The basic liposuction operation in Singapore involves making a small incision less than 1cm long in the skin then inserting a metal ‘straw’ called a cannula into the fat and sucking the fat out. The fat is not liquid, so the cannula needs to be moved in and out to loosen it so it can be removed.
A good knowledge of anatomy is essential to avoid putting the cannula in the wrong place.
There are many ways this basic operation can be modified. Personally, I perform a technique called SAFE lipo. This uses special cannulas and powered liposuction to break up the fat prior to suction and then redistributing the fat to reduce contour irregularities.
In Singapore, the Ministry of Health regulates who can do liposuction and how it can be done. A doctor needs to be accredited to perform liposuction outside of restructured hospitals. It can only be done in clinic if the amount of fat removed is less than 100mls and only a syringe is used to suck out the fat.
Unless it’s liposuction of the face, most liposuction procedures will remove more than 100mls, therefore, it usually needs to be done in at least an Ambulatory Surgery Centre (ASC). If more than 2L of fat is removed, then the procedure must be performed in a hospital on an inpatient basis.
Not all liposuction must be performed under general anaesthesia, but patients will not struggle or feel any pain under a full general anaesthesia. Liposuction can be done under deep sedation or even just infiltration with local anaesthesia, but patients may feel some mild discomfort.
For that reason I prefer a general anaesthetic. In any case, whether using general anaesthesia or deep sedation it must be administered by an anaesthetist, so I don’t see much benefit in performing liposuction under deep sedation.
