Ultrasonic-assisted liposuction (UAL)created a myriad of interest among American liposuction surgeons in 1996 to 1997. Much of the original information in the literature was generated by liposuction surgeons comparing UAL (with tumescent anesthesia) to traditional liposuction (dry technique). These reports did not account for the intrinsic advantages afforded by tumescent anesthesia. Because of this, the accounts were greatly biased in favor of UAL. It was not until liposuction surgeons experienced in tumescent liposuction compared UAL to tumescent liposuction that the place for ultrasonic liposuction could be better defined. Although UAL did not create the revolution in liposuction that was originally suggested, it does have a place in the liposuction armamentarium. In addition, it is important that liposuction surgeons continue to follow the developments in this emerging technology.

Surgeons experienced in tumescent liposuction have been understandably skeptical in “improvements” to a procedure that is already safe and efficacious. From their viewpoint tumescent liposuction is an ideal procedure with minimal risk and high patient satisfaction. Although this observation is true, most patients would prefer a completely painless, noninvasive, high-technology treatment for fat removal. One only needs to look at the popularity of thigh creams, body wraps, and compression devices to understand the public's desire for fat loss without a surgical procedure. Such an advance in technology is not beyond reach. In the past 10 to 15 years we have seen a number of “surgical” diseases such as peptic ulcer disease, gallstones, and kidney stones now managed with medicine or minimally invasive procedures.