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Breast Augmentation Davenport

Breast Augmentation at Iowa Plastic Surgery

Dr. Van Raalte has treated thousands of patients for breast surgery, but we treat each patient as an individual. Our revision rate for breast augmentation is well below the national average. Our goal is to listen to our patients and meet their needs, whether they want a subtle, natural appearance, or a fuller larger look.

We have used saline or gel implants, round or shaped (anatomic teardrop), and even adjustable saline implants depending on the situation. Dr. Van Raalte has one of the most extensive experiences with the new cohesive gel implants known as the “Gummy Bear” implants.

Iowa Plastic Surgery has a private, but full sized hospital operating room that is certified by the Joint Commission, the same accrediting broadly used by hospitals. This allows us to do the majority of procedures in our office facility but with the utmost safety. With a team that works together, our safety record is outstanding and yet allows the privacy that a large facility cannot offer. In addition, our facility has had a much lower infection rate than procedures done at larger facilities. Safety is our utmost goal, yet we are able to offer the convenience, privacy, safety, and familiarity of a team dedicated to aesthetic plastic surgery.

Other breast augmentation and enlargement options we offer include mini lifts, breast fat grafting, and revision of prior breast implant surgery.

OUR BREAST AUGMENTATION CONSULTATION

At our consultation, we not only listen, but it is the careful measuring and planning that we do that helps you to achieve your goal with a low re-operation or revision rate. We measure, use sizers, and computer imaging to help you choose. During your consultation, we will show you before and after pictures of patients that have had breast augmentation surgery by Dr. Van Raalte. In addition, we provide 3D imaging with Crisalix, a program that can show computer generated pictures of your potential outcome. We also have a sizing kit that we will utilize to help you pick out your preferred size. Although perfect results can never be guaranteed, we will use our expertise to get your best result.


 

“Dr. Van Raalte and his staff were exceptional, knowledgeable, and caring. Great team and great experience from day one to the month after the post-op check-up!”

-Breast Augmentation Patient
Individual results may vary


 

OPTIONS

Iowa Plastic Surgery has extensive experience with different options for breast implant placement including submuscular (preferred), subglandular, or subfascial placement. We have used different incisions for placement, and our preferred incisions are transaxillary for smaller or saline implants, and inframammary for larger, or gel implants. The inframammary incision is also best for those with a degree of droop. The transaxillary incision is the one placed in the armpit. Axillary incisions are best for the smaller round gel or saline implants. Cohesive gel shaped implants are best placed in an incision under the breast fold or inframammary incision. We place the majority of implants under the muscle, but a few may be placed below the breast tissue fascia.

We offer both general anesthesia and intravenous (IV) anesthesia. Intravenous anesthesia is the medication given by an IV that makes you forget, feel intoxicated, and tolerate the procedure. Numbing medications are then administered. General anesthesia is when you are put completely to sleep. Currently, about 80% of our patients choose IV sedation.

The same implant can look different in different people, and one size implant will not guarantee the same cup size for different patients of different body build or type. Differences include not only the size of the patient including height and weight, but also the width of the rib cage or even the appearance of the rib cage itself. Differences in volume may change the width more than the projection. A different style implant such as a high profile implant may give more projection. Lastly, the appearance of the existing breast tissue will affect the outcome. Breast enlargement is not placement of a new breast on the outside but using the existing breast tissue and placing an implant below. We recommend the cohesive gel implants as they have the best chance of molding or shaping the existing breast tissue.

Iowa Plastic Surgery uses the best implant to fit your desire, your body type, and your chest width. It is often the width and style of the implant that is more important to the size or volume of the implant for your best result.

IMPLANTS

Saline implants have a silicone shell. They are called saline implants because they are inflated with saline solution. Should they deflate, saline is physiologic with blood and would be absorbed by the body and the implant will be go flat or deflate. The different types of saline implants include round, anatomic (also known as a teardrop or shaped implant), and expandable (postoperatively adjustable) implants. Saline implants can be placed through smaller incisions but do have higher wrinkling and rippling rates than the gel implants.

Gel implants are composed of silicone gel. They have a silicone shell, and they are filled with silicone gel. The majority of implants used around the world today are gel implants. Many women feel the gel implants have a softer and more natural feel. They do not deflate, but can rupture. They do have less rippling than the saline implants and are better for thinner women. They also are best for older patients as in that age group they look the most natural.

The cohesive gel or Gummy Bear Implant has the least rippling, wrinkling, and holds the shape of the breast. Over time, the cohesive gel seems also to have less displacement. Our cohesive gel expertise has been noted by the manufacturers of the cohesive gel implants. We have become one of the most experienced users of these in the upper Midwest. These implants have a natural feel and look. The cohesive gel implants have lower reported complications and mold the shape of the breast. These implants also can correct mild degrees of droop.

SHAPES

Round implants are available both in saline and gel. A round implant when upright becomes more teardrop shaped.

The anatomic or teardrop-shaped implants not only look the most natural but seem to correct mild-to-moderate droop better. With a push up bra they become rounder.

Expandable saline implants allow fluid to be injected at a later date if the patient needs or desires to become larger. They are useful when the patient wants to be larger than the tighter skin envelope might allow. Fluid is injected at several postoperative visits to stretch out the skin to a more acceptable size. They are also helpful in cases where either both breasts are poorly developed or misshaped.

Breast implants can be low, moderate, or high projection. The surface of the implants can be smooth or textured, and all the shaped implants have a textured surface to avoid turning.

We will help you choose the best implant for you depending on your anatomy, your concerns, and your desires and choices. We use measurements, implant sizers, computer simulation, as well as Dr. Van Raalte’s extensive experience to determine your best fit.

INCISIONS & LAYER PLACEMENT

An implant can be inserted under the crease in the breast, around the nipple, or through the armpit. The nipple incision has higher reported rates of infection and capsular contracture. The inframammary incision (underneath the fold of the breast) is best for placement of shaped implants or correcting mild droop, and the axillary incision (armpit incision) is used for either saline or smaller implants. Dr. Van Raalte has extensive experience with placing the implants through the axillary or armpit incision. Sometimes the incision is as short as an inch, and his experience goes back to 1988 using that approach.

Covering the upper portion of the implant with the pectoralis muscle (submuscular placement) is probably better for mammograms and less capsules and is the recommended approach. There are some instances where going subglandular may give a better appearance.

Dr. Van Raalte also has experience with correcting breast droop or ptosis either using the shaped implants, biplanar muscle approach where it is placed partly where the upper portion is covered by muscle, but the muscle is more freed to correct the droop. In more cases of droop, we may suggest either a mini lift or a full lift.

Types of Breast Implant Placement Locations

Our most common breast implant placement is submuscular . Prior to the cohesive gel implants, 99% of our saline and regular gels were submuscular. The exceptions were an occasional bodybuilder and those with pectus (chest wall ) abnormalities. With the cohesive gel (“gummy bear”) we now do 85% submuscular and 15% subfascial, with those with moderate droop being most of the 15%.

Subfascial is not the same as subglandular. Although both are above the muscle, subfascial is a thin layer below with advantages over the subglandular of less capsules. I only do subfascial with the cohesive gel shaped implants as the others do have more problems.
Also, even in submuscular the lower half is subfascial anyway. In biplanar just the upper third is submuscular.

Advantages of Submuscular breast implants

-Good taper in upper pole
-Best mammograms
-Possibly lower contracture
-Upper pole covered by muscle

Disadvantages of Submuscular breast implants

-More pain the first day
-Muscle creasing in tight clothes when flexing
-Mild loss of strength
-If moderate droop can get the breast hanging over the implant, the “snoopy dog” deformity.

Advantages of Subfascial breast implants

-Corrects moderate droop better possibly avoiding the scars of a breast lift
-May allow a larger implant to be placed for either patient desire or to correct moderate breast droop (ptosis)
-Less pain
-No muscle injury
-No muscle flexing over implant. No muscle creasing. No loss of strength

Disadvantages of Subfascial breast implants

-Slightly higher hematoma rate, bleeding
-Probable increased capsule rate.
-Increased implant visibility in upper pole, including less taper, and possibly more wrinkling and rippling
-No 10 year US Data. Overseas reports rates are low, though
-Possible increase mammogram interference with capsules

So far, after 12 months we are seeing excellent results in selected patients with subfascial. We are correcting greater degrees of breast droop without the need for additional breast scars. The breast is a very natural looking breast.

SURGICAL RISKS OF BREAST IMPLANT SURGERY

The risks related to surgery include hematomas, infections, scarring, nipple numbness, and asymmetry among others.

A hematoma is post-operative bleeding that occurs in the breast pocket. It occurs in 1% of operations and is generally not life threatening but may result in a return to the operating room. Avoid aspirin, ibuprofen, or other medications that increase the risk of bleeding for 10 days prior to surgery.

Infections occur in about 1% of operations. Bacteria live on our skin and despite use of antibiotics and sterile preparation, bacteria are not entirely eliminated. Infections unfortunately can occur and then do result in loss of the implant. The implant then is replaced three months later. The occurrence of infection in patients who are nonsmokers has been less than 1%.

Scars occur with any operation and take time to fade, but only about 1% of patients will form thicker scars.

Asymmetry or unequal size or shape occurs in 2% to 4% of patients. If the skin is tighter on one side, it is going to push the implant differently. One side of the chest may be wider, or the breast may be shaped differently. Sometimes this asymmetry can be corrected by use of the cohesive gel implants. Use of a band or bra afterwards will help to stretch the skin. Lastly, 2% of the people may require repeat repositioning of an implant.

RISKS OF BREAST IMPLANTS

Capsular contracture or firmness is due to excess scar tissue that has formed around the implant. The body forms scar tissue around any operation. Unfortunately, in the case of an implant, that may make it feel too hard.

The patients who form too little scar tissue may see rippling or wrinkling of the skin over the implant, usually in the lower portion not covered by muscle. The cohesive gel implants have the lowest rate of wrinkling.

Deflation or rupture
Saline implants are reported to deflate at 1% per year or higher. Routine activities will not cause deflation. It can happen in the first year or 10 years later or may never happen. There is no “life expectancy of the implant.”

Gel implants do not deflate, but they can rupture. The gel thickens and is enclosed by scar tissue that forms around the implant. Rupture rates are 0.5% for the newest cohesive gel implants. There are no known health problems with rupture. The implant might interfere with the quality of mammograms. Techniques that can be done to correct this include placing the implants under the muscle or obtaining additional views on mammograms. If you have a strong family history of breast cancer, this should be discussed with your physician.

Rippling or Wrinkling
The lower portion of the breasts may not have enough tissue to cover the implant. The patient may see rippling or wrinkling. This is more common in thin patients. Cohesive gel has the lowest rate of wrinkling or rippling.

ALCL
There has been an association of a rare cancer, ALCL, or anaplastic large cell lymphoma that has been reported in approximately 60 cases in the 10 million women worldwide who have had implants.

Why Iowa Plastic Surgery for breast enlargement?

Some patients wish to improve the way they look in clothes or a swimsuit. Others wish to regain the figure they had before children. Most patients feel that their breast implants have improved how they feel about themselves.

Dr. Van Raalte has extensive experience with a large number of breast augmentations including the different incisions, different sites of implants, as well as correction of breast droop. We will help you pick the optimal shape, style, or implant rather than just volume alone. We offer all the options and tailor that to your body frame and desires. We hope our experience can help you to obtain the best possible result and appearance!

QUESTIONS

How do I know what type of implant is best for me?
At your personal consultation, Dr. Van Raalte will work with you to determine which implant size and shape will best suit your needs based on your physical dimensions and your size desired.

How long does a surgery take?
Breast augmentation is an outpatient surgery and typically takes 1 to 2 hours.

How long do I have to take off at work?
Based on the type of work you do, most patients find they can return to work in as little as a few days for a desk-type job.

How long can I wait till exercise after surgery?
You must wait three weeks before beginning any vigorous exercise. You will have a 20-pound weight restriction for the first three weeks.

What can I expect during recovery?
You will be released to go home about 1 hour after surgery. Your chest will be taped, and you will have a wrap on. You should keep this on until your first postoperative appointment, and we will unwrap you. Breast pain in the first week is not unusual. Pain medication, including narcotic pills, is written for you. We also use other medications to make your experience more pleasant. Most of the discomfort is in the first 24 to 48 hours.

What is the cost of breast augmentation or implants?
Our surgical package includes implants, surgeon, facility, and anesthesia. We offer both intravenous sedations and general anesthesia. Our surgeon’s fee does not vary for the type of implant. The variation is due to the specific type of implants which do have different prices. Be aware that many surgeons will quote a price based on the surgeon’s fee alone and not include the facility or anesthesia prices or these may vary. Our price for breast enlargement or implants ranges from $3900 to $6200 depending on the type of the implants and anesthesia.

Breast Augmentation Prices

Expertise in Coherent Gel, Gummy bear implants Iowa Plastic Surgery

  Peoria doctors’ regular pricing* Peoria doctors’ “special” pricing* IOWA PLASTIC SURGERY EVERYDAY PRICING
Saline 6300 5195 3900
Round Gel 7500 6195 4900
Gummy Bear 9400 7695 5900

*from April 2016 newspaper ad

BREAST AUGMENTATION PATIENT EXPERIENCES

“Excellent service and care throughout my entire experience. I couldn’t be happier with my results!”
-S.M.
Individual results may vary

“Amazing results. All questions and concerns were answered. I was very nervous prior to surgery, but the nurses and staff were so comforting and helped to make everything run smoothly. I do not regret my decision. Dr. Van Raalte does incredible work.”
-A.L.
Individual results may vary

“Dr. Benjamin Van Raalte and his team have been fantastic, very supportive, and patient. I wish I did this years ago. Very happy.”
-E.B.
Individual results may vary

“Dr. Van Raalte and his staff were exceptional, knowledgeable, and caring. Great team and great experience from day one to post-op check-up.”
-K.E.
Individual results may vary

“This procedure has made a huge different in my life. I am so happy that I came to IPS! The results are amazing and I was well cared for and would do it again in a heartbeat!”
-G.C.
Individual results may vary

“I was extremely insecure with my body and was also afraid of things not going right with surgery; however, the staff was very professional, explained everything in full detail and ultimately, I was extremely satisfied with the outcome.”
-C.A.
Individual results may vary

“Great experience, great results! Highly recommend!”
-P.N.
Individual results may vary

“Recommend this office, they are very professional. Treated me like family. Nurses were amazing, talked me through whole procedure so I wasn’t scared. Definitely coming back to do more work.”
-J.H.
Individual results may vary

“Wouldn’t recommend anyone else but Dr. Van Raalte for procedure. Very honest opinion. Couldn’t be happier with my results.”
-M.M.
Individual results may vary

“Very pleased with results.”
-K.G.
Individual results may vary

“I am very satisfied with my results! Great staff. Answered all of my questions. Awesome doctor!”
-B.C.
Individual results may vary

“I was amazed. I was so scared. Everyone was so sweet, helpful, and even when I emailed late one night to a nurse, she e-mailed me back. So did doctor. Very happy.”
-C.P.
Individual results may vary

“Dr. Van Raalte’s team did a very good job with prep and follow-up. Dr. Van Raalte’s work is fantastic. I love the results.”
-S.C.
Individual results may vary

“I couldn’t be happier with how everything went. The staff and Dr. Van Raalte were great and explained everything. They do great work!”
-L.M.
Individual results may vary

“Such an amazing, life changing experience. Dr. Van Raalte and his staff were amazing. I have never felt more comfortable in my own skin! Thank you!”
-M.O.
Individual results may vary

“I am so very happy with the outcome of my breast augmentation. The staffing, nurses, and doctor are very kind and comforting. Thanks so much to all of you.”
-M.W.
Individual results may vary

Click here to read more testimonials from Dr. Van Raalte’s patients

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