Liposuction is one of the most recognized of all cosmetic plastic surgery procedures and has been done in the U.S. since 1981. As the science of liposuction has evolved, particularly over the past two decades, new methods of extraction has appeared applying energy technologies such as ultrasound, laser, infrared and pulsed water. These modern-day liposuction methods, all promoted as offering better results with less recovery, appears to make the historic method of liposuction seem barbaric and now irrelevant. It seems most people have watched a video somewhere of liposuction being performed with the in and out movement of a cannula being worked by a surgeon, definitely leaving the impression of the brutal nature of ‘old-style’ liposuction. For understandable reasons, these newer technologies seem more gentle, sophisticated and less invasive, appearing to provide an easy way for fat to exit the body. The reality is, regardless of the technology used, liposuction is a two-part process. First the fat must be loosened up and then it can be suctioned out. The suctioning out part has never changed in forty years and likely never will. (cannula moving in an out) The improvements have been in the loosening up phase, using different focused energies to help make the fat ready to be suctioned out. So while newer liposuction technologies may have certain advantages, usually a more efficient method of fat mobilization, they are anything but less invasive.