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significant contributions to the advancement of this procedure. Ives-Gerard Illouz of France was invited to present his work at the educational meeting of the American Society of Cosmetic Surgery. The implications of his January 1982 report on lipolysis was immediately apparent to those in his audience and stimulated extensive exchanges of information. For example, Fred Berkowitz from Newport Beach, Calif, traveled to Paris to observe Illouz, Fournier, and Otteni.!" Upon his return to the United States, Berkowitz conveyed his experiences and observations to his associate, Michael Elam, in California. Richard Dolsky, of Philadelphia, visited and observed Bahman Teimourian, a Maryland plastic surgeon who had begun suctioning fat several years earlier. Berkowitz, Elam, and Dolsky conferred on an almost daily basis on surgical procedures, instruments, and results. In October 1982, a workshop was held at the Graduate Hospital in Philadelphia, and Dolsky's surgical demonstrations marked the first or113 ganized teaching of liposuction to American surgeons. In December 1982, Julius Newman incorporated the American Society of Liposuction Surgery. The first of many workshops, instructional courses, and World Congresses was held at Hollywood Community Hospital in Los Angeles in June 1983. In 1984 and 1985, surgeons practicing cosmetic surgery in the United States recognized that many of them had dual memberships in the American Association of Cosmetic Surgeons and the American Society of Cosmetic Surgery. In addition, they recognized that the 2 organizations were competing for members and for attendance at their educational meetings. The American Society of Liposuction Surgery was closely aligned with the American Society of Cosmetic Surgery, which published the American Journal of Cosmetic Surgery," The leaders of these 2 organizations, George Brennan, president of the Association, and Benito Rish, president of the Society, appreciated the value of the maxim "strength in numbers." The 2 societies amalgamated in 1985 to form the American Academy of Cosmetic Surgery, the first annual scientific meeting of which was held in Los Angeles in 1985. Richard Webster was elected the founding president of this organization. The techniques of cosmetic surgery have developed to a striking degree in response to increasingly sophisticated consumer demand. For example, hair transplantation is the most common cosmetic procedure sought by American men. Patients and doctors will not accept the artificial work of the old hair plugs. State-of-theart hair restoration combines the techniques of scalp expansion and reduction, mini- and micrografts, and individual hair grafts. Many surgeons are employing lasers to produce accurate graft recipient sites bloodlessly. In January 1995, under the direction of the president of the American Academy of Cosmetic Surgery, Howard Tobin, the American Society for Hair Restoration Surgery was formed. This is a multidisciplinary organization devoted to advancements in this subspecialty area of cosmetic surgery. One of the most exciting areas of cosmetic surgery is the utilization of lasers for many tasks. CO2 lasers are used as cutting instruments in transconjunctival blepharoplasty, endoscopic forehead-lifts, and endoscopic transaxillary augmentation mammoplasties. II In addition, KTP and contact YAG lasers have advocates for their use in face-lifts, abdominoplasties, and reduction mammoplasties. Pigmented and vascular skin lesions, as well as tattoos, are obliterated and lightened without scarring by the Q-Switch Ruby laser, Copper Vapor laser, Flashlamp Pulsed Dye laser, and the QSwitched Frequency Doubled Nd:YAG laser. Perhaps the greatest excitement in cosmetic laser surgery involves facial skin resurfacing. New techniques such as the Coherent UltraPulse CO2 laser and the Sharplan Silk Touch CO2 laser provide new tools in the battle against facial wrinkles and aging." The ongoing evolution of laser cosmetic surgery continues with the use 114 of the Erbium:Yag laser for the treatment of wrinkles. Today, surgeons are combining treatment with both the Erbium:Yag and the CO2 lasers to enhance the results available to patients. Overall, liposuction continues to be the most popular cosmetic surgery procedure. The use of tumescent infiltration is accepted by most surgeons as a major advance in the effort to decrease blood loss and to improve cosmetic results. Instruments continue to get smaller and smaller." Many surgeons advocate superficial lipoplasty to improve results. Ultrasonic liposuction has been brought to the United States. The Task Force of the American Academy of Cosmetic Surgery and the American Society of Liposuction Surgery has studied this procedure and has presented its initial findings to the Academy and to the Society. These organizations are at the forefront in evaluating and teaching the newest technologies in liposuction. Options in chemical peel have increased with the introduction of new peeling agents and new combinations of agents." Glycolic acid, lessner's solution, trichloroacetic acid, and phenol are the major peeling acids. Control of pigmentation is increased with the use of new topical agents such as Kojic acid. Perhaps the area of American cosmetic surgery generating the most interest is endoscopically assisted
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