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
Lip Augmentation / Enhancement
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.
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 fixedVaginal Rejuvenation
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.
Male nipple problemsMale Breast Reduction
The most common is there is a breast bud, or mild gynecomastia, male breast enlargement pushing behind the areola. This can be treated in mild cases under local, or mild sedation, in the office by removing this tissue by an incision in the areola or colored portion. In more severe cases gynecomastia surgery is done. If just the size of the nipple itself, that is rarer in men, but can be treated by excising a portion of the nipple by several different methods depending on the type. This also, can be done under local, reducing the cost.
Charting requirementsBotulinum Toxin
No there is no legal requirement. Typically the doctor will document the amount injected and locations and the discussion of the risks. My office does not chart expiration date and lot number in the individual patient chart but keeps track of bottles in a office log, and there is no legal reason or need to do so. The brand of neurotoxin though should be charted. Each doctor may have his own preference how to prepare it, and as long as the number of units is used, the dilution ratio is not significant and there is a range. In the United States any physician, and in some states dentists and nurse practitioners can inject Botox, and in many can delegate anyone in their office to inject. Some you neither have to be a physician or nurse to inject. So it is up to the patient to do their homework and ask who is injecting, and their residency training and beware of embellished resumes. There would be no repercussions to any of the questions you mention, unless no charting of any kind .
Lipomatic vs vaser liposuctionLiposuction
No machine or other technique has been proven to be better than standard tumescent liposuction. The surgeon is the one that uses the suction and thus choosing the surgeon is also important. In fact, one study comparing a highly marketed liposuction device not only did not prove the device to be better, but actually worse in terms of recovery and pain. Other devices have resulted in increased complications. The devices are, marketing devices rather than results devices. Surgeons will purchase and market that this is better, to help pay for the device. The devices may make it physically easier for the surgeon and thus some surgeons may need such a device.
Body contouring for Post-Op Gastric Sleeve PatientBody Contouring
No. This is too much surgery to do at once with markedly increased risks. In addition the recovery would be a multiple and much longer, not shorter. You should stage the surgeries for overall faster recovery and less risk.
The term Mommy Makeover is a lay term and not a specific medical terminology. It has generally referred to improvements in the anatomy changed by pregnancy, such as breasts and abdomen. There are a lot of considerations with doing two procedures. While generally safe, there is increased risk of blood clots, hospitalization, and recovery from combined procedures. More importantly most patients find the recovery from both together is more than anticipated, and much longer than either alone. I do carefully selected patients. I tell patients if a friend of yours broke their arm in an accident you would state they need recovery, if they broke their leg you would anticipate a recovery, but if they broke both an arm and a leg you know they have a difficult recovery. Operating on the abdomen and chest is like that, a harder and more complicated recovery and should be carefully considered.
Scar revisionBody Contouring
Appendectomy scars can be improved in several ways. The cheapest might be to reexcise and close which could be done under local anesthesia in the office. If there is extra fat but not loose skin liposuction could make the area flatter. And if there is loose skin a tummy tuck would remove the scar, but place a longer one lower and less depressed. Of course patients who form poor quality scars may do it again with reexcision.
Cleavage AugmentationBreast Augmentation
To improve breast that have a wider breastbone either fat grafting or implants over the muscle are the best options. Implants under the muscle have advantages but unless you already have cleavage they do not help a wide breast bone. Fat grafting requires enough available fat to graft, and fails about 15 % of the time.
FDL and BTLTummy Tuck
I do not recommend internal surgery and a tummy tuck at the same time. The tummy tuck can mask the signs of complications from internal surgery making a complication life threatening. I feel they are best done separately for safety. A Fleur de lis abdominoplasty is a big undertaking too, and both together as two separate procedures also markedly increase the risks.
I want to have a better bodyTummy Tuck
You will need to consult with the transplantation service for their clearance. I would recommend a plastic surgery consultation in the department of that same institution to coordinate. The scars on your abdomen from the prior procedures will have to be evaluated to see what could be done safely as the scars may make a traditional abdominoplasty not safe. On the other hand, some abdominal improvement might be considered reconstructive and covered by insurance. An evaluation in those two Departments will give you both answers about safety, what can be done, and what even might be covered by insurance