When you can’t get rid of that fat by diet and exercise, liposuction may be the lone remaining effective option. But liposuction has evolved since it appeared in the U.S. in 1981 and it now associated with many high-tech and appealing names. All of the buzzwords and marketing behind liposuction today make it seem like the procedure has been re-invented and is somehow not like having surgery at all. The reality is that liposuction has always involved a two-part process, loosening up the fat and then sucking it out. The suction part has never changed and all the new technologies are about how ways to make the fat extraction process easier. Whether these technologies involve the use of laser, ultrasonic, vaser, power-assisted or any variation in between, much of liposuction remains not that different. Fat still must be loosened up and it must be suctioned out. It is still surgery. These liposuction technologies offer some more efficient ways to perform the procedure but, in the end, the quality of the result is largely determined by the surgeon performing the procedure and the quality of the skin that overlies the treated area.