Women with lipedema in the legs live with unbearable pain and invisible symptoms. We need to raise awareness in Singapore so patients can get proper care.
May 15, 2025
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Fat transfer, also known as fat grafting, is a procedure that harvests fat via liposuction. It is then placed in a centrifuge where the fat cells are separated from the non-fat ones. The fat is then injected, using small cannulas, into areas where volume is needed.
What is interesting, and at the same time makes this procedure viable, is that the fat (re)used is from the patient themselves. This reduces the likelihood of tissue rejection. Fat grafting can be done on the breasts, buttocks, face, feet and even hands and is also used in corrective surgeries for botched liposuction, body deformity and scarring from other surgeries.
Fat grafting has been piquing interest since its invention. As such, many questions have been raised by interested individuals.
To learn more about this "miraculous procedure," here are ten things about fat grafting or fat transfer.
#1 You can transfer your fat from anywhere with excess fat pockets to any part of your body, even your hands!
Fat grafting can be done in many areas, and opting for the procedure to increase one's breast size seems to be a common trend among women. Fat grafting or fat transfer for breast augmentation is an example of such a procedure. This 2-in-1 treatment provides a natural method to increase the cup size. It is lauded to be an ideal alternative to breast implantation, as the fat utilised is from the patient's own fat source. Breast enhancement via fat transfer for women is also popular among those who have lost volume in the breast due to breastfeeding.
Aside from the breast, fat transfer to the face is also a popular treatment. Some people need some "plumping up" of the face to restore lost volume, and according to a survey by the American Society of Plastic Surgeons, fat grafting for the face was up by 22 percent in 2017.
#2 The key to a successful fat grafting procedure lies in the doctor's technique
A doctor's experience, skills and qualifications are essential factors to consider for fat grafting. Patients must do comprehensive research on their shortlisted doctors. Only doctors who have received liposuction accreditation from the Ministry of Health Singapore can perform fat grafting procedures on patients in Singapore. The doctor should also have a good artistic sense and, at the same time, put the patient's safety as the priority. This is so they can deliver results without compromising the patient's health.
Dr Ivan Puah, Medical Director of Amaris B. Clinic, believes that it is "70% art and 30% science" when it comes to body-sculpting procedures. A doctor with a sense and appreciation of aesthetics can visualise and deliver natural-looking results that complement a patient's overall physique.
Dr Puah has more than 20 years of clinical experience – over 17 years were spent performing surgical body contouring procedures, and medical aesthetics procedures such as dermal fillers, skin lasers and others. He is trained in Vaser Liposuction in Colorado and Argentina. Dr Puah is also certified to carry out laser liposuction after completing his surgical training in Italy and further honed his gynecomastia surgical skills in San Francisco.
Dr Puah always prioritises his patients' safety and wellbeing by adopting a meticulous approach. As an accredited doctor by the Ministry of Health Singapore, Dr Puah is licensed to perform surgical body sculpting procedures such as liposuction, Vaser Liposuction, Laser liposuction, and fat grafting in Singapore.
#3 Fat grafting is more than just a copy and paste kind of surgery - it is a work of art
On the surface, many would assume that fat grafting is a simple "copy and paste" procedure - obviously a wrong assumption. Fat transfer is a delicate and procedure made to look easy in the hands of a skilled and experienced doctor.
Excess fat is removed from the donor site(s) during the procedure, where it exists in abundance. These include the thighs or stomach. This extraction is done via a cannula through small incisions made on the site(s). It takes more than just steady hands for a doctor. The doctor must understand facial and body anatomy, particularly his patients. He must gauge the amount of fat needed to be extracted and inserted. A good anatomical understanding, knowledge and years of experience enable a doctor to sculpt the desired results, akin to a sculptor working on his masterpiece.
This approach applies to all body parts because a well-crafted and overall balanced appearance ultimately pleases both the beholder's eye and that of objective ones.
#4 Fat injection (with your excess fat) works better than dermal fillers for your face
Using a patient's own body fat is a 2-in-1 bonus. Patients get to reduce excess fat in problematic areas and fill areas where it is much needed. The risks of tissue rejection and the occurrence of allergic reaction is minimal as compared to dermal fillers, where synthetic materials are involved.
The retention rate of fat transfer, in general, is between 60% to 70%. Like dermal fillers, fat grafting is an effective treatment to help retard signs of skin ageing. However, it is important to remember that facial fat grafting, like other cosmetic and aesthetic treatments, cannot prevent future ageing.
When the procedure is done under the hands of a skilled and experienced doctor, the patient can expect the fat filling to be injected in just the right amounts, achieving natural-looking results that will complement her overall facial contour. An aggressive fat filling is discouraged; although it can improve the contour and gives a smooth skin surface, it generally results in a large, overfilled look that appears unnatural and unfeminine.
For a patient, the difference between good and bad lies between a look of admiration and a stare of horror from others.
#5 Fat grafting/Fat injection is great at creating volume and contouring
Facial fat grafting is often used to correct sunken and hollow eyes and dark eye circles due to fat loss around the eyes and sagging cheeks. Other facial areas treatable with this procedure include temples, forehead, brow, glabella, radix, upper orbit (upper eyelid), cheeks, mid-face, buccal recess, jawlines and many others.
The best way to determine where the loss of facial volume occurs is for the doctor to conduct a thorough facial assessment of the patient and identify areas requiring grafting.
#6 Fat grafting/fat transfer is a more popular treatment to replace volume loss and counter ageing in Singapore
Fat grafting is gaining popularity in Singapore and worldwide as it can counter volume deflation (fat loss) over time and counter the signs of facial ageing. Although facial wrinkling and sagging are treatable by injecting both neurotoxin injectables and dermal fillers, the results are temporary. Using either treatment modality alone cannot restore the plump and youthful quality of the face that is possible with fat grafting.
It works well for the face, but fat grafting has also allowed many post-breast feeding mothers, women with asymmetrical breast shapes, and small or sagging breasts due to ageing, to restore body confidence. When done correctly under a pair of skilled hands, the fat grafting results are consistent and longer-lasting. Patients can achieve body sculpting and breast enlargement in one session by removing excess body fat and reusing it to increase cup size.
#7 Fat grafting is not done in the name of vanity but also for confidence restoration
A patient's needs and concerns should always take precedence. Based on these, a doctor should advise on what is realistically possible.
There are many reasons why a person is seeking aesthetics and cosmetic treatments. Dr Ivan Puah, who has seen patients from diverse backgrounds and different reasons for walking into his clinic, such as to correct botched lipo jobs done in Singapore or overseas, cites self-confidence and major life-changing personal events as two of the more common ones. He treats each of them with a personalised approach because he knows that wanting to proceed with cosmetic surgery is a significant and, at times, nerve-racking decision.
One of the prerequisites of an attending doctor is a good, non-judgmental listening ear. He should also be able to alleviate any concerns that a patient has and earn their trust.
#8 Fat grafting for buttocks to get perkier bums
Although fat grafting to the breasts is more popular than fat transfer to the buttocks, according to 2016 Annual Statistics, fat grafting to the buttocks is fast rising to be one of the most sought-after cosmetic surgeries. The stats showed that buttock augmentation with fat grafting had increased 26% more than the previous year, compared to buttock enhancement with implants which only increased by 18%.
The "Brazilian Butt Lift" is another term for buttock enhancement with fat grafting, where excess fat from a patient is transferred into the derriere to achieve a fuller, more rounded appearance. This 2-in-1 body sculpting treatment also contours your overall body shape and gives your buttocks a perkier shape and a more harmonious outlook.
#9 Fat (adipose tissue) is your ideal filler for rejuvenation and enhancement
Fat or adipose tissue is the closest, most ideal filler for volume restoration on the face and body and facial rejuvenation to counter ageing. It is readily available and obtainable from the patient with low donor-site morbidity. It is repeatable as long as the patient has enough fat stores for the doctor to draw from.
Needless to say, it is biocompatible as it is from the patient's own fat source. The versatility of fat allows the doctor to use it for cosmetic purposes and correct scars, corrective liposuction, and gynecomastia cases.
#10 Not all doctors in Singapore can perform fat grafting procedures
Getting fat grafting done is more than just a simple matter of walking into a clinic. You don't walk into a fast-food restaurant expecting a meticulously-prepared gourmet meal; you're not part of their demographic, and they are not what you're looking for to suit your pressing intention.
It can never be reiterated enough that a doctor needs to be qualified and experienced. Because it involves fat extraction via liposuction, he must be accredited by the Ministry of Health Singapore to perform fat grafting procedures in Singapore. Like any other surgical procedure, fat grafting also has risks and possible complications. Therefore you must seek a doctor who can give you a detailed consultation and assessment, who is experienced in body sculpting, facial and body enhancement is well-documented with proven results. A doctor who has surgical experience will be able to show you different varieties of cases they have performed, including corrective cases, not just one or two before and after pictures.
The correct technique (and being good at them) is important in fat transfer. Remember always to thoroughly research your shortlisted doctors and ensure that all your concerns and worries are alleviated during consultation.
How can I maximise my fat transfer results?
Preparing oneself for a procedure is an important and crucial part of the bigger picture, such as maximising results. A patient has to commit from the start, and self-preparation can help reduce risks and enable the doctor to perform his part efficiently.
Some things to do and not to do include:
Staying off cigarettes
One of the many downsides of smoking is that it affects the delivery of vital nutrients and oxygen in the body. This disruption leads to issues in tissue healing and repair. A transferred fat needs vital nutrients to survive, and smoking harms this need significantly, resulting in non-results or worse. Refrain from smoking in the weeks leading to the procedure. Not only is it highly recommended, but it may help a person quit the habit.
Hold off on strenuous exercises
Be patient and restrain yourself from engaging in strenuous exercises during the recovery phase. Light exercise such as walking is good to go. Once the fat tissue has properly settled and the doctor approves, a patient can start engaging in a higher-intensity exercise. Heed the doctor's advice.
Maintain a stable weight
Maintaining a stable or healthy weight is a challenge for many —fluctuation in weight before a procedure can affect results. Be mindful of one's food intake and ask the doctor for advice, if needed.
