Liposuction is a cornerstone of body contouring, evolving over the past century from early attempts at fat removal to standardised tumescent techniques with energy adjuncts. Here, we describe the historical development of liposuction and the key advances that have shaped modern practice. Contemporary liposuction is an infiltration-based procedure performed with small blunt cannulas, typically using wet, superwet or tumescent solutions. Ultrasound, power, laser and water assistance are selected according to tissue characteristics, surgeon preference and operative setting. The first widely cited attempt was Dujarier’s operation on a dancer in 1921, which resulted in significant complications that slowed progress for several decades. Modern liposuction began with Arpad and Giorgio Fischer in the mid 1970s, who introduced blunt cannulas and cross tunnelling to remove subcutaneous fat through small incisions. Illouz subsequently popularised the wet technique, introducing it between 1978 to 1982, favouring dilute infiltration and smaller blunt cannulas to improve haemostasis. Fournier furthered these principles and refined syringe-based techniques, first described in 1985. Klein’s introduction of tumescent local anaesthesia in 1987 significantly reduced blood loss and reliance on general anaesthesia. Further, Fodor’s superwet technique, described in 1986, gained widespread adoption through the 1990s for higher volume cases by balancing infiltrate and aspirate volumes. Energy assisted techniques followed as surgeons sought greater efficiency and improved management of fibrous tissue. Power assisted liposuction emerged in the late 1990s, using a reciprocating cannula to reduce surgeon fatigue. The 2000s saw further advances with laser assisted lipolysis and water assisted systems that used hydro-dissection to reduce mechanical trauma.