Liposuction has become the most frequent aesthetic procedure, and its indic
ations continue to expand to different areas of plastic surgery. In this ar
ticle the authors present their experience with liposuction in the treatmen
t of nine cases termed "atypical," for not being purely aesthetic. Included
are four congenital lipodystrophies-occult spinal disraphism, osteogenesis
imperfecta, congenital lipomatosis difusa, and Klinefelter syndrome-and fi
ve acquired ones-posttraumatic lipoma, posttraumatic asymmetry, insulinic h
ypertrophic lipo dystrophy, adiposis dolorosa, and TRAM flap. Particular fe
atures of each lipodystrophy are reviewed and details of fat distribution a
nd density are described. We also review some specific details of the techn
ique. On the other hand, we wish to point out the importance of recognizing
and correctly diagnosing some specific lipodystrophies that are part of de
fined clinical patterns and that require an integral therapeutic approach.