Proposed Liposuction Regulatory Regime

27 Apr 2008

The Ministry of Health has formulated its draft regulatory regime pertaining to liposuction.  In the proposal, MOH will regulate liposuction as a special care service under the Private Hospitals and Medical Clinics Act. Any clinic that offers liposuction must obtain prior approval from the Ministry and comply with specific licensing conditions. The licensing conditions will regulate two aspects of liposuction: the premises and the practice (See draft conditions at Annex) 

(a) Premises

2          Only liposuction procedures that (a) remove less than 1 litre of supernatant fat[1] in healthy patients, and (b) are performed under local anaesthesia, may be permitted in appropriately equipped surgical facilities of approved medical clinics.  When the above procedure is undertaken with sedation, the practitioner would, at a minimum, need to be assisted by a registered nurse. 

3          When liposuction involves (a) the removal of more than 1 litre of fat, (b) the use of general anaesthesia or (c) patients with medical conditions, the procedure can only be performed in an ambulatory surgery centre or a hospital.

(b) Practice

4          A doctor who wishes to practise liposuction must have undergone at least 1 year of surgical training following housemanship. The doctor must also have attended relevant liposuction-specific education and training (e.g. liposuction workshops), observed and performed a minimum number of liposuction procedures under preceptorship. 

5          These are broad requirements.  When evaluating individual applications for approval, the training requirements may vary depending on the total experience of the doctor and the type of liposuction he does.  For example, for less invasive procedures which are modifications of liposuction such as lipoaspiration where the volume of fat aspirated is less than 100ml, a period of 6 months of surgical training and/or relevant procedure-specific training may suffice. 

6          All practitioners must also be certified and be current in basic resuscitation (viz. Basic Cardiac Life Support) skills.

7          Practitioners with previous experience in liposuction who wish to continue to perform liposuction in their clinic will have their performance records reviewed.

8          Hospitals and ambulatory surgery centres will need to have credentialling systems in place to accredit their doctors who perform liposuction.  For a start, the training requirements mentioned above will be used as minimum standards for credentialling.

9          Every doctor who performs liposuction must have properly evaluated and counselled the patient on the procedure. 

10        We recognize that most patients seek liposuction to enhance their physical appearance.  In view of this, and as liposuction is not a procedure to treat a life-threatening condition, and yet carries some risks, MOH is proposing to make it mandatory for patients to be given a minimum15-day period to consider the procedure and risks before the procedure may be carried out. If patients have traveled from abroad for the procedure, this requirement may be waived but the doctor will need to document the evaluation and counselling process in detail.

11        All doctors who perform liposuction must do so under a quality assurance framework.  This means that the doctor must keep proper patient medical records and document his patients’ outcomes and satisfaction and any adverse events arising from liposuction.  He should also participate regularly in peer review and practice improvement programmes. 

12        MOH will audit the quality assurance programme periodically to assess the safety and quality of the liposuction services provided, which, in turn, will determine whether the licence for such services will be renewed.

13        MOH will be gathering feedback on the proposed regulatory regime for liposuction. The feedback and views gathered will be used to determine the final licensing conditions. The public can give us their feedback at moh_info@moh.gov.sg or send their comments to:

Feedback on liposuction regulation

Ministry of Health

Collegeof Medicine Building

16 College Road

Singapore 169854

Fax: 6224 1677

MINISTRY OF HEALTH

27 APRIL 2008

[1]A liquid containing a local anaesthetic and vasoconstrictor (to reduce blood loss) is usually injected into the fat layer to facilitate liposuction.  The resulting mixture of fat, blood, and liquid that was originally introduced would then be removed through suction.  If left to stand, this mixture will eventually separate out into different layers, with the fat in the upper layer.  This upper layer is called the supernatant fat.

• Annex (15 KB)