Is liposuction right for you? Top Singaporean plastic surgeons and aesthetic doctors talk benefits, risks, and results

Is liposuction right for you? Top Singaporean plastic surgeons and aesthetic doctors talk benefits, risks, and results

Chew the fat

Text: Emily Heng

Fat removal and reduction processes is multitudinous. With many a non-invasive option such as Coolsculpting, Radiofrequency, and LipoLaser entering the fray, it seems once-favoured surgical methods are being shunted out of the spotlight... or are they? According to leading personal finance portal, MoneySmart, liposuction is still the third most popular cosmetic procedure in Singapore since 2018, while the US has experienced a revival with a five percent annual increase in cases over the last two years. Regarded as one of the most recognised (and arguably, reliable) methods of fat removal, we speak to a band of plastic surgeons and aesthetic doctors in Singapore to get the lowdown on this tricky treatment.

What is liposuction?

"Liposuction is a medical procedure which removes unwanted fat tissues from selected body areas," Dr Ivan Puah, lead aesthetic doctor of Amaris B. Clinic, explains. "It is designed to target excess fat tissues resistant to dieting and exercise. Through targeted body fat reduction and body sculpting, it reduces the number of fat cells in the isolated area. Liposuction can be used to treat conditions such as lymphedema, gynecomastia, lipodystrophy syndrome, and lipomas. In general, localised fat tissues do not return after liposuction."

Where can liposuction be performed?

According to Dr David Loh, aesthetic doctor and founder of David Loh Surgery, liposuction is commonly conducted around the abdomen area and flanks, the outer and inner thighs, and the arms. They also receive occasional requests to sculpt areas like the cheeks, the calves, and under the chin.

How does liposuction work?

Associate Professor and board-certified plastic surgeon of Dream Aesthetics and Plastic Surgery, Dr Vincent Yeow, breaks it down: "Prior to starting the procedure, the localized fat for removal is indicated with a surgical marker. Once the patient is in the theater, general anesthesia is administered. Surgical gowns are then draped over the patient, exposing only the target area(s) and the skin that will be sterilized.

Depending on the size of the area(s), two or more tiny incisions are made in less obvious areas such as the crease along the buttocks or groin, allowing the canula to access the target area. The cannula is then introduced beneath the skin to infiltrate local anesthesia and adrenaline for pain relief and the reduction of bleeding.

Once enough fat tissues have been removed, the incisions are stitched up. Compression garments will be worn over the treated areas to bringing the swelling down. If fat totaling two litres or more are extracted, patients will need to be hospitalized for one night for further observation. Those whose fat extraction is below two litres can return home after recovering from the general anesthesia."

Who is the ideal candidate for liposuction?

People of average weight with firm, elastic skin and pockets of excess fat tissues will benefit most from this treatment. "They are the ones with stubborn fat but are unable to reduce them through weight loss with realistic expectations," Dr Puah says.

Conversely, who is unsuitable for liposuction?

"Apart from those who are unwell from other conditions? People who are obese, for whom liposuction is not a suitable method of weight loss," Dr Loh declares. "We tend to screen customers on their frame of mind before recommending liposuction. Those with unrealistic expectations, we are most cautious about. Liposuction is a way to sculpt areas of disproportion; it is not a weight reduction tool. Weight reduction can only be achieved through diet, exercise, or an individual is very severely obese, bariatric surgery."

How long does liposuction take?

Dr Vincent Yeow claims that each area takes one-and-a-half hours on average to complete. The duration of the procedure is dependent on the size and number of treated areas.

How can you prepare for liposuction?

It is recommended that you inform your doctor of any existing conditions or if you've been on medications such as blood thinners and various anti-inflammatory drugs. Garlic, gingko, and traditional Chinese supplements should be stopped three weeks prior to the procedure as it might make patients more prone to bleeding and bruising.

What are the risks of liposuction?

"Liposuction is generally safe and its risk or side effects can be minimised if it is handled by an experienced plastic surgeon," Dr Yeow reveals. "Even then, all surgical procedures present a risk for infection, bleeding, and bruising. One of the most common side effects is the feeling of temporary numbness in the treated areas, which should recover with time. In certain cases, the skin around the treated area may not conform completely to the new body contours, resulting in dimpling or surface irregularities. Blood clots (hematomas) and fluid accumulations (seromas) under the skin can also happen when dealing with multiple areas, or a large treatment area."

Are there serious complications that can occur with liposuction?

Generally, no, though there are some risks commonly associated with undergoing anaesthesia according to Dr Puah. In fact, there have been two reported deaths caused by using too potent a sedative during liposuction procedures in Singapore — both doctors were fined and one was struck off the register of approved medical practitioners.

How much does liposuction typically cost?

Treatments for small areas such as knees may cost from S$1500 to S$2000 onwards, while multi-area liposuction may cost more.

What is the aftercare like?

Dr Loh assures that a compression garment is provided post-surgery. It is to be worn for the first one to two weeks when the bruising is at its worst as it helps bring swelling down rapidly. Sometimes, a temporary drain may even be attached to promote fluid drainage. Painkillers and anti-swelling supplements may also be prescribed.

How long do the effects of liposuction last?

"Generally, the improvement from liposuction is relatively permanent as the isolated pockets of fat layers that are removed do no grow back," Dr Puah remarks. "In other words, the re-contouring or re-shaping is permanent. However, your body weight will depend on your lifestyle, and too much weight gain will adversely affect your overall shape."

Are non-surgical alternatives just as — if not, more — effective than liposuction?

Not entirely. Dr Yeow says it best: "Alternatives such as cryolipolysis is a common non-surgical option (for small areas), but it relies on the patient's body to absorb the fat. In addition, there have been cases of fat hypertrophy after cryolipolisis procedures. In comparison, liposuction surgically removes the fat but is more invasive and more effective." Dr Puah agrees, though he points out that it is a treatment more suited for those look to remove significant fat layers — think saddle bag fats for those with 'pear-shaped' bodies, or those who want to achieve an hourglass figure.