Koch Facial Plastic Surgery & Spa
4855 Mills Civic Parkway #100
West Des Moines, IA 50265
Phone: (515) 277-5555
Fax: (515) 277-0060
Monday-Friday: 8:15 a.m.- 5 p.m.
Saturday: By Appointment Only

Breast and Body Plastic Surgery

Dr. Michael Carlisle is a board-certified plastic surgeon in Des Moines who specializes in plastic surgery procedures for the breasts and body. His specialties include breast augmentation, breast lift, tummy tuck, mommy makeover, and liposuction.

Dr. Carlisle’s incredible rankings and reviews are testament to not only his skill, bedside manner, and outcomes, but also to his reputation among his peers across Iowa. He looks forward to meeting with you to help you achieve your aesthetic goals. Request a consultation with Dr. Carlisle or call our office at (515) 277-5555 to schedule an appointment.


Breast Augmentation

The Benefits of Breast Augmentation

People desire breast augmentation to:

  • Increase the size of naturally small breasts
  • Restore volume that was lost after pregnancy or losing weight
  • Improve uneven breasts
  • Enhance self-esteem by restoring feminine proportions and contours

Personalized Breast Augmentation

Dr. Carlisle is known for his personalized approach to each patient as he strives to understand your desires and concerns. He will help you develop a safe surgical plan, give you realistic expectations about your results, and clearly communicate what is best for your body and goals.

Breast Implant Options

There are several implant types available, and Dr. Carlisle will help you understand the advantages of each option. While there are many options, the most commonly-used implant is a smooth round silicone implant because of the natural feel and the known safety of these implants.

Dr. Carlisle will help you decide which implant is best based on your body type, concerns, and goals. Implants currently available:

  • Silicone gel
  • Silicone gummy (“gummy bear” implants)
  • Saline
  • Shaped (“tear drop” implants)

How Much Does Breast Augmentation in Des Moines Cost?

In general, breast augmentation costs between $7,500 and $10,000 total (including surgeon’s, facility, and anesthesia fee) depending on implant type and other factors. Many women also have a breast lift at the same time as augmentation, and these prices do not include breast lift. During your consultation, you will receive a customized price quote that reflects your specific surgical plan.

How Do I Choose the Right Size Breast Implants?

  • Implant sizes are measured using cubic centimeters (CC). As most women know, bra sizes vary significantly from brand to brand and is not a reliable or precise measurement of volume like CCs. However, having a desired cup size in mind is a good starting point to communicate with your doctor.
  • During your consultation, you will be “sized” using a Volume Sizing System that creates a more realistic preview of your new size on YOUR body. A series of soft sterilized silicone inserts will be placed over top of your breasts inside a sports bra until your desired proportions are achieved. It is important to see how the new size looks on YOUR body when choosing an implant size.  This system has been shown to increase the likelihood of size satisfaction over computer-generated images, which can be confusing.
  • It is common for patients to look at celebrities and others for inspiration on size, but it is important to remember that each body proportion is unique. What looks good on one woman may look different on other women of a different height, weight, breast size, or body type.

Which Procedures Can Be Combined With Breast Augmentation?

Breast lift is one of the most common procedures performed with breast augmentation. If the nipple/areola position is below the level of the breast crease, then a lift will likely be needed in order to have a desirable breast shape.

How Much Time Should I Take Off Work?

Typically, breast augmentation patients need only 3 to 5 days off work. However, if your job requires more use of your arms, we recommend taking 2 weeks off work to ensure proper healing. Too much arm motion can affect the final position of the implants and shape of the breast.

Breast Augmentation Recovery

It is important for excellent results to avoid strenuous activity for 4 weeks following breast augmentation. While you can go about your normal business after the initial 3-5 days, purposeful exercise is NOT recommended because it can affect your final results. Breast augmentation patients typically have no problem resuming normal exercise activity after the 4-week hiatus.

Scar Reduction

Most scars are just a fine line after breast augmentation, which is only visible when you lay down without clothing. This makes breast implant surgery one of the most common cosmetic surgeries in the world. Genetics plays an important role in scar formation. We offer scar reducing products after surgery and post-mommy makeover laser packages to help your scars be the best they can be.


Does breast augmentation lift the breasts?

Implant surgery may elevate the breasts slightly, but an implant will not correct droopy breasts on its own. Many women combine implants with breast lift surgery, especially after pregnancy and breastfeeding. One of the first issues Dr. Carlisle will assess when a patient comes in for a breast augmentation consultation is whether a breast lift is needed to complete the rejuvenation of the breast.

What is fat transfer breast augmentation?

Using liposuction, fat is removed from one area of the body then purified and injected into the breasts. Because only 60-80% of the fat survives, and only a certain amount can be injected at one time, this technique will increase the breast size modestly. However, this is a practical alternative to using breast implants, or an excellent enhancement to the breast shape during augmentation with implants.

How long after breast augmentation can I resume exercise?

No strenuous exercise for 4 weeks. This is important for implant position. Immediately after augmentation, implants appear unnaturally high in position. The breasts soften and the implants “drop” into a natural position for 2-3 months. Strenuous exercise can be a contributing factor for implants to heal in a “high” position, which is undesirable for the final shape.

Light activity such as walking may be done 1 week after surgery.

How long will it take for my breasts to look natural after breast augmentation?

Generally, it takes 3 months for implants to soften and drop into a natural position. Most patients are happy with their results 6 weeks after surgery, but the appearance will continue to improve for 3-6 months. Often, we will recommend massaging the implants and breasts to help with this process, but this should be done only at the direction of your surgical team.

How long should I sleep on my back after breast augmentation?

Typically, we recommend that patients having breast augmentation sleep on their backs for a few weeks to ensure favorable healing and an attractive, symmetrical shape. For women accustomed to sleeping on their sides or stomachs, this can be challenging. It is a good idea to begin several days before surgery to train your body to sleep on the back. Many patients find it helpful to support their limbs with pillows. This helps them fall asleep and also prevents them from shifting positions throughout the night.

Can I still breastfeed after getting breast implants?

Yes. It is safe to breast feed after implants. The implants are placed under the actual breast tissue and normal function of the breast gland and ducts are not altered by augmentation through a typical incision. Having a breast lift at the same time may alter breast feeding capability, however, this is difficult to predict. Plenty of women are still able to breast feed after a breast lift.

It is better to have implants placed above or below the pectoral muscle?

The overwhelming majority of implants are placed below the pec muscle. This is shown to have longer-lasting and more natural results.

Do breast implants interfere with mammograms?

While breast implants can make performing a mammogram more technically difficult, it has been shown that it does not interfere with detecting breast cancer compared with women who do not have implants. Special mammogram techniques are used in women with implants to view the breast tissue just as clearly as patients without implants. Also, placing implants under the pec muscle makes the implant interfere even less with viewing mammogram. Breast augmentation surgery is so common that radiologists are vastly experienced at reading mammograms for patients who have implants.

Breast Augmentation Revision

Dr. Carlisle is known for breast augmentation revision surgery and has extensive experience correcting breast shape for women who are unhappy with their results. Most women who get breast implants are happy with their results, but revision surgery may be needed for a variety of reasons: changing sizes, lifting the breast, or correcting a complication.

Breast Lift

Dr. Carlisle specializes in the breast lift procedure and is known for using the breast lift procedure extensively in breast revision surgery.

Benefits of Breast Lift

Women who undergo a breast lift desire to restore the shape of the breasts. Sagging and a low nipple/areola position are corrected with a breast lift.  If the skin is sagging and/or the nipple position is below the level of your breast crease, then a breast lift is right for you. You can also consider having breast implants placed during your breast lift surgery to increase the fullness of your breasts. This is one of the most common surgical combinations performed after pregnancy or weight-loss.

Does a Breast Lift Change the Size of the Breasts?

No. Breast lift alone will change the shape, but not the size of the breasts. However, some women do find that a change in bra size is needed because the new lifted shape does not require as much support. Adding a breast implant to the breast lift to increase size is common.

What Happens During a Breast Lift?

Excess skin is removed, the nipple/areola is placed in a higher position, and the surrounding skin is brought up and tightened to lift and reshape the breast.

What Are Breast Lift Scars Like?

Most breast lifts require the “anchor” incisions. Some breast lifts can be done with just the “lollipop” incisions. Both have a scar around the areola.

These scars come from moving the nipple/areola higher and from the excess skin removal and reshaping.

There are two other types of “lifts” called the “donut” and “crescent” lift. However, these lifts are highly under-powered and are generally not recommended for actual lifting and reshaping.

Breast Lift Scar Reduction

The scars are often the most-feared part of considering breast lift surgery. However, most women who want breast lift are willing to trade the scars for a new shape. Most scars are a fine line after a year. Genetics plays an important role in scar formation. We offer scar reducing products after surgery and post-mommy makeover laser packages to help your scars be the best they can be.

What Can I Expect After Surgery?

Initial recovery from a breast lift is 3-4 days, then patients will experience bruised and swollen breasts for 2-3 weeks. No strenuous exercise for 4 weeks to help the breasts come into their new shape.

Breast Reduction

Breast reduction is one of the most common procedures that Dr. Carlisle performs. It is also one of the most life-changing procedures he performs! Even though full breasts are often considered an asset, many women wish their breasts were smaller.

Benefits of Breast Reduction

Overly large breasts make many women feel self-conscious in addition to causing physical complications – from neck, shoulder, and back pain to rashes and chafing. Droopy breast skin and downward-pointing nipples are also corrected during a breast reduction, much like a breast lift. Different from a breast lift, a breast reduction reduces a large proportion of the breast skin, fat, and gland tissue to decrease the size and weight of the breast.

Who Is a Candidate for Breast Reduction?

Women who experience one or more of the following could be a candidate:

  • Breasts that are out of proportion with body size
  • Persistent shoulder, neck, back pain due to the weight of the breasts
  • Painful grooves in the shoulders caused by bra straps
  • Significant breast drooping due to the breast weight
  • Difficulty with exercising or physical activity due to the breast size
  • Rashes under the breasts
  • Self-consciousness due to the size of the breasts

Women who currently smoke are not candidates for breast reduction surgery. Patients must be smoke-free for 3 months prior to surgery in order to safely undergo the procedure. Women with a body mass index (BMI) greater than 36 are also not candidates for breast reduction surgery.

How Small Can I Go?

More important than cup size is the weight that is removed from the chest. Cup size can go down by anywhere from 2-6 sizes, but more importantly, 60-80% of the breast volume can be removed. The goal is to deliver significantly smaller and perkier breasts that are proportionate with the body frame. It is always difficult to predict exactly what the final bra size will be since bra manufactures don’t agree on cup size either.

Breast Reconstruction Revision

Women who face the loss of breasts through mastectomy can have a reconstructive surgery that looks or feels undesirable as early as 1 year after surgery.  Women throughout the region have appreciated the expertise of Dr. Carlisle in performing successful revision surgery. Dr. Carlisle will listen to your concerns, establish goals, inform you of what is achievable, and help you weigh the options.

Male Breast Reduction

Gynecomastia is the technical term for enlarged male breasts. This can cause significant embarrassment and cannot be improved with diet and exercise alone. While this develops during puberty, most men grow out of this by their twenties, but some still deal with enlarged breasts further into adulthood.

Gynecomastia is not commonly talked about, so men are usually unaware of options. Diet and exercise can help achieve a healthier physique, but true gynecomastia cannot be corrected by a healthy lifestyle alone and often requires surgery.

What Are Male Breast Reduction Scars Like?

Most gynecomastia is corrected through a small incision around the areola, but some require a larger scar if there is excessive droop to the skin.


Mommy Makeover

Motherhood brings many joys to life, but pregnancy can change the body significantly. Sagging skin of the tummy and deflated breasts are normal after pregnancy. This can make clothing and swimsuits feel uncomfortable. Mommy makeover is a customized combination of procedures that is individually designed to improve multiple trouble areas into a single surgery. Breast augmentation, breast lift, tummy tuck, liposuction, and labiaplasty are all commonly performed in a single surgery. Each mommy makeover procedure is customized to the individual’s concerns, and prices vary based on the specific combination.

Coolsculpting® Elite

CoolSculpting Elite is a nonsurgical non-invasive treatment that removes unwanted fat from the body. It is designed to treat small pockets of stubborn fat that are not affected by diet and exercise.

CoolSculpting Elite works by using cooling technology to freeze fat and remove it over time. It is a safe and effective treatment for removing unwanted fat without surgery or downtime.

CoolSculpting Elite provider

Tummy Tuck

Benefits of a Tummy Tuck (Abdominoplasty)

People desire a tummy tuck to:

  • Get rid of stretched skin
  • Flatten a tummy
  • Sculpt the waistline
  • Improve the fit and feel of clothing around the waist

Tummy tuck is one of the most popular surgeries in America! Most of the patients who desire tummy tuck are women who have been pregnant or those who have had significant weight-loss. Increasingly, men who have had weight-loss also have tummy tucks!

Types of Tummy Tuck

While the vast majority of tummy tucks are “Complete” tummy tucks, each patient is different, and there are a variety of techniques that are available dependent on your aesthetic goals:

  • Complete tummy tuck (a.k.a. full tummy tuck) – restores the contour of the abdomen and waistline by removing the stretched skin/fat and tightening the abdominal wall through an incision from hip-bone to hip-bone.
  • Mini tummy tuck – removes loose skin below the belly button
  • Fleur-de-lis tummy tuck – used mostly in patients who have had massive weight-loss (>100lbs), there is an extra incision vertically from the upper abdomen down to the pubic area. This makes it possible to remove the maximum amount of skin and also tighten the waistline.
  • Extended tummy tuck – extends the horizontal incision around the waist, like a belt, above the buttocks to tighten sagging of the hips/buttock area.

What’s the Difference Between a Mini Tummy Tuck And a Complete Tummy Tuck?

A mini tummy tuck is not the right choice for women who need their abdominal wall tightened after it has been stretched out by pregnancy. It is also not appropriate when there is a significant amount of skin/fat to remove.

A mini tummy tuck tightens a small amount of loose skin below the belly button through a shorter scar between the hip-bones. It does not tighten skin above the belly button.

How Is Tummy Tuck Surgery Performed?

Under general anesthesia, the abdominal wall is stitched tight and the extra skin is removed to flatten the tummy. The incision usually spans from hip to hip and around the belly button. The low scar can usually be hidden by underwear or swimsuits, and most women find that the belly button scar is a good trade-off for the new abdominal contours and waistline. Liposuction is often used to sculpt the waist area.

How Much Time Should I Take Off Work for a Tummy Tuck?

Typically, tummy tuck patients need 2-3 weeks off work depending on the type of work. If you work at a desk or from home, 2 weeks might be enough. If your job requires much body movement, we recommend taking 4 weeks off from work. In general, our recommendation is to plan for 3 weeks off.

Tummy Tuck Recovery

It is important for excellent results to avoid strenuous activity for 4-6 weeks following tummy tuck. While you can resume light activity (errands, LIGHT house-work) after 2 weeks, purposeful exercise is NOT recommended because it can affect your final results.

Which Procedures Can Be Combined with a Tummy Tuck?

Breast lift and breast augmentation are the two most common procedures that are combined with tummy tuck.

Mommy makeover is a customized combination of procedures that is individually designed to improve multiple trouble areas into a single surgery. Breast augmentation, liposuction, and labiaplasty are all commonly performed in a single surgery along with tummy tuck.

CoolSculpting® Elite is another procedure that can be performed in conjunction with a tummy tuck or as an alternative to a tummy tuck if you have just a small amount of fat to remove. While it will not tighten loose skin, CoolSculpting can effectively remove pockets of unwanted fat from the abdomen to enhance the results of a tummy tuck.

How Much Does a Tummy Tuck in Des Moines Cost?

In general, complete tummy tuck costs between $12,000 and $13,000 total (including surgeon’s, facility, and anesthesia fee). Women often combine tummy tuck with other procedures. These prices do not include additional procedures. During your consultation, you will receive a customized price quote that reflects your specific surgical plan.

Tummy Tuck Scars

Even though tummy tuck scars do not go away, most are very low so that they can be hidden by a bikini or underwear. The tummy tuck scar can be very different from person to person.

Genetics plays an important role in scar formation. Some are slightly raised and pink for a period of time. However, most scars turn out to be a fine line after a year, but always visible while nude. Women having tummy tuck are usually happy to trade the scar for the new abdominal contour.

We offer scar reducing products after surgery and post-mommy makeover laser packages like the Sciton® Halo laser to help your scars be the best they can be.


Liposuction is used to surgically remove fat on a focused body area. Every person stores fat in certain areas, and eliminating it can be difficult with diet and exercise alone. Most people having liposuction are overall satisfied with their body weight, but want some fine-tuning in a specific area. The abdomen, thighs, hips, arms, chest, and breast can all be treated with liposuction.


Many women suffer physical discomfort or embarrassment because of enlarged/elongated labia. This is common, both because of development or childbirth, yet many women are reluctant to discuss it. Labiaplasty involves a short surgery to reduce the excess labia, restoring a more comfortable and confident shape.

Arm Lift

Either from genetics or significant weight-loss, sagging upper arm skin can be bothersome. Arm lift (brachioplasty) removes the sagging skin with an incision from the armpit to the elbow. If you consciously avoid showing your upper arms because of the loose skin, then arm lift could be helpful. This is one of the most common procedures Dr. Carlisle performs after significant weight-loss.

Thigh Lift

Sagging thigh skin can be uncomfortable or embarrassing. Good thigh lift candidates have excess and loose skin along the inner thighs. The procedure removes the skin/fat layer to contour the inner thigh area. Liposuction can also be performed of the outer thigh at the same time.

Body Contouring After Weight Loss

Dr. Carlisle is known throughout the region for his expertise in treating patients who have lost a significant amount of weight. Reaching a weight-loss goal is a huge step to a healthier, happier, and more energetic life. However, when the skin loses its elasticity by becoming stretched for a long period of time, it often does not conform to the new smaller figure. Body contouring after weight loss can help patients gain a sense of healing and confidence. Common procedures include tummy tuck, breast lift , arm lift, and thigh lift.

Your surgeon can discuss all of your options plastic surgery during a comprehensive consultation. Please request a consultation online or call our office at  (515) 277-5555 to schedule an appointment to meet with Dr. Carlisle.