When losing fat gains you a whole load of trouble
Tuesday • March 11, 2008
THEY offer shortcuts to weight loss at cheaper rates. But as more general practitioners (GPs) enter the growing market for liposuction in Singapore, the problems that arise are proving a costly burden for unwary consumers.
Today understands that the number of complications following liposuction procedures — such as patients going into shock from too much blood loss — is on the rise, with at least one near-fatal incident.
Last week, Health Minister Khaw Boon Wan told Parliament that the Ministry of Health had "unconfirmed feedback" of complications from liposuction done in some outpatient clinics. When contacted, the ministry said it could not comment as "there is a case which is currently under Singapore Medical Council investigation".
Echoing the view of most plastic surgeons Today spoke to, Dr Hong Soo Wan said liposuction was "safe if done properly under well-trained hands in a proper manner" but under inexpert hands, the risks increase.
Infection, for example, could set in if the facility is not sterile or well-equipped, or if the surgery is not done properly.
More common are patients who turn to plastic surgeons for revision surgery — on average, five or six cases in the past year, compared to one or two the year before. At the extreme end of the scale, plastic surgeon Dr Woffles Wu saw as many as 30 cases of botched liposuctions performed by GPs within the past year.
Results include irregular contours, scarring or skin rippling from too much fat removal, said fellow professional Dr Ivor Lim. His patients — women from their late-20s to mid-40s, some of whom are foreigners — were too scared to go to their original doctor and required "a lot of hand-holding" when they consulted him for revision surgery.
Said Dr Lim: "This is affecting our national credibility as a medical centre of excellence. Foreigners think because we are so tightly regulated, if a GP says he's trained, he should be qualified."
Prices advertised by GPs are one huge draw. While plastic surgeon Dr Martin Huang charges "well over $10,000" for a patient who wants "a lot of work done," he estimated a GP's fee would be half that.
But as one secretary in her mid-20s discovered, this can prove a costly gamble. She paid a four-digit sum to a GP for a liposuction procedure — then another five-digit fee to correct the results, after discovering uneven contours along her thigh.
"The doctor claimed he was trained in liposuction. When I raised the issue, the clinic kept saying it would go away," she told Today. It did not even after two years.
So, should GPs and other specialists be allowed to undertake plastic surgery? Or should Singapore go the way of France and Malaysia, which have made it illegal for non-plastic surgeons to perform such procedures?
Some say this call by plastic surgeons for more regulation is motivated by a turf war. There are 35 registered plastic surgeons here and more than 1,400 GPs.
"Plastic surgeons seem to think that GPs and other specialists are invading their turf," said a gynaecologist who also performs cosmetic surgery and liposuction.
"We need to move away from the mindset that you need years of training to perform plastic surgery. Doctors go for a weekend course, but also educate themselves at home. Some train overseas under plastic surgeons, some even practice on dead bodies."
Another GP with training in aesthetics said: "Complications can arise from all forms of surgery, sometimes from the doctor's lack of skills, other times from the suitability of the procedure for the patient."
He has "heard and seen first-hand" the problems arising at the hands of GPs and plastic surgeons.
He added that with newer drugs for local anaesthesia and newer techniques, certain liposuction procedures can be performed in the outpatient setting — with backup plans to evacuate to the nearest hospital if needed.
But Dr Wu is adamant — he points out that while specialists may have surgical training, it is not in plastic surgery.
Dr Huang noted that with many GPs now calling themselves aesthetic physicians or cosmetic surgeons, patients could be misled into thinking they are plastic surgeons.
"We are not saying you can't do this work, but get trained and qualified. Become a bona fide plastic surgeon."
Playing it safe
Check the list of registered plastic surgeons at the Singapore Medical Council website.
A qualified one should have a Fellow of the Academy of Medicine, Singapore (FAMS) in plastic surgery.
Get a fully qualified anaesthetist.
Understand what results to expect from the procedure, eg before and after photos of the surgeon's work.
Provide your doctor with a full medical history.
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Is this MOH's way of making their displeasure known? Let the media "expose" the GPs & stir up the masses before putting their foot down on aesthetics practice by GPs? I wouldn't be surprised. It seems to be the path they are taking .