In each edition, Modern Aesthetics® asks top cosmetic doctors about the newest devices they are using in their practices. Paul Jarrod Frank, MD, Director and Founder of Pfrankmd and Pfrankmd Skin Salons in New York City, shares his enthusiasm for Emsculpt, BTL's latest body sculpting device.

What Differentiates Emsculpt?

Paul Jarrod Frank, MD: Emsculpt really does something that no other device does—which is focus on the muscle. Muscle loss and laxity have always been big among the multifactorial reasons that things go south as we age. Having a technology that challenges and builds muscle in a way that voluntary exercise cannot is a game-changing advancement. The fact that Emsculpt also destroys surrounding fat is an added bonus. No other device out there accomplishes this. I expect this technology will do to the body contouring market what Botox Cosmetic did to the facial rejuvenation market in the new millennium. The opportunities for growth and development are endless for cosmetic medicine as well as rehabilitation medicine.

Any patient selection tips to share?

Dr. Frank: As with any treatment, it is all about candidate selection. We want people who are close to their ideal body weight and who are looking for better muscle definition in the belly and some lift and added firmness in the buttock area. We want people who look good in clothes, but want to look better in a bathing suit. In New York City, this is a huge target audience. I am also using Emsculpt in combination with all my other body contouring technologies. I use it post-abdominal liposuction to improve muscle definition almost universally. I also combine it with many skin-tightening devices such as the BTL Exilis Ultra for improved skin tone and BTL's Cellutone shockwave therapy for cellulite. I think it's important to pick a self-motivated patient regardless of what the reason to treat is.

It is an easy device to learn to use, but it is certainly a serious medical device that requires use by medical professionals.

What is your treatment protocol?

Dr. Frank: The protocol is four treatments in two weeks time. We definitely stress the importance of the time period as we find that those patients who are not compliant don't get the same results. Although the patient is strapped in and the machine does the work, there is a learning curve to maximize treatment. My registered nurses have learned how to gradually increase the intensity of the treatment as it commences and tolerance to the contractions increases…like with any exercise. Patients do see results immediately after a treatment, but the long-term muscle building effects take a month or two after the treatments. We tell people to drink a lot of water afterward and avoid high-intensity exercise in that area for the next 24 hours.

How do you describe the treatment to your patients?

Dr. Frank: It feels like a weird workout, but it should never be painful. Patients often compete with themselves shooting for the highest setting. We reinforce that the numbers don't mean better or worse necessarily. It is the quality of the contractions and some patients in great shape tolerate less than someone who doesn't exercise much. Most patients are a little sore.

How is the ROI?

Dr. Frank: I have purchased 30 to 40 devices in my practice during the past 18 years, and I can honestly say that no device has paid itself off 100 percent so rapidly as Emsculpt. I am well into profit making on the device after only 10 to 12 weeks. The idea of building muscle tissue and melting fat is the Holy Grail. Once patients do one treatment, they are hooked. We recommend two to four maintenance treatments a year, but a large group of patients buy packages for monthly maintenance.