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January 28, 2026
Table of Contents
Patient's Profile
Ms Sy, a 40-year-old woman, has experienced years of discomfort and frustration due to increasingly painful and swollen legs.
Background
Despite maintaining a healthy lifestyle, Ms Sy noticed a persistent, symmetrical buildup of fat in her legs that seemed resistant to diet and exercise. In 2024, she was diagnosed with lipedema by Dr Ivan Puah and underwent lipedema surgery on her hips, thighs, and knees.
Consultation & Assessment
Ms Sy has a BMI of 25, is a non-smoker, and has no underlying medical conditions. Following her initial lipedema surgery, she observed a significant improvement in her daily life, motivating her to seek treatment for her bulky and painful calves.
"I first noticed the changes in my legs during my late teens," she shared during the consultation. "Over the years, the pain intensified, and my legs always felt heavy and tender. I couldn't understand why this was happening, which was incredibly frustrating. When I was diagnosed with lipedema and realised there was finally a treatment for me, it was a turning point."
During the consultation, Dr Ivan Puah explained that lipedema is a chronic condition characterised by the symmetrical accumulation of painful fat in the limbs, predominantly affecting women. This condition leads to pain, swelling, and easy bruising, significantly impacting daily life.
A physical examination revealed bilateral, symmetrical fat accumulation in the calves, accompanied by varicosities. On palpation, there were nodules with a dense, cement-like texture, in addition to pain and tenderness in the affected area.
Dr Puah recommended lipedema surgery to remove the diseased fat tissue, alleviate pain, and restore normal function to the calves.
Treatment Plan
Ms Sy's lipedema surgery is scheduled at a Ministry of Health (MOH) accredited day surgery centre under local anaesthesia. She will be under twilight sedation during the 1.5-hour procedure, cared for by the anesthesiology team. The lipedema surgery involves making small, short and strategic incisions on the calves. Afterwards, anaesthetic fluid is infiltrated.
Dr Ivan Puah utilises his proprietary liposuction technique, MDC-Sculpt®️Lipo, to carefully remove the diseased fat tissue from her calves. This multi-dimensional contouring approach targets multiple fat layers to restore a more shapely contour and reduce discomfort.
The surgical goals are to alleviate the pain and heaviness she has been experiencing, improve mobility, and enhance the overall contour of her calves. The surgery was uneventful, and Ms Sy was discharged home the same day.
Post-Op Recovery & Results
Like her previous lipedema surgery, Ms Sy carefully took care of her wounds and adhered to her compression regimen. She recovered well and experienced remarkable improvement. The pain and heaviness in her calves have significantly diminished.
Lipedema is not uncommon, but it is frequently misdiagnosed and misunderstood. If you are experiencing similar symptoms, do not lose hope. Seek medical professionals who understand lipedema and can offer appropriate treatment options. Receiving the correct diagnosis and care can be life-changing.
Medical Disclaimer: Due to strict regulations from the Ministry of Health Singapore, licensed healthcare practices are not allowed to show and share before-and-after photos or videos in the public domain or through any form of push technology. "Before-and-after" or only "after" treatment visuals may be shown to patients privately during in-clinic consultation with Dr Ivan Puah.
Our patient narratives aim to provide valuable insights into individual experiences with our clinic's treatments; however, it is imperative to acknowledge the inherent variability in results. While the information shared is genuine and reflects the real journeys of our patients, it does not purport to be representative of typical outcomes, nor does it serve as a guarantee of similar results for all individuals.
Each patient's response to treatment is contingent upon a myriad of factors, including, but not limited to, their level of commitment, lifestyle choices, and medical history. It is essential to recognise that patient narratives are illustrative examples of potential outcomes and should not be construed as predictive of specific results. We advise a consultation with our doctor for comprehensive guidance tailored to individual circumstances.
