Body contouring with traditional suction-assisted lipoplasty is currently the most commonly performed aesthetic surgical procedure. In competent hands, traditional lipoplasty has a low complication rate, a short recovery period, and a high patient satisfaction rate. Body contouring with ultrasound-assisted lipoplasty has recently gained considerable attention, and its proponents have claimed many benefits over the traditional method. This pilot study consists of one surgeon's clinical experience with ultrasound-assisted lipoplasty in 100 cases. In 63 of these patients, ipsilateral traditional lipoplasty and contralateral ultrasound-assisted lipoplasty were done on one or more body areas. These patients were blinded in the study. Complication rates, lipocrits from the aspirate, postoperative ecchymosis, postoperative swelling, patient satisfaction, and surgeon satisfaction were then compared for each patient studied. Ten randomly selected patients were also evaluated by an independent panel of reviewers who compared ecchymosis and swelling in ultrasound-assisted versus traditional lipoplasty-treated areas. Their observations in this subset of 10 patients were subjected to statistical analysis. This initial pilot study failed to prove most of the benefits attributed to ultrasound-assisted lipoplasty by other surgeons. However, the method is an evolving technology, and the authors remain optimistic about the role of ultrasound in body sculpting surgery.