Rear View: How BTL's Emsculpt is Reshaping the Buttocks

From pop stars to social media influencers, women with voluptuous bottoms have made their posterior curves a subject of envy. The Brazilian Butt Lift has become part of the popular consciousness as demand for the procedure has climbed significantly year-over-year. Despite its playful name, the procedure is rife with potential complications and risk for death, surgical societies warn.

Consider the experience of Yael Halaas, MD, a facial plastic surgeon in New York City. One of her former patients underwent an illegal injection of a substance into her buttocks that resulted in a fatal embolism. “The risks, especially with these black market illegal injection factories, are enormous for people who are interested in buttocks augmentation,” she says.

Today's aesthetic practices and their patients have a new, non-invasive option to treat the buttocks: Emsculpt from BTL. Cosmetic surgeons like Dr. Halaas are embracing the technology both for its safety and for its impressive results. Emsculpt uses high frequency electromagnetic (HIFEM) energy to reduce fat and increase muscle tone. “The great thing in the gluteal region is you can see a distinct improvement and the treatment itself is quite comfortable,” says Dr. Halaas.

Mariano Busso, MD, a dermatologist in Miami, notes that his town, “always was a highly cosmetic city. There's a lot of skin show year-round, so people are extremely conscious about their looks and bodies.” In his practice, Emsculpt has been an “instant success,” he says. “Patients are aware of the downtime as well as the risks and side effects that have occurred with the Brazilian Butt Lift, so anything that can replace that is very well received. In terms of our results with Emsculpt, you see a unique lifting and tightening of the area.”

Behind the Scenes: Technology

Emsculpt's HIFEM is the first and only technology that has been shown to both build muscle and sculpt the body by instigating supramaximal contractions. “When we apply Emsculpt on buttocks, we can contract those gluteus muscles approximately 20,000 times in a 30-minute session, which is beyond what a person can accomplish through exercising,” Dr. Busso explains. The result is, “a tighter, more toned buttock. It gives you a little bit of a lift.”

According to plastic surgeon Brian Kinney, MD, a key benefit of Emsculpt for buttocks treatment is that it provides a clinical result that is more consistent with aesthetic goals. Whereas previous treatment approaches relied on placement of fat, Emsculpt works to build and tone muscle. “Do we really want a big buttock that's very full of fat? Is that the aesthetically desirable buttock?” he asks. “Or, is it simply that that's the best option technology was offering us until recently?”

The evidence—and advocates note Emsculpt has an unprecedented amount to back it up—shows that Emsculpt treatment applied to the gluteal muscles induces hypertrophy and hyperplasia, which seems to create a lift. The objective outcomes assessed for HIFEM application to the buttocks and abdomen include traditional pictures and tape measures, ultrasound studies, CT imaging, and animal studies. “In the case of the buttocks, I think we're going towards more of an aesthetic ideal,” Dr. Kinney says.

A Unique Fit

Emsculpt treatments for the buttocks are provided in half-hour sessions, administered two times per week for two weeks. The treatment itself feels like a massage, Dr. Halaas says. Patients can see an effect almost immediately, “but the real result is evident a couple weeks after,” she says.

Emsculpt treatment can appeal to a wide range of individuals, and many are, indeed, good candidates for it. Patients who are obese are not good candidates, Dr. Halaas says, because they likely will not see sufficient improvement. Conversely, however, patients need not have excess buttock fat to benefit from Emsculpt. Because treatment targets and tones muscle, those without excess fat will see improvement.

“Those patients that have been able to accomplish some good results going to the gym, but they want to go beyond, love this technology,” observes Dr. Busso. “It takes them to another level. Of course, patients that do not go to the gym will also benefit tremendously.” In contrast to exercise, which cannot isolate specific muscle groups, Emsculpt activates only the gluteal muscles. This, Dr. Busso points out, means patients don't need to develop massive thigh muscles as they build the buttocks. “You want just to isolate and reshape and tighten the buttocks, not the whole thigh,” he says.

Older patients can benefit from Emsculpt treatment of the buttocks, Dr. Halaas says, but it is essential to discuss any skin laxity before treatment. “Patients with excess laxity will get improvement in the muscle but they may need a concomitant treatment to truly improve the laxity of their skin,” she adds.

A benefit of Emsculpt treatment is that when patients see results they often are inspired to do more to promote their own fitness. “That complements what we do in the office, and definitely the results that we get are much better when the patient is highly motivated,” Dr. Busso notes.

Many physicians have begun offering retreatment of buttocks or abdomen at six-month intervals. For Dr. Halaas, such an approach makes sense for many patients from a practical standpoint. Even the most disciplined patient may overindulge around holidays or on vacation. “When you offer that interval treatment it's a little reminder to patients to maintain their lifestyle. Sometimes they know that the result is still there, but at the moment there may be a few too many desserts over top.”

Bottom Line

For Dr. Halaas, Emsculpt is a worthy addition to an aesthetics practice. “I recommend it,” she says. “I see this as a perfect complement, really expanding the market, and doing things that we just haven't been able to do before. It's really accomplishing something that people want and haven't been able to do before.” Dr. Halaas also notes that she is looking forward to additional future applications for the device.

Dr. Busso also sees an opportunity with Emsculpt. “I see this as bringing in more millennials, bringing in more younger people, that are more concerned about their bodies, and body shape,” he says. “I assume that patients will bring other patients because of the high level of satisfaction that we see with this procedure.”

Sponsored by BTL Aesthetics