1 Am I a good candidate for liposuction?
A full medical history and physical examination will help decide that. You are a good candidate if you are physically fit for surgery and have pre-existing medical conditions such as high blood pressure and diabetes under control. You should be close to your ideal body weight and have only pockets of fat that resist diet and exercise. You should also have good skin elasticity so the skin can shrink properly afterwards.
2 Why is liposuction not appropriate for obese individuals?
Liposuction removes only fat below the skin, called subcutaneous fat. It does not remove a deeper layer of fat in the abdomen that surrounds the organs, called visceral fat, which increases the risk of developing heart disease when there is too much of it. So liposuction is not a treatment for obesity or used as a means of weight control. People who are morbidly obese and have a body mass index – a measure of a person’s weight in relation to height – of above 35 are usually rejected for liposuction. The obesity is a sign of an unhealthy lifestyle which would predispose them to weight gain after the procedure. Such patients are advised to lose weight first and return for the procedure only to shed the last 3kg to 4kg. They may also consult a bariatric surgeon to consider lap band surgery, which reduces the size of the stomach and therefore food intake.
3 How do I choose a good doctor?
Since 2008, all doctors who wish to perform liposuction in medical clinics, except those employed by hospitals, need to be accredited by a committee set up by the Ministry of Health (MOH). The ministry lets hospitals accredit their own doctors for performing various kinds of operations, including liposuction. About 50 doctors – 38 general practitioners and 12 plastic surgeons – from 33 medical clinics are accredited. Those who are practising are listed at www.street-directory.com/moh/index2.htm.
4 What should I ask my doctor about the procedure?
Ask about his qualifications, training and experience with liposuction. Get him to share how well his patients have done, their pre- and post-operation photos and if these patients have had any complications. Ask about the type of machine or technology which the doctor will use. Most importantly, discuss your goals with the doctor so you can both reach an understanding about what can realistically be achieved. Accept that liposuction does not make everyone a supermodel.
5 What is the maximum amount of fat that can be removed in a single procedure?
There is no hard and fast rule as it depends on the patient’s height, weight and overall fitness. Small-volume liposuctions can be performed as day surgery, but procedures that remove above 3 litres of fat will usually require a night’s stay at the hospital for observation. MOH says liposuction can be performed in medical clinics only if it removes less than a litre of fat per session and does not involve general anaesthesia. Otherwise, the procedure has to be done in a day surgery centre or a hospital operating theatre.
6 What should I know about the possible risks and complications?
After liposuction, there may be some bruising and scars which will diminish over time. A common complaint is skin irregularities which may be improved with massage therapy or may require more surgery to re-inject fat into the area and smooth out the unevenness. Severe complications that can turn fatal include perforation of an internal organ and fat embolism, a condition in which fat cells get into the blood vessels, travel to the lungs and cause a blockage. These risks are present for both small- and large-volume liposuction procedures.
7 What happens if I gain weight after the procedure?
Your genes determine how many fat cells you are born with. These increase in quantity until the person reaches the end of puberty. When a woman is pregnant, the number of fat cells will increase again in order to store fat for her child. Liposuction essentially reduces the number of fat cells present in the treated area. But as each fat cell in the body has the ability to increase 20 times in size – from 0.8 microns to 16 microns wide – a person can still get fat in the same area as the remaining cells can expand. Therefore, it is important for patients to maintain their weight to achieve long-term results from liposuction.
Source: Dr Andrew Khoo, plastic surgeon at Mount Elizabeth Medical Centre; Dr Karen Sng, president of the Singapore Society of Cosmetic (Aesthetic) Surgeons; Professor Walter Tan, a specialist in plastic surgery at Raffles Hospital; Ministry of Health