Plastic surgeon Dr Wong Manzhi on helping women reclaim their bodies – no matter their age

Reconstructive plastic surgery may be less glamorous than its aesthetic counterpart, but its impact on patients – from those recovering from a mastectomy to accident survivors – is profound.

Breast reconstruction, one of the most common procedures in this field, has seen significant advancements. Yet some patients are still not offered the option, often dismissed by doctors solely because of their age.

“They were told, ‘You’re over 50, 60 – you don’t need it.’ But then they come to us and say, ‘Actually, I really want it,’” says Dr Wong Manzhi, 44, senior consultant and visiting plastic surgeon at Thomson Specialists (Paragon).

In the traditionally male-dominated field of plastic surgery, Dr Wong has built a reputation as a specialist in plastic, reconstructive and aesthetic surgery, with subspecialties in vascular anomalies, reconstructive microsurgery, aesthetic procedures, and facial nerve disorders.

A recipient of multiple Singapore Health Quality Service Awards and the Service with a Heart Award, she spent over 18 years at Singapore General Hospital (SGH) before moving into private practice in 2023.

At the time of this interview, Dr Wong was preparing to operate on a 75-year-old patient. She recounts another case involving a 73-year-old woman who underwent breast reconstruction.

“She was otherwise healthy. These days, people in their 70s are still very active, and may have many years ahead of them. And reconstructions can be done using simple methods – implants or tissue flaps,” she explains.

Body image and the sense of symmetry remain important at any age, adds Dr Wong. “Unless there are very serious medical concerns, I think we should offer reconstruction to every patient.”

She explains that immediate breast reconstruction, done right after mastectomy, typically yields better outcomes and is less traumatic, as the skin envelope is still intact. In contrast, delayed reconstruction is more complex – often requiring skin expansion or tissue transfer – yet many patients remain unaware of their options due to common misconceptions about pain, cost and recovery.

“Fortunately, that mindset is starting to change as people become more informed,” she says.

In some cases, patients who first come in for reconstructive procedures later return for aesthetic enhancements. Aesthetic treatments now make up about half of Dr Wong’s caseload. While plastic surgeons are often associated with cosmetic procedures like breast augmentation or eyelid surgery, she notes that much of the work isn’t publicly advertised, especially if they are attached to public hospitals.

In contrast to cosmetic surgery, which is elective and aims to enhance appearance, reconstructive surgery is often medically necessary to improve a patient’s quality of life. It’s about rebuilding not just physical structures, but also restoring function and confidence,” says Dr Wong.

Plastic surgeons assist burn survivors by reconstructing damaged skin to restore mobility and protect vital organs. They also correct cleft lips and palates in children, enabling them to eat, speak and smile with ease.

“We also reconstruct breasts for women after mastectomies, helping them reclaim their sense of self. Each case is unique, but the goal is always to restore what’s been lost – whether it’s function, form, or both.”

Reconstructive and cosmetic surgery are often seen as separate fields, but they are really two sides of the same coin, Dr Wong adds.

“The common misconception is that reconstructive and cosmetic surgery are completely different. But something that functions well should look good, and something that looks good must also function well.

“There’s a lot of overlap in terms of skills and techniques. The same laser used for facial rejuvenation can also be used to improve scars. There’s overlap between reconstructing an eyelid defect after skin cancer removal and performing cosmetic eyelid surgery, for example,” she says.

Making her mark in a male-dominated field

A Raffles Girls’ School alumna who graduated from the National University of Singapore’s School of Medicine in 2004, Dr Wong spent a year on scholarship at Stanford University’s Institute for Stem Cell and Regenerative Medicine.

There, she conducted stem cell research under Professor Irving Weissman, a renowned and award-winning pioneer in the field.

After returning to Singapore, Dr Wong chose to specialise in plastic surgery. “What attracted me to plastics was that it’s not repetitive. In general surgery, for example, you might do one appendicectomy (a surgical procedure to remove the appendix) after another – it’s the same procedure each time.

“But in plastic surgery, there are many different types of operations, and even a single problem can be addressed in multiple ways,” she explains.

In 2015, Dr Wong received a Health Manpower Development Plan (HMDP) scholarship to complete a year-long fellowship at Tokyo’s Kyorin University Hospital, specialising in facial nerve paralysis. The condition affects muscle control and can impair functions like eye closure and smiling.

Back home, she initiated multi-disciplinary facial nerve clinics to treat both subsidised and private patients in 2017 at SGH and Tan Tock Seng Hospital. A similar clinic opened last year at National University Hospital, and Dr Wong remains a visiting consultant at all three institutions.

Singapore’s plastic surgery scene has long been dominated by prominent male figures, such as Dr Woffles Wu and Dr Martin Huang. When Dr Wong was a trainee, she was the only woman in her cohort, and her department had just one female consultant.

“It was just a numbers game,” she says. “The previous generation didn’t have many women in surgery, and that’s reflected in today’s media profiles. But I think it’s changing. More female plastic surgeons – my peers and junior colleagues – are becoming visible on social media. It just takes time to build that presence.”

There was also a perception that women wouldn’t last in such a demanding training programme, with the assumption that family commitments would eventually lead them to drop out. But the gender balance has improved in recent years.

“In some operating theatres, the only male might be the patient. Everyone else – the anaesthetist, nurses, even the surgeon – could be female. So it’s not as much of an issue now,” says Dr Wong, though she admits she sometimes felt the need to prove herself a little more than her male counterparts.

“There’s still this expectation that women should behave a certain way – be softer, more accommodating. If I say something directly, it can be interpreted differently than if a male colleague says the same thing,” she explains.

Dr Wong had to face many challenges in her journey, especially in the early years when she was juggling the demands of motherhood and her career after graduating in 2004.

She’s a mother of three: a 14-year-old daughter, and two sons, aged 12 and four. The support of her husband, parents, in-laws and helper has always been instrumental in allowing her to follow her dreams.

Says Dr Wong: “You’re competent at work, but you’re not the mum you want to be. If I didn’t have kids, maybe I’d be doing more research or flying around for conferences. But time is limited. So I focus on what matters most. I still write papers when I can, and attend conferences – many of them are now online or recorded.”

While surgery is undoubtedly a demanding vocation, Dr Wong is firm in her belief that women should not be given any “discounts”.

“If someone is passionate about surgery, they should pursue it. But there’s no shortcut – you still have to put in the same hours, the same training, as the men,” she says.

“Most of us female trainees just cope. We juggle everything – our husbands help, our parents help – we get by. The ones who choose this path know what they’re getting into. And they’re committed.”

Giving her patients’ self-confidence a boost

When she’s not working, Dr Wong is either spending time with her family or brushing up on the latest technologies and research – sometimes even while on the toilet.

“One thing I tell my residents is: You always have to keep studying. I read while I’m on the toilet, in the car, in taxis. You learn to speed-read, to absorb information quickly,” she shares.

“The good thing is that over time, your knowledge base grows, so picking up new material gets easier. But every case still requires fresh thinking – asking, ‘What can I do better here?’ We can’t afford to be stagnant.”

In addition to keeping up with the latest research, Dr Wong volunteers on overseas cleft lip surgery missions with SGH, Operation Smile, and Smile Asia, travelling to countries such as the Philippines.

“Sometimes, you meet people in their 20s or 30s who’ve lived with a cleft lip their entire life. No one ever helped them. After surgery, it can take time to adjust, because they have to get used to an entirely new self-image. It’s something you can repair in about an hour, but it makes a huge difference in someone’s life,” she shares.

She’s seen a similar effect in her patients in Singapore; though not cleft lip cases, many experience a significant boost in confidence following aesthetic surgery.

“Even something like axillary breast tissue – extra breast tissue in the armpit area – can be very pronounced, appearing as a noticeable bulge. Patients often struggle to wear certain clothes and feel very self-conscious. With just a small 5mm incision, we can use liposuction and a specialised device to remove the tissue.

“Afterwards, patients are so happy. It’s these small things that make a big difference. Every patient comes with a unique concern, and whatever affects them is worth addressing.”

Still, the challenges remain – particularly the level of technical precision expected of surgeons, and even more so in plastic surgery, says Dr Wong.

Managing patient expectations is a delicate balance. “Nowadays, people come in having already googled everything. They know all the terms and procedures and ask, ‘Doctor, can I do this? Can I do that?’ So we have to guide them.”

Then there’s the emotional aspect. Dr Wong observes that female doctors often feel more emotionally connected to their patients. In her case, some are undergoing chemotherapy or navigating deeply personal challenges.

“They share that with us, and it takes a toll. As a caregiver, as a doctor, you absorb some of that,” she says.

She recalls a young patient who was diagnosed with breast cancer early in her pregnancy and was traumatised by the prospect of having to terminate the pregnancy.

“I encouraged her not to worry and to keep the baby, and during the second trimester when it was safer for the baby, she underwent mastectomy and implant reconstruction. Two and a half years on, she still sends me photos of her family and is happily expecting another child.”

For Dr Wong, it affirms her belief that a doctor’s role goes far beyond performing surgery – it’s also about offering reassurance and guidance, helping patients through their lowest points and back to a sense of normalcy.

“I think patients really just need someone who listens,” she says. “I read an article that said, on average, patients get interrupted within 18 seconds of speaking during a consultation. So I try to be mindful of that – to let them talk, to show me who they are and what matters to them.”

Before every surgery, Dr Wong – a Christian – takes a moment to pray, seeking peace of mind as she prepares to operate.

“I think there’s a lot we can’t control as doctors. Some people can be very clinical: ‘I’m going to operate on this person today.’ But for me, it’s not that simple. So prayer helps.

“In the end, I just try my best and entrust the rest to God. That’s all I can do – be present, be supportive, and encourage them. That’s often what they need most,” she says.

PHOTOGRAPHY Phyllicia Wang
ART DIRECTION Ray Ticsay
COORDINATION Chelsia Tan