Using unwanted fat to enhance your curves

The triceps are a problematic area as the skin here does not contract well after liposuction and may turn out flabby, says Dr Lee. — 123rf

Fat is gold, says consultant plastic and aesthetic surgeon Dr Lee Kim Siea.

“The more fat you have, the more ‘gold’ you have, because it is very useful to enhance other body parts.

“There is no technology to freeze and store fat cells, and since they cannot be transferred to another person, why let it go as medical waste?

“For example, if a patient has a big buttock, but it is flat, i.e. there is no curve at the back (side view), they still won’t look nice after liposuction.

“So we put the fat back into this area of the buttock to create a natural curve,” he says.

This procedure is called liposculpture or lipofilling.

Unlike traditional liposuction, which focuses on debulking large areas, liposculpture involves precise sculpting by transferring fat to other areas such as the breast, buttocks and face to enhance curves or define underlying muscles.

In fact, fat cells can also be transferred to the scalp to help stimulate hair growth!

This procedure – often called nanofat or stem cell-enriched fat injection – involves harvesting a small amount of fat from an area like the abdomen or thighs, processing it to isolate stem cells and growth factors, and then injecting it into the scalp to improve hair follicle health and encourage new hair growth.

It can’t be done

There are many cases of patients bringing in pictures of how they want their body parts liposculpted, but Dr Lee knows when these are unrealistic expectations.

Ladies, he says, tend to be obsessed with reducing big thighs.

“You cannot change what you are born with, so if you are born with big thighs and want slim ones, it’s not possible.

“Some people also have well-defined, large thigh muscles, and we cannot create a space between the thighs.

“Others want to trim their calves, but the calves are largely muscle, so it’s better to use botulinum toxin injections, although you need to do it every six months and it can be expensive,” he points out.

Another problematic area for women is the triceps (which forms the back of the upper arm).

Dr Lee says: “The skin in the tricep area cannot contract well, and if you suck too much fat, it will turn flabby.

“To remedy this problem, we may need to cut the excess skin, but the patient will end up with a long scar, which they cannot accept.

“So, this area is a source of unhappiness for many women.”

For men, it’s always the tummy they want flattened.

Here’s where Dr Lee and his team check whether the fat is under the skin or inside the abdomen (visceral fat).

“We do a rough assessment via a pinch test.

“If we can pinch more than 2cm, then there is extra fat that we can remove.

“If it is less than 2cm, then we know the fat is not under the skin so they have to try losing weight.

“Of course, we also evaluate the patient’s mental state,” he says.

‘Remove it all!’

Often, patients want to suck out fat from multiple areas in one setting and get upset when Dr Lee advises against it.

He explains: “It’s best to do the procedure over two or three sessions, but they complain it is expensive.

“Similar to losing weight naturally, if you lose 20kg in two months, you will have loose skin everywhere.

“To eliminate this problem, wait six months before doing it again – but people are always in a hurry.”

And no, surgeons cannot suck out 100% of the fat in a specific area.

“We can only suck out so much without endangering their lives.

“When we suck out fat, we are going to break some blood vessels and some people are more prone to bleeding, so you end up with quite a lot of blood.

“If the fat aspirated is mostly red (which means it is mixed with a lot of blood), we stop, but if it is nice and yellow, we keep going,” he says.

Dr Lee emphasises that liposuction is not a solution for obese individuals.

“If you weigh 100kg and I take out 4kg, you will still be big at 96kg.

“For the ones who have tried and cannot lose weight, we contour the area they want so they have more motivation to continue losing weight,” he says.

One of the problems with liposuction is that the skin will become loose, so it’s not ideal for older patients.

“Skin has a lot of capability to stretch and shrink, so skin elasticity is important – when you’re younger, your skin can contract better.

“We find the optimum solution for patients,” he says.

Remember that liposuction is an injury to the body and there will be pain, but you can control this via painkillers.

Dr Lee says: “The mindset and pain threshold is important.

“Patients must be fit – you can have a medical condition, but it must be well controlled.“

They have to understand the whole procedure – the body needs time to recover from the swelling and bruises.

“It’s not a solution for you if you are not going to exercise or control your diet.”

Unfortunately, he does get customers requesting liposuction of the same area again.

“They don’t always follow our advice and instructions.

“There is no limit as to how many times you can do liposuction – it’s only the pocket that is the limit!” he says, laughing.