The evolution of fat removal has gone from simple excision to curettes and then liposuction with an electrical cutting cannula instrument that could be used with simple liposuction or with cutting of the fat globules with a blade or mainly simple liposuction. Further evolution led to ultrasound-assisted liposuction, power-assisted liposuction, and, at times, a return to cutting instruments. The techniques that evolved were to reduce scar and make liposuction easier to perform. Some of the ancillary techniques are discussed.