Since the importation of liposuction surgery into the United States more than a decade ago, we have witnessed a number of major technique changes and practice trends occur. One of us (L.M.F.) was the first dermatologic surgeon to undergo the "lipsuction experience" (Paris, 1977) under the tutelage of Giorgio and Arpad Fisher and Pierre Fournier, and another (R.S.N.) the first to undergo training with Yves Illouz (also Paris). All three co-workers have served on teaching faculties of both the International and American Societies for Dermatologic Surgery, the American Society of Liposuction Surgery, and the American Academy of Cosmetic Surgery, have performed many hundreds of procedures, and have lectured/published on this subject on repeated occasions. We recognize certain vital changes and expansions have occurred during the past decade, and share our impressions of these with you.