified plastic surgeon or two for opinions.
Lower Eyelid Surgery to correct dark circle and hollownessEyelid Surgery
You have two options. Surgery would to inside the eyelid, release the tear trough, and blend the fat over the edge. It would make it anywhere from 50 to 75% better because part of the cause is descent of the cheek fat. Fat grafting could add additional improvement. You could also improve it non surgically by adding filler. My preferred safe method is to inject Voluma deep on the bone for volume in the upper cheeks followed by RHA4 secondarily in the subdermal layer to blend it in better. I find that safer and less problems than tear trough injections.
Face liftCosmetic Surgery
Most facelifts do not improve the marionette lines well. In fact, those that do tend to make the person look unnatural. Fillers or fat grafting are the best way to treat the marionette lines well. Yours look deep so it may take more than one syringe, and perhaps a syringe of calcium hydroxyapatate deep for support and a hylaluronic acid filler more superficial. The fillers can also be used to camouflage the jowl although that the right jowl is an area of concern. Most studies have shown the threads have a high incidence of complications and only give improvement for a year.
Fat graftingBreast Reconstruction
Generally fat grafting fails 20% of the time completely. Some patients dont form the capillaries (tiny blood vessels) for the fat cells to survive. Generally only a certain amount of fat will fit in the reconstructed tissue. So it could be limited to half a cup or less. As the layer thickens more can be added. For reconstructive fat grafting, multiple fat grafting operations may be required to fit in a little each time, and have it survive.
Breast Lift & AugmentationBreast Lift
Usually each 200 cc is one additional cup size for an average woman. In most women 375 cc would add two cup sizes. But remember there are no standard bra sizes. Victoria Secret C is really a smaller B in Walmart bras. There are also other options. If you are doing a full lift and have bra roll fat that can be used to auto augment with an extended mastopexy adding one half to one cup size without an implant. Use of dissolvable mesh can create a fuller breast. Augmentation mammaplasties are one of the highest risk operations. A periareolar lift with an implant though, is not as high risk. A full mastopexy with a larger implant has a high revision rate and increased complications and many surgeons stage their full lifts if the patient wants to go larger. I find many patients want a different size after the mastopexy has healed and often do two stages when a full lift is needed for better results with less complications.
Explant and fat transfer to breastBreast Implant Revision
From my experience and published data, the average amount of size from fat grafting is one half to one cup. About 20% of patients will see even less or none, due to unknown factors that affect the ingrowth of blood vessels that nourish the fat. It is genetic, so it is on both sides, About 20% will get greater than one cup size. That assumes you have sufficient fat, you need at least 500 cc removed to attempt one cup. Although it can sometimes be done at the same time as implant removal, ideally it is done later to allow more layers to safely inject the fat as well as to correct contour deformities from the previous surgery . If you want more than one cup, you should consider another implant.
could I get a breast reduction revision??Breast Reduction
What you mention is common. Sometimes there is more of a rubber band effect on one side when the weight is relieved. Sometimes things heal differently. I have even seen it change the first day. First of all, many women are not even. But when they are larger they dont notice as much. The left is usually larger because the left chest is wider and the heart is on the left. So revisions are not uncommon, because human tissue is alive and does change, unlike clay or dead wood. Your original surgeon may even be able to do it under local anesthesia. Insurance is a different issue if they will cover revisions and that is why returning to your original surgeon first is usually your least expensive option. It could be just the left side needs the nipple repositioned and some more tissue removed along the scars to make it more even. So don't despair and return for another appointment. Interestingly over the years I have had patients that had differences and not care at all, and I wanted to do.
Labia Minora fixedAesthetic Genital Plastic Surgery
We do this frequently at Iowa Plastic Surgery. The majority of patients have it repaired in our office under either local anesthesia, nitrous oxide (laughing gas), or IV sedation. Rarely someone chooses general anesthesia. The healing is sometimes an issue with about a 10% revision rate, since it can either swell and stretch, or scar and contract. It is also an area with a lot of small infections. So usually there are a few post operative visits. The range depends on the type of anesthesia and is from about $2000 to $4000. In Iowa, insurance does not cover it, and even if it did, would require that it be performed at a hospital with additional costs, copays, and risk of denial. Our office offers virtual consultations. Clive is about 2.5 hours from us on I80.
Penis injectionDermal Fillers
RUN AWAY! Liquid silicone injections for cosmetic purposes are NOT FDA approved and have a very high failure rate. Any person purporting to do this is most likely NOT a licensed medical professional with appropriate training. This is a procedure that is disastrous and has and could result in penis amputation.
Our Office Hours
Monday: 9 a.m. to 7 p.m., Tuesday: 8:30 a.m. to 5 p.m., Wednesday: 9 a.m. to 7 p.m., Thursday: 9 a.m. to 5 p.m., and Friday: 9 a.m. to 5 p.m.