Specialist Q&A , Medical Care , Aesthetics
Dr Ivan Puah looks at why men opt for body sculpting – and how it can go (and has gone) wrong, including results such as scarring and lumpiness (and a side effect of fat freezing known as paradoxical adipose hyperplasia).
Body sculpting and liposuction are being used by men (as well as women) to get them into a shape they feel good about. It’s obviously important that you come out looking better than when you went in! Unfortunately, there have been plenty of botched liposuction procedures and also fat freezing and cosmetic procedures that have gone wrong. Many of the ones being corrected here in Singapore were carried out in different countries, including “medical tourism” destinations.
It's good to know that the Ministry of Health (MOH) in Singapore has tightened its restrictions and accreditation criteria; according to Dr Ivan Puah, Medical Director of Amaris B. Clinic, “Singapore now has one of the most stringent policies in the world, to ensure patient safety and maintain the highest standard of care for patients.” But you may be surprised to know that there are also many botched liposuction cases in Singapore - happening right under our nose!
Here, Dr Puah looks at why men opt for body sculpting – and how it can go (and has gone) wrong, including results such as scarring and lumpiness (and a side effect of fat freezing known as paradoxical adipose hyperplasia). Plus, he explains what to look for in a doctor before you make a decision.
There are many common reasons for wanting to undergo treatments such as VASER Lipo or VASER Hi-Def Lipo. These include a desire to boost self-esteem and confidence, improve overall health, permanently remove stubborn fat from specific body parts (particularly those resistant to diet and exercise) and achieve a more sculpted appearance.
Gynecomastia is a medical condition that affects men not only physically, causing them pain and discomfort, but more importantly mentally, affecting their psychological wellbeing and self-confidence. As many as 60 to 70% of men worldwide in certain age groups may suffer from gynecomastia. The good news is that gynecomastia is treatable with gynecomastia surgery.
"It is important to zoom into the intent of the patient for wanting to improve themselves. Mostly, they have thought it over carefully, are in good health and have good self-esteem, and they understand the risks of the procedure they’re considering. Patients seek cosmetic procedures for a multitude of personal reasons that are beyond vanity," says Dr Puah.
Most of his patients who are satisfied with their body sculpting experience, whether it's VASER Lipo, VASER Hi-Def Lipo or gynecomastia surgery, continue to upkeep their appearance by adhering to a better lifestyle, including exercising regularly and eating more nutritiously.
The doctor who performs the body sculpting procedure plays a critical role in achieving satisfactory results for the patient, according to Dr Puah. To do so, he or she needs to have a 3D artistic understanding of the anatomical and surgical adipose layers, and a practical application of scientific knowledge with artistry and precision. It’s a skill that is attained only with vast amounts of surgical experience. Often, botched liposuction results are due to under-correction and over-correction.
Secondary liposuction may improve under-correction to achieve a more proportionate appearance. On the other hand, over-correction results in excess fat being removed – more than the desired contour line – causing noticeable indentations and skin irregularities such as depressions, bumps, dents and asymmetries.
Dr Puah has noticed a rise in failed results, such as botched liposuction and gynecomastia surgery, among patients who had their cosmetic procedures or body sculpting is done overseas. Popular medical tourism destinations for those in Singapore include nearby Malaysia, South Korea, Thailand and even China.
The primary reason for beauty tourism is the relatively lower cost of cosmetic procedures, plus the opportunity to explore the host city or country after getting a treatment done. However, the lack of stringent regulations and clinical standards is often overlooked or doesn’t pose a deterrent. These inadequacies can lead to the need for revisionary work and additional corrective treatments, which may mean additional expense.
According to Dr Puah, patients who have been through such experiences frequently complain of a lack of medical follow-up, miscommunication, improper preparation and incomplete procedure counselling. Despite these real and unfortunate experiences, he says there was an alarming rise in botched procedures in 2019, before travel restrictions put a hold on medical tourism.
Don’t opt for a procedure just because it’s cheap or the cheapest option. Dr Puah says the aim is to get the most appropriate procedure done to best suit your needs without incurring unnecessary risks to your health and wellbeing.
Finding the right VASER Lipo doctor in Singapore who has trained to perform liposuction is only the beginning. It's crucial to find a doctor who not only performs the procedure regularly but who can also consistently achieve a high patient satisfaction rate. Do check out the before and after photos of cases performed by your doctor; they'll show clear indications of results. After accessing your condition and medical history, they should give you an uncomplicated and straightforward explanation of the recommended treatment.
The Ministry of Health in Singapore is strict about which health professionals are allowed to perform liposuction. This is why they issue liposuction licences to doctors based on strict criteria; only a certified, recognised and accredited doctor is permitted to perform liposuction in Singapore.
If you’re unhappy with the results of your liposuction procedure, it may be possible to undergo revision surgery. This is sometimes known as liposuction correction, it’s a further surgery carried out with the intention of addressing the issues.
For uneven lipo, fat injections or grafting can fill out the uneven fat below the skin, and excess tissue can be taken from elsewhere on the body and transferred to the dimpled area to fill, patch and smooth out the dents.
In Singapore, healthcare professionals who perform liposuction without accreditation or the proper compliance to licensing conditions face stern action.
Liposuction is a delicate procedure, says Dr Puah. When done right, it can significantly improve the confidence and outlook of the patients. When it goes wrong, it can result in a body shape that looks worse than it was in the beginning. "One of the main reasons a person opts for liposuction is to correct disproportionate body fat distribution and to improve their body confidence. Therefore, the psychological effects of a procedure gone wrong can be devastating. These include anxiety and low self-esteem and body confidence, among others that I’ve seen in patients who have sought correction surgeries with me."
Dr Puah adds that, apart from honing the necessary skills to perfect the results for patients, a liposuction doctor must be ethical. They need to possess an equal blend of empathy to understand a patient's needs, concerns and worries, and professionalism to provide the best advice and solution to alleviate concerns and help the patient achieve a realistic goal.
Choosing a liposuction doctor based on the price tag, forgoing their reputation, experience and surgical approaches, often results in patients having to undergo secondary surgery or live with the aftermath of poorly performed liposuction.
Before you schedule an appointment for liposuction in Singapore, it’s crucial to only source a credible and experienced liposuction doctor accredited by the Ministry of Health. Dr Puah is accredited by the MOH to perform liposuction, including SmartLipo and VASER Lipo in Singapore. He obtained his VASER Fundamental and Advanced Body Sculpting training in Colorado and Argentina, with further training in laser lipolysis in Italy and gynecomastia surgery in San Francisco.
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