Liposuction is the gold standard for removal of fat from the abdomen and flanks. Advances in liposuction technology have provided numerous options but on the whole VASER liposuction is still considered to be the treatment of choice for most cosmetic surgeons. VASER liposuction has the added benefit of providing some skin tightening effect in addition to removal of fat. Over the skin, non-invasive radio-frequency and ultrasound treatments, such as 3D Lipomed, Cool-Sculpting and Ultherapy, can help to reduce fat and tighten skin but the results are very variable and multiple sessions are needed. Liposuction should not be considered a weight loss alternative and it is necessary for any treatment to be supplemented with lifestyle changes including a healthy diet and regular exercise.