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Kimy
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from Singapore asked a question

How safe is liposuction in Singapore?

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Plastic Surgery Aesthetic Medicine

I would like to know how safe liposuction is in Singapore, and what are the risks and complications that might arise from the procedure?

DOCTOR’S ANSWER (3)

Hi Kimy, good question!

Liposuction in Singapore is safe. The Ministry of Health has set many regulations to ensure patients' safety.

Local patients who are planning to go for liposuction are usually given 7 days “cooling off” period to consider their decision.

This period is mandatory for liposuction, because MOH has tightened the rules for invasive cosmetic procedures in 2011.

For foreigners this cooling off period doesn’t apply. If you are a foreigner and coming to Singapore to consult for liposuction and want to do it immediately, or the day after, you can get it done.

Doctors are regulated by MOH. Only certified doctors with liposuction accreditation are allowed to perform liposuction. Doctors like me are also required to attend regular peer reviews to discuss on cases done.

We also have to follow the regulations of performing liposuction in surgical facilities such as in the clinic.

This means:

  • Not more than 100cc of pure fat can be removed under Local Anesthesia
  • 100ml to 2L of pure fat can only be removed in facilities in the Ambulatory Surgical Centre ( under either LA or GA)
  • The removal of anything more than 2L of pure fat must be done in the hospital .

In any surgical procedure, There is always some degree of risk and complications.

You can reduce your risks by:

  • Making sure your doctor explains clearly to you about all the possible risk and complications that might arise from the procedure.
  • It is also very important for you to search for the right Plastic Surgeon.

Choosing a Plastic Surgeon

Be sure that you choose a certified Plastic Surgeon:

  • Who has a lot of experience
  • With a good reputation
  • Who works in a safe environment.
  • Don’t go cheap. Safety costs money. Safety is a well-qualified team working in a well-equipped medical facility to guarantee your life support.

Risk and Complications for Liposuction

These can include:

  • Anaphylactic shock:
    This means an allergy that can cause one to go into shock. If you are in a good well equipped environment, we have a higher chance of saving your life.
  • Cardiac related complications:
    Once again, the right team and right facility can save your life. The pre-operative medical checkup is mandatory to minimize this kind of event
  • Losing too much blood by over doing liposuction:
    The number of areas of intra-surgery bleeding is another risk.
    Pre-op blood checks on your coagulation profile, and investigation into whether you have any blood disorders can prevent the possible risk.
    (The rule is that there is a limit: supernatant fat up to 7% of the body weight can be removed)
  • Mechanical injury like puncturing inner organs:
    This is related to the doctor’s experience and also the equipment.
    Some liposuction machines like vaser and laser are more aggressive than the traditional liposuction method and can easily perforate the organs.
  • Other minor mechanical injury:
    Damaged nerves and skin necrosis could occur. It is rare but is still a part of risks and complications.

Among the later-stage complications, there are:

  • Pulmonary thromboembolism
  • Pulmonary edema.

In summary, liposuction is a very safe procedure when you go for a well-trained doctor. Most of these risk and complications can be avoided or can be managed properly.

Consult Doctor
0 304 views 0 Doctors agree 17 Oct 2018

Dear Kimy,

This is a great question! Liposuction is safe in Singapore just like most things in Singapore as the Ministry of Health has implemented additional requirements and licensing conditions for conduct of safe liposuction. The Singapore Association of Plastic Surgeons and the Chapter of Plastic Surgeons, Academy of Medicine work closely with the College of Surgeons and the Ministry of Health to constantly review safety guidelines regarding liposuction and the practice of Aesthetic Surgery. 

Under the amended guidelines (Feb 2015), all liposuction procedures are only to be performed at specialised Ambulatory Surgical Centres (ASCs) or a hospital to ensure that the facility has the necessary equipment to deal with complications.

Aspiration of less than 100 mls for fat transfer using a syringe and local anaesthesia can be done in approved medical clinics. Liposuction involving the removal of more than 2 litres of fat per session can only be performed in a hospital on an inpatient basis. When sedation or general anaesthesia is used on a patient during liposuction, an anaesthetist myst be present at all times until the patient is fit for discharge. Doctors performing liposuction must be specially accredited by the Accreditation Committee for Liposuction (ACL).

Every surgical procedure has risks and you are right to want to know what are the risks associated with liposuction. While liposuction is largely a safe procedure, it has to be done by a well-trained doctor in the right facility with adequate monitoring. Severe complications have arisen from liposuction performed in sub-optimal facilities without proper anaesthesia support.  

The common complications of liposuction include: 

  • bruising
  • swelling
  • numbness
  • asymmetry (of the area where liposuction was performed) and scars.  

Sometimes, follow-up surgery might be required, although liposuction aims to improve most of the contour irregularities in one session. I recommend the S.A.F.E Liposuction technique which helps to reduce the risk of irregularities.  

More serious complications, which are very rare but deserve mention due to its severity, include: perforation of abdominal organs. The risks of this is increased if patient had previous surgery to the abdomen or there is use of energy assisted liposuction devices.

It is important to update your surgeon on any previous operations that you may have had. Other rare complications include:  pulmonary embolism (blockage of pulmonary artery in the lungs), deep vein thrombosis, fat embolism (the blockage of a blood vessel by a fat particle), skin necrosis (death of skin tissue) and excess fluid loss leading to shock. Hence it is important to select a surgeon who is experienced and accredited to perform liposuction.

I hope this gives you a better understanding of liposuction and its risks and complications. While it is a safe procedure, it is important that it is done by well-trained surgeons and in the right facilities with the correct monitoring.

Dr. Terence Goh

Consult Doctor
0 388 views 0 Doctors agree 22 Sep 2018

In Singapore, liposuction is a special service that is regulated by the Ministry of Health. This was done to improve the safety of the procedure.

This means that patients cannot be rushed into the surgery (they have to wait 1 week between consultation and surgery), and only doctors with the required training are accredited to do it. The procedure must be carried out in an approved facility with adequate emergency facilities.

The safety has also been improved by anaesthetic guidelines that mean only qualified anaesthetic doctors can give deep sedation. These doctors are the best in dealing with life threatening situations.

Overall, it is a very safe procedure.

The risks for liposuction are small but you can get infections, bleeding, contour irregularities, asymmetry or perforation of abdominal organs.

The most dangerous complication is perforation of your organs, the risk is higher if you’ve had liposuction in that area before or if you have an abdominal hernia. Technique plays a huge part in whether this happens or not, so it’s very important that the procedure is done by a qualified plastic surgeon.

It is not easy to differentiate plastic surgeons from ‘cosmetic surgeons’ overseas. However in Singapore, doctors are not allowed to call themselves by any title they choose.

Consult Doctor
0 479 views 0 Doctors agree 6 Aug 2018
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