How to Spot if I have Lipedema? Self-Diagnosing Lipedema at Home
Lipedema is not weight-related but it can coexist with obesity and is often confused by other conditions. Here's how you can identify & self-diagnose lipedema.
April 17, 2025
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WHAT IS UAL (VASER LIPOSUCTION) & WHAT DOES IT DO?
UAL (Vaser Liposuction) is a liposuction technique that utilises ultrasonic energy to break down giant fat cells in the deep fat deposits, while preserving normal size fat cells in the superficial subdermal fat layer, producing a smooth body contouring result. UAL delivers ultrasonic energy internally and directly to the fat deposits via a probe, liquefying the unwanted fat into a “buttery” consistency. This allows the liposuction doctor to suction the fat out easily while leaving the important connective tissues relatively undisturbed.
VASER [1, 2, 3, 4, 5, 6, 7] (Vibration Amplification of Sound Energy at Resonance) Liposuction, developed by two plastic surgeons, Dr John Millard and Dr Alfredo Hoyos, has become another method of liposuction.
Dr Ivan Puah has been performing this form of liposuction technique for close to two decades in Singapore.
How Does UAL (Vaser Liposuction) Work at Amaris B. Clinic?
Dr Ivan Puah carries out UAL (Vaser Liposuction) and all other forms of liposuction, such as Laserlipolysis (Laser Liposuction), Modern Liposuction with MDC-Sculpt®️ Lipo Technique and 4D Liposuction (Hi-Definition Lipo) for his patients in an accredited Day Surgery Center. Local anaesthesia with twilight sedation (not GA) will be administered during the procedure, meaning the patient has a shorter recovery period and lower post-operative discomfort.
MAJOR ADVANTAGE OF UAL (VASER LIPOSUCTION)
One major advantage of UAL (Vaser Liposuction) [8, 9, 10] over traditional liposuction is that it is a gentler fat removal technique as fat is liquefied before it is removed, reducing the tugging, tearing and pulling that occurs with traditional liposuction.
UAL (Vaser Liposuction) utilises ultrasound waves to selectively destruct fat cells by means of emulsification and enhances skin tightening which is not achievable by traditional liposuction. The degree of skin firming following UAL (Vaser Liposuction) will depend on the patient's age and skin quality.
What is the typical recovery time for UAL (Vaser Liposuction)?
Compared to traditional liposuction, the recovery time from UAL is faster, and the patient can return to the daily routine within 2 to 3 days. Recovery from traditional liposuction may take 10 to 14 days and requires at least 24 hours of inpatient care (hospitalisation) post-op.
Can UAL (Vaser liposuction) effectively remove stubborn fat from specific areas?
UAL (Vaser Liposuction) can remove stubborn fat from almost any body part, such as the abdomen, back, waist, thighs, hips, male chest, buttocks, arms, armpits, neck, knees and calves.
The liquefied fat that has been removed can be further repurposed to parts of the face or body that require enhancement
Pseudogynecomastia
Pseudogynecomastia is characterised by the presence of excess fat deposits on the male chest, without glandular tissue enlargement. For those with pseudogynecomastia, the initial approach typically involves weight management and regular exercise.
However, if chest fat persists despite these efforts, the recommended course of action is often a surgical procedure such as UAL (Vaser Liposuction) or Modern Liposuction with MDC-Sculpt®️ Lipo Technique.
outer thighs (saddlebags) & inner thighs
The outer and inner thighs are areas where stubborn fat is known to accumulate and is hard to get rid of. For example, women with a particular genetic predisposition to have a pear body shape are susceptible to excess fat stored in these areas.
The pear body shape is characterised by large hips, which are wider than the bust and shoulders, making it difficult to fit into jeans, skirts or shorts. A sedentary lifestyle, poor dietary habits and estrogen dominance are also known causes.
UAL (Vaser Liposuction) is recommended for volume reduction on the outer thighs, inner thighs and knees as it provides significant aesthetic improvement of the leg silhouette, creating an “elongating” effect, and improving the proportions of the lower extremities.
abdomen (muffin top) and waist
The abdomen is one of the most common areas of concern for both men and women.
The accumulation of belly fat can be the result of ageing. This accumulation usually results in the "muffin top" appearance.
arms (bingo wings)
The 'bingo wings' is another that is dreaded by many. This wobbly and less-than-flattering loose flesh found on the upper arms is a common occurrence, and one of the causes is genetics.
Some people are, therefore, more predisposed to them because they tend to store more fat in the affected area. UAL (Vaser Liposuction) of the arms produces the most visible cosmetic result of arm slimming as well as skin firming.
armpit fat
Armpit fat or axillary fat is common among adults and often caused by excess weight, although hormones and genetics may also play a role.
There are no spot reduction exercises to rescue its appearance. The most effective solution is to surgically remove the fat via liposuction.
back fat
Back fat, often resulting in the appearance of "back rolls," is a common concern for many. It can be attributed to various factors, including ageing suboptimal nutrition, hormonal changes, genetic predisposition, and excess weight.The presence of back rolls can lead to self-consciousness.
In such cases, UAL (Vaser Liposuction) proves to be an effective solution for targeting and addressing stubborn back fat.
"Paradoxical Adipose Hyperplasia" (PAH)
Cryolipolysis (fat freezing) is a non-invasive fat reduction treatment that freezes fat, which is then removed via the body's natural elimination process.
A serious side effect of fat freezing is "Paradoxical Adipose Hyperplasia" (PAH). Although rare, it is not uncommon. Due to its appearance, it is also known as the "stick of butter" effect.
It happens when the treated areas increase in size instead of shrinking. They also become firmer compared to the surrounding tissues. Liposuction is the only remedial option.
UAL (VASER LIPOSUCTION) VERSUS CONVENTIONAL LIPOSUCTION
The origins of liposuction date back to the 1970s. Advances in technology and techniques have made liposuction safer, more effective, and less invasive. Below are the differences between traditional liposuction and UAL (Vaser Liposuction).
Scroll to view the table
| Treatments | Conventional Liposuction | UAL (VASER LIPOSUCTION) |
|---|---|---|
| Technique | Uses a manual cannula to break down fat and a vacuum suction device to suck out the fat | Ultrasonic-assisted liposuction uses Vibration Amplification of Sound Energy at Resonance technology to emulsify the fat prior to removal via suction |
| Invasiveness | Invasive | Minimally invasive |
| How fat is broken down | The doctor moves the cannula back and forth under the skin to break up the fat cells and removes them with a vacuum pump | Vaser liposuction uses ultrasound waves to break up the fat in a gentler and less intrusive manner |
| Anesthesia | Patients are placed under general anesthesia, adding the risk of anaesthesia-related complications | Can be performed under local anesthesia |
| Skin tightening | X | Stimulates collagen production, resulting in tighter skin |
| Bruising | Bruising and pain may be experienced longer by patient post-op | Lesser bruising and faster recovery for patient |
| Blood loss | Traditional liposuction removes fat through avulsion, which can damage surrounding tissue | Minimal disruption to surrounding connective tissues and blood vessels |
| Recovery | More traumatic procedure so recovery is longer | Minimal downtime as compared to traditional liposuction |
UAL (VASER LIPOSUCTION) VERSUS FAT FREEZING
Scroll to view the table
| Treatments | FAT FREEZING | UAL (VASER LIPOSUCTION) |
|---|---|---|
| Type | Non-surgical fat reduction | Surgical fat loss and body contouring |
| Procedure | Involves vacuuming the targeted areas externally with a handheld device and applying subzero temperatures to freeze the fat. Your body will then metabolise the frozen fat cells and expel them naturally | Involves local anaesthesia, infiltration of anaesthetic fluid via incision sites made on targeted areas followed by emulsifying of fat cells via a ultrasound probe (delivering ultrasonic energy internally) and subsequent removal of liquefied fat via suction |
| Fat reduction claims | Reduce 20% to 25% of localised over multiple sessions, without body contouring | Remove over 70 - 80% of localised fat in one session, with body contouring |
| Skin Tightening | Not applicable | Has the capability to stimulate collagen production and tighten the skin |
| Results | It can take between 3 to 6 months or more to achieve subtle results if the patient responds to the treatment. For some, there may be no result at all | Yields immediate visible results, but full results will show between 3 or 6 and 12 months when the post-procedural swelling subsides |
| Areas | Treat abdomen, waist, thighs, and arms but areas are limited by the size of the applicator head | Treat all body parts with excess fat pockets and face successfully while contouring the body shape smoothly |
CAN UAL (VASER LIPOSUCTION) TREAT MEDICAL CONDITIONS?
UAL (Vaser Liposuction) and all other forms of liposuction, is also effective beyond cosmetic needs and purposes and can be used to treat certain medical conditions.
UAL (Vaser Liposuction): What to expect
On the day of the surgery, the patient's concerns and desired outcomes will be discussed. A comprehensive understanding of the procedure, post-operative care, and expected aesthetic results is vital.
In the surgical suite, the treatment areas are marked. Twilight sedation is administered by the anaesthetist to ensure the patient's comfort and safety, with continuous monitoring of vital signs.
Dr Ivan Puah prepares the targeted area, making small incisions and uniformly infiltrating it with anaesthetic fluid. The ultrasonic probe is then used to melt fat cells within deep tissues.
Employing cannulas of varying sizes, Dr Puah sculpts the treated areas and extracts the liquefied fat. Incisions are sutured, and the area is dressed accordingly.
Before and After Your Procedure
- Arrange for someone, preferably a family member or friend, to pick you up after the procedure.
- On the day of the procedure, arrive on an empty stomach and avoid oral intake for at least eight hours.
- You'll receive antibiotics, anti-swelling, and pain relief medications.
- A post-liposuction compression garment should be worn 24/7 for 6 to 8 weeks to reduce complications.
- Expect minor leakage from incisions post-surgery; we provide a care pack to manage this.
- Our medical team will schedule post-operative reviews and offer guidance for each stage to address any concerns.
HOW TO FIND THE RIGHT LIPOSUCTION DOCTOR IN SINGAPORE
Choosing the right doctor with a keen aesthetic sense is crucial for achieving your desired silhouette and real results.
Think of a body sculpting procedure as a work of art in the making. The artist's expertise, experience, and deep grasp of the aesthetics of the human body are what distinguish a masterpiece from an ordinary work.
Dos
Ensure that the doctor is accredited by the Ministry of Health (MOH) Singapore to perform the procedure. Doctors are not allowed to offer liposuction if they do not receive accreditation from MOH.
Make an effort to find out the doctor's experience in the treatment you seek. Experience usually comes with years of practice in such procedures as body sculpting and liposuction.
Ask the doctor for examples of the results of his work. These should be a good indication of what you can expect and a reflection of the doctor's capabilities. The doctor should be able to show you various body regions they have treated.
Do understand the benefits as well as potential side effects of the procedure. Clear your misconceptions and ask the doctor any questions you find relevant and necessary.
Note that post-treatment follow-up and care are equally important, as they can help to improve your recovery and final results. Adhere to the pre and post-procedure advice given.
You have to do your part as much as the doctor will. This will go a long way in ensuring a smooth procedure and, equally important, in recovery.
Don'ts
Never opt for a procedure just because it is cheap or the cheapest option. The intent is to get the most appropriate doctor that to best suit your needs without incurring unnecessary risks to your health and wellbeing.
Do not be afraid or shy to ask the doctor any questions. Your doctor should be able to alleviate your concerns and worries.
Don't have unrealistic expectations. Everyone is unique, and each need must be addressed and met as realistically as possible. Discuss your goals and keep an open mind regarding what can and cannot be achieved.
A key point that can never be reiterated enough is to discuss matters in regards to your goals and needs with the doctor. Also, raise any concerns, including the risks involved, cost and benefits. You should feel assured because comfort and safety matter.
Do not forget to provide essential information such as any pre-existing and prevailing medical conditions, including past medical history, allergies and medications that you are taking.
LIPOSUCTION DOCTOR IN SINGAPORE, DR IVAN PUAH
Having trained in liposuction is only the beginning. Dr Ivan Puah believes it is crucial to understand and master the technicalities of the procedure, including the potential complications that may arise. To be meticulous in approach, with a detailed overview and foresight capabilities, are essential must-haves for a doctor.
Dr Ivan Puah is an accredited liposuction doctor and Chairman of Lipo Peer Review Committee in Singapore with nearly two decades of liposuction experience. He has completed fundamental and advanced Vaser Liposuction training under Dr John Milard and Dr Alfredo Hoyos in Argentina and Colorado. He is also trained in laserlipolysis (laser liposuction) in Italy and has received dedicated gynecomastia surgery training in San Francisco.
Dr Ivan Puah
Dr Ivan Puah is known for his aesthetic sense and meticulousness. Effective doctor-patient communication is paramount in the realm of aesthetics and Dr Puah truly takes the time to understand each patient’s unique needs, and goals and tailors his treatment accordingly.
Dr Puah marries the principles of science and art in liposuction, delivering natural and optimal body contouring results for his patients.
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UAL (VASER LIPOSUCTION) FAQS
Am I a suitable candidate for UAL (Vaser Liposuction)?
This procedure is suitable for men and women. Generally, you are a good candidate for UAL if you are in good health, with a localised area of fat that does not respond well to diet and exercise and would like to correct disproportionate body shape.
Who should not have UAL (Vaser Liposuction)?
In general, the following group of patients will not be suitable for any form of liposuction including traditional liposuction, Laserlipolysis (Laser Liposuction) and tumescent liposuction:
- Pregnant women
- Patients with pre-existing medical conditions will be assessed during the consultation to ascertain their suitability for the procedure.
- Patients who present with serious underlying medical issues and who are psychologically unstable will not be suitable for the procedure.
What happens if I gain weight after UAL (Vaser Liposuction)? Will fat return and migrate to other body parts?
UAL removes fat permanently. A healthy lifestyle with a proper diet and exercise will help to maintain your new look. It is highly recommended that you do your best to keep your weight after treatment.
If any weight gain does occur, it will be proportionally distributed over the entire body. Changes to treated areas are usually more notable, with more than 3 to 4 kg of weight gain. You can also expect changes that are associated with the normal ageing process.
Is UAL (Vaser Liposuction) for weight loss?
No. UAL (Vaser Liposuction) is meant to remove fat and contour specific body parts, not a weight loss tool or solution for obesity.
If your objective is to lose weight, you can consider our weight management programme.
Is UAL (Vaser Liposuction) safe?
Your safety is always our utmost priority. We carry out our fat removal procedures in an accredited Day Surgery facility.
Our anesthesiologist is always present in the operating theatre during the surgery to monitor your vital stats and administer twilight sedation, ensuring you are comfortable and safe throughout the process.
How long will the treatment take?
Depending on the number of areas to be treated, UAL (Vaser Liposuction) may take between 1.5 and 3 hours.
How much fat can be taken in one procedure?
Liposuction is a strictly regulated procedure in Singapore. According to MOH, a maximum cap is set on the total amount of fat that can be aspirated in one session. Based on your clinical condition, our doctor will advise you accordingly.
Does UAL (Vaser Liposuction) hurt? How long is the recovery?
Depending on the extent of the UAL, you can generally return to work in 2 to 3 days. In the first 48 hours post-surgery, you can usually manage the discomfort, soreness and pain (if any) with paracetamol. Bruising, if any, dissipates in a couple of days to weeks. Swelling will subside and improve with time. Our doctor will advise you when to resume strenuous or water-based activities during the follow-up review.
How much does UAL (Vaser Liposuction) cost?
The liposuction doctor's fees are generally based on their experience, skills, and the body areas to be treated. A very experienced doctor would have completed many procedures, including addressing complex conditions and procedures of the corrective kind. Other charges include the type of anaesthesia used, hospital or surgical facility costs, medical tests such as blood tests, post-surgery garments, pre and post-medication, etc.
Can I eat anything without accumulating fat in the treated body part?
It is highly recommended that you do your part to maintain the results. This means adopting a healthy lifestyle that includes adequate physical activity. The procedure removes fat from the targeted body region. However, it does not prevent fat gain, especially if you do not take care of your body. It also does not prevent physical body changes due to the normal ageing process.
What are the realistic expectations for my liposuction surgery?
Results are visible even on the first-day post-surgery but will be more evident as your body contours improve over 3 to 6 and 12 months when the tissue swelling subsides.
Fat that is removed permanently lost. However, patients must maintain a proper balance between calorie intake and exercise. If you gain excessive weight, it will cause fat cells all around the body to enlarge.
Can I use medisave/insurance for UAL (Vaser Liposuction), Traditional Liposuction, Vaser* Liposuction or Laserlipolysis?
No. Liposuction in any form is considered an elective cosmetic surgery to improve one's body contours; hence is not covered by Medisave or insurance.
Does Amaris B. provide aftercare treatments?
At Amaris B. Clinic, aftercare significantly assists you with faster recovery and ensures optimum results. We have curated a bespoke aftercare program designed to help you with the healing process, such as MLD Therapy, skin firming and many others.
Reference
[1] Garcia O Jr. Ultrasound-assisted liposuction: Current concepts and techniques. Cham, Switzerland: Springer Nature Switzerland; 2020.
[2] Hoyos, A. E., & Millard, J. A. (2007). VASER-assisted high-definition liposculpture. Aesthetic surgery journal, 27(6), 594-604.
[3] Di Giuseppe A, Shiffman MA. Aesthetic plastic surgery of the abdomen. Springer International Publishing Switzerland; 2016.
[4] Hoyos AE. High Definition Liposculpting. In: Body Contouring: Art, Science, and Clinical Practice. Springer-Verlag Berlin Heidelberg; 2010: p. 419-424.
[5] Serdev, N. P., & Serdev, N. (2011). Ultrasound Assisted Liposculpture–UAL: A Simplified Safe Body Sculpturing and Aesthetic Beautification Technique. Advanced Techniques in Liposuction and Fat Transfer, N. Serdev, ed., InTech, Rijeka, Croatia, 135-150.
[6] Nagy MW, Vanek PF Jr. Plast Reconstr Surg. 2012;129(4):681e-689e.
[7] Prendergast PM, et al. Aesthetic medicine: Art and techniques. Springer-Verlag Berlin Heidelberg; 2012.
[8] Zocchi M. 2006 Ultrasonic liposculpturing. Aesthetic Plast Surg 1992; 16287298 Mark Laurence Jewell. Lipoplasty. In: M. Eisenmann-Klein, Constance Neuhann-Lorenz, eds. Innovations in Plastic and Aesthetic Surgery. Springer, Berlin Germany;:439-444
[9] Haeck PC, Swanson JA, Gutowski KA, Basu CB, Wandel AG, Damitz LA, Reisman NR, Baker SB; ASPS Patient Safety Committee. Evidence-based patient safety advisory: liposuction. Plast Reconstr Surg. 2009 Oct;124(4 Suppl):28S-44S. doi: 10.1097/PRS.0b013e3181b52fcd. PMID: 20827238.
[10] Gingrass MK, Kenkel JM.Comparing ultrasound-assisted lipoplasty with suction-assisted lipoplasty. Institute for Aesthetic and Reconstructive Surgery, Nashville, Tennessee, USA
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