With the recent death of a man after liposuction, Tan Dawn Wei and Debby Kwong talk to doctors in this controversial multimillion-dollar industry
17 January 2010
Every year, thousands of women - and increasingly men - subject themselves to liposuction at a clinic or hospital here in a bid to attain an enviable, svelte figure.
This surgical procedure to remove fat through suction is a burgeoning multimillion-dollar industry, but not one without risks, as the recent death of property head honcho Franklin Heng has shown.
While details of what caused his death have not been revealed, it has nonetheless cast a pall on a controversial industry that has, in the last few years, been the subject of much heated debate that has split the medical fraternity and seen the Ministry of Health’s (MOH) eventual intervention.
Once the exclusive domain of plastic surgeons, general practitioners (GPs) have been getting in on the act, lured by the good money to be made. Liposuction is part of a rapidly growing $200-million- a-year aesthetic industry here.
Demand for such quick fixes has been on the rise, doctors reported, fuelled by the media, advancements in medical technology and aggressive marketing by clinics and liposuction equipment distributors.
While there are no statistics on how many liposuction procedures are done here each year, it is estimated that the number could easily be 5,000 or more.
MOH’s Accreditation Committee on Liposuction has licensed 57 doctors to perform liposuction, out of 77 doctors who applied. Of those given the green light, 36 are GPs and 12 are plastic surgeons.
These doctors say liposuction accounts for between 15 and 50 per cent of their total business, which includes other cosmetic procedures. It is a competitive business, they concede. Prices have dropped since GPs began muscling in on the action.
A liposuction procedure can cost anything from $2,000 to more than $20,000, with GPs generally charging half the price of plastic surgeons.
The competition is not just confined to Singapore. More cost-conscious Singaporeans are also choosing to get their nip and tuck in cheaper countries like Thailand, Indonesia and South Korea.
But there is insufficient awareness of the risks and complications of liposuction, and this in turn is driving people to try it, in the hope of finding an easy solution, said Dr Andrew Tay, consultant plastic surgeon at The Plastic Surgery Practice.
Liposuction is not to be taken lightly, said liposuction doctors The Sunday Times spoke to.
‘Liposuction might seem to be an easy procedure, but the reality is that complications can occur as a direct result of the procedure. Also, bear in mind there are risks related to the anaesthesia given too,’ said Dr Ivor Lim, chairman of the Chapter of Plastic Surgeons at the College of Surgeons, Academy of Medicine.
Indeed, several reports have emerged in recent years of patients who have died after liposuction.
In 2004, a 43-year-old woman in Kuala Lumpur died after removing abdominal fat by liposuction. A post-mortem revealed she died of extensive internal haemorrhaging.
In November last year, a 28-year-old woman in Washington state in the United States died after doing liposuction on her abdomen, love handles and upper arms.
She was found lying in a bed soaked with bloody fluid that leaked from 11 puncture wounds left by the liposuction tubes. The autopsy ruled that she died from acute lidocaine intoxication. Lidocaine is a nerve blocker which suppresses pain during liposuction.
But not everyone is overly concerned, especially since new-generation methods like ultrasound-assisted and water-jet liposuction have promised less invasive surgeries that are supposedly safer and come with less downtime.
Dr Kevin Teh, medical director at the Singapore Lipo, Body and Face Centre, said his patients typically go back to work or do household chores within a day or two.
‘I even had a young man do his lipo in the morning and by lunchtime was back on his computer working away,’ said the GP. He does treatments at an accredited day surgery centre where he can remove more than one litre of fat.
One of his happy clients is Ms Jelyn Yew, 25, who saved up for a liposuction on her upper and lower abdomen which she did recently. The customer service officer spent $2,900 - a steal compared to the $8,000 she would have had to pay a plastic surgeon, she said.
The 1.58m-tall woman, who weighs 50.4kg, went through a four-hour surgery and even went to a late lunch later.
She took painkillers twice a day, wore a compression garment for a month and thinks nothing of the small incisions - less than 1cm at her belly button, on her hips and groin - made for the procedure. ‘Liposuction is a safe procedure,’ she said.
But in 2008, in response to growing concern and pressure from plastic surgeons that GPs and specialists in other fields may not be equipped to handle the procedure, MOH set new guidelines which made it mandatory for doctors who want to perform liposuction to get accreditation from a new committee.
They also had to satisfy other regulations such as having at least one year of surgical training, following their housemanship, plus training in the procedure.
Those who choose to do treatments in a clinic must also have medical staff to monitor sedated patients, and can remove only up to one litre of fat per session. Anything more must be done at a hospital or a surgery centre.
Records of all cases also have to be kept and complications or complaints reported.
The Singapore Medical Association says it has received only three complaints related to aesthetics treatment since then, none of which was about liposuction.
The Singapore Medical Council received four complaints related to liposuction from 2007 to last year. It got 40 aesthetic-related complaints in the same time - a relatively small number given the total number of complaints for all medical matters from 2007 to 2009 was 349.
Doctors interviewed say they do not treat anyone who walks through the door. Generally, patients have to be healthy and have a Body Mass Index of 28 or less.
One of the biggest misconceptions about liposuction is that it can help someone lose weight.
‘It can’t,’ said Dr David Loh, a GP who specialises in aesthetic treatments, including liposuction. ‘Liposuction - any form - is purely a sculpting tool. And it is only best for small areas like love handles.’
The invasive surgery involves sucking solid fats out of the body, mostly from the abdomen, thighs, buttocks and arms. Usually performed under general anaesthesia, it typically takes a few hours and recovery follows in one to three weeks.
The tummy is the most popular spot for a fix among Singaporeans.
But potential complications could arise from the anaesthesia given or the fat removal, including bleeding, infection, prolonged swelling and bruising, contour irregularities, and even perforation of the abdominal or chest wall resulting in injury to internal organs.
All eyes will be on the outcome of the findings of Mr. Heng’s case and the industry is keeping a close watch before taking action.
Dr Vincent Yeow, president of the Singapore Association of Plastic Surgeons, which lobbied for restrictions on who could perform liposuction in 2008, said: ‘It’s unfortunate there has been a death. The industry per se is a contentious one. While there are many points of opinion, this is not an appropriate time until details are clearer as to what course of action to pursue.’
For now, all the doctors interviewed said they have not seen cancellations for liposuction procedures since Mr. Heng’s death, and are not worried that their business will be hit.
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Fat Takings
With the recent death of a man after liposuction, Tan Dawn Wei and Debby Kwong talk to doctors in this controversial multimillion-dollar industry
17 January 2010
Every year, thousands of women - and increasingly men - subject themselves to liposuction at a clinic or hospital here in a bid to attain an enviable, svelte figure.
This surgical procedure to remove fat through suction is a burgeoning multimillion-dollar industry, but not one without risks, as the recent death of property head honcho Franklin Heng has shown.
While details of what caused his death have not been revealed, it has nonetheless cast a pall on a controversial industry that has, in the last few years, been the subject of much heated debate that has split the medical fraternity and seen the Ministry of Health’s (MOH) eventual intervention.
Once the exclusive domain of plastic surgeons, general practitioners (GPs) have been getting in on the act, lured by the good money to be made. Liposuction is part of a rapidly growing $200-million- a-year aesthetic industry here.
Demand for such quick fixes has been on the rise, doctors reported, fuelled by the media, advancements in medical technology and aggressive marketing by clinics and liposuction equipment distributors.
While there are no statistics on how many liposuction procedures are done here each year, it is estimated that the number could easily be 5,000 or more.
MOH’s Accreditation Committee on Liposuction has licensed 57 doctors to perform liposuction, out of 77 doctors who applied. Of those given the green light, 36 are GPs and 12 are plastic surgeons.
These doctors say liposuction accounts for between 15 and 50 per cent of their total business, which includes other cosmetic procedures. It is a competitive business, they concede. Prices have dropped since GPs began muscling in on the action.
A liposuction procedure can cost anything from $2,000 to more than $20,000, with GPs generally charging half the price of plastic surgeons.
The competition is not just confined to Singapore. More cost-conscious Singaporeans are also choosing to get their nip and tuck in cheaper countries like Thailand, Indonesia and South Korea.
But there is insufficient awareness of the risks and complications of liposuction, and this in turn is driving people to try it, in the hope of finding an easy solution, said Dr Andrew Tay, consultant plastic surgeon at The Plastic Surgery Practice.
Liposuction is not to be taken lightly, said liposuction doctors The Sunday Times spoke to.
‘Liposuction might seem to be an easy procedure, but the reality is that complications can occur as a direct result of the procedure. Also, bear in mind there are risks related to the anaesthesia given too,’ said Dr Ivor Lim, chairman of the Chapter of Plastic Surgeons at the College of Surgeons, Academy of Medicine.
Indeed, several reports have emerged in recent years of patients who have died after liposuction.
In 2004, a 43-year-old woman in Kuala Lumpur died after removing abdominal fat by liposuction. A post-mortem revealed she died of extensive internal haemorrhaging.
In November last year, a 28-year-old woman in Washington state in the United States died after doing liposuction on her abdomen, love handles and upper arms.
She was found lying in a bed soaked with bloody fluid that leaked from 11 puncture wounds left by the liposuction tubes. The autopsy ruled that she died from acute lidocaine intoxication. Lidocaine is a nerve blocker which suppresses pain during liposuction.
New procedures
But not everyone is overly concerned, especially since new-generation methods like ultrasound-assisted and water-jet liposuction have promised less invasive surgeries that are supposedly safer and come with less downtime.
Dr Kevin Teh, medical director at the Singapore Lipo, Body and Face Centre, said his patients typically go back to work or do household chores within a day or two.
‘I even had a young man do his lipo in the morning and by lunchtime was back on his computer working away,’ said the GP. He does treatments at an accredited day surgery centre where he can remove more than one litre of fat.
One of his happy clients is Ms Jelyn Yew, 25, who saved up for a liposuction on her upper and lower abdomen which she did recently. The customer service officer spent $2,900 - a steal compared to the $8,000 she would have had to pay a plastic surgeon, she said.
The 1.58m-tall woman, who weighs 50.4kg, went through a four-hour surgery and even went to a late lunch later.
She took painkillers twice a day, wore a compression garment for a month and thinks nothing of the small incisions - less than 1cm at her belly button, on her hips and groin - made for the procedure. ‘Liposuction is a safe procedure,’ she said.
But in 2008, in response to growing concern and pressure from plastic surgeons that GPs and specialists in other fields may not be equipped to handle the procedure, MOH set new guidelines which made it mandatory for doctors who want to perform liposuction to get accreditation from a new committee.
They also had to satisfy other regulations such as having at least one year of surgical training, following their housemanship, plus training in the procedure.
Those who choose to do treatments in a clinic must also have medical staff to monitor sedated patients, and can remove only up to one litre of fat per session. Anything more must be done at a hospital or a surgery centre.
Records of all cases also have to be kept and complications or complaints reported.
The Singapore Medical Association says it has received only three complaints related to aesthetics treatment since then, none of which was about liposuction.
The Singapore Medical Council received four complaints related to liposuction from 2007 to last year. It got 40 aesthetic-related complaints in the same time - a relatively small number given the total number of complaints for all medical matters from 2007 to 2009 was 349.
No weight loss
Doctors interviewed say they do not treat anyone who walks through the door. Generally, patients have to be healthy and have a Body Mass Index of 28 or less.
One of the biggest misconceptions about liposuction is that it can help someone lose weight.
‘It can’t,’ said Dr David Loh, a GP who specialises in aesthetic treatments, including liposuction. ‘Liposuction - any form - is purely a sculpting tool. And it is only best for small areas like love handles.’
The invasive surgery involves sucking solid fats out of the body, mostly from the abdomen, thighs, buttocks and arms. Usually performed under general anaesthesia, it typically takes a few hours and recovery follows in one to three weeks.
The tummy is the most popular spot for a fix among Singaporeans.
But potential complications could arise from the anaesthesia given or the fat removal, including bleeding, infection, prolonged swelling and bruising, contour irregularities, and even perforation of the abdominal or chest wall resulting in injury to internal organs.
All eyes will be on the outcome of the findings of Mr. Heng’s case and the industry is keeping a close watch before taking action.
Dr Vincent Yeow, president of the Singapore Association of Plastic Surgeons, which lobbied for restrictions on who could perform liposuction in 2008, said: ‘It’s unfortunate there has been a death. The industry per se is a contentious one. While there are many points of opinion, this is not an appropriate time until details are clearer as to what course of action to pursue.’
For now, all the doctors interviewed said they have not seen cancellations for liposuction procedures since Mr. Heng’s death, and are not worried that their business will be hit.
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