When asked by the Health Ministry for recommendations regarding 'Aesthetic Medicine', our priorities have always been patient safety and public education. In our opinion, it is paramount that the innocent patient understands fully the level of training and credentials of the doctor treating them, as well as the risks and benefits of each procedure in order to make truly informed decisions.

Dr Ho's article prompts the need for several corrections. Firstly, about 15 years ago, our two associations were responsible for alerting the Ministry of Health and the public to the severe complications which arose out of 'cosmetic' procedures, such as silicone injections into the face and breasts and double-eyelid operations, being performed in beauty salons or by unlicensed practitioners. This prompted new laws and a tightening of regulations to protect the public from such illegal practices. Secondly, Dr Ho's comments about liposuction are incorrect. The true inventor of liposuction as practised today was Dr Yves-Gerard Illouz, a French plastic surgeon who wrote his first paper in 1977. For brevity's sake, the history of liposuction will be clarified in a separate post from Dr Illouz himself.

The concerns of our two associations and that of the ministry's centre on more invasive procedures, such as liposuction and cosmetic body contouring as well as breast enhancement. These concerns escalated with the rising numbers of serious complications arising from aesthetic surgery performed by non-plastic surgeons.

The issues of public safety and of protecting Singapore's reputation as a centre of medical excellence prompted ministerial action. Contrary to Dr Ho's assumption, we did not officially voice any concerns about non-plastic surgeons performing non-surgical treatments, such as IPL.

We share Dr Ho's hopes that stringent regulations are imposed equally with respect to these invasive cosmetic procedures. We are certain that there will be no grandfather clauses inserted as they are unnecessary. Our core curriculum for plastic surgery training already includes liposuction and all other forms of aesthetic surgery; something no other specialty has in their syllabi.

Finally, our plastic surgeons' association's Constitution commands not that we 'protect our turf' but that we 'protect our patients'. We have been trying to do exactly that.

Dr Colin Tham
Honorary Secretary
Singapore Association of Plastic Surgeons
Singapore Society of Cosmetic (Aesthetic) Surgeons