SINGAPORE - Out of 29 clinics now offering liposuction, the removal of fat for aesthetic reasons, only nine will be allowed to continue doing so from March next year.

This is because, in future, liposuction treatment can be done only in surgical centres, or in hospitals.

This comes as the Ministry of Health (MOH) tightens control of this procedure, to improve patient safety. Liposuction has already led to at least two deaths here.

In addition, the removal of more than one litre of fat from one spot will have to be done in a hospital as an inpatient treatment. So will any liposuction for people with a body mass index of 28 and below, or who require general anaesthesia.

Until now, these could be done in ambulatory surgical centres, or operating theatres outside of hospitals that are licensed to do day surgeries.

In future, these centres will only be allowed to do liposuctions that involve less than one litre of fat - something that normal clinics that are not surgical centres can now do.

All clinics that are now licensed to do liposuction have been informed of the changes, which are already in effect, but will not be enforced till March 1 next year, to give them some grace period to wind down their liposuction treatments.

Regulations on doctors and clinics allowed to do liposuction was instituted in November 2008, and revised in 2010. The moves followed a growing number of general practitioners offering the treatment.

In a statement issued yesterday, the MOH said: "As a highly invasive procedure, liposuction has been known to cause severe complications, including death.

"Hence, it should be carried out only by trained doctors in well-equipped and well-staffed facilities."

Doctors need to do at least one liposuction treatment a month for two years to get full accreditation to perform liposuction. Those who fail to meet that criteria have to work under preceptorship and accumulate at least 12 cases over the a year before they can get full accreditation.

Doctors working in hospitals do not need this accreditation.

In December 2009, real estate firm boss Franklin Heng, 44, died after the doctor doing the liposuction accidentally punctured his intestines several times.

In June last year, Ms Mandy Yeong, 44, died following her liposuction procedure at a Clarke Quay clinic. Fat loosened during the treatment had blocked the blood vessels in her lungs, causing difficulty in breathing.