A Fitness First: Emsculpt Builds Muscle and Reduces Fat in the Abdomen

As waves of fitness fads have swept the US over the past several decades, a cadre of medical professionals and fitness gurus has declared the sure-fire way to a tone and fit physique is through diet and exercise. But that's simply not true. Despite their best efforts, many people can't achieve the flat belly and rippling abdominal musculature they desire. Enter Emscuplt from BTL Aesthetics.

“To my knowledge this is the first device that has been used clinically that gives you this combination of decreasing fat and increasing muscle in one treatment,” says Beverly Hills plastic surgeon Brian Kinney, MD.

“This is a first-in-class technology. There's no other technology that targets muscle. So, from that standpoint and my assessment, this is a must-have technology,” adds David Kent, MD, a dermatologist in Macon, GA. “This technology was extensively studied and documented prior to launch, and it's the only technology that focuses on muscle.”

First in Science

Emscuplt employs High Intensity Focused Electromagnetic (HIFEM) Energy that builds muscle and eliminates fat for a first-of-its-kind approach to body sculpting. “I've lectured about this at a few meetings in the last six months since we completed the studies, and my colleagues are very excited about it,” observes Bruce Katz, MD, Director of the JUVA Skin & Laser Center in New York City. “It's very interesting, because it's a whole new energy source that hasn't been used before, so they're all very curious about it. We've not had any devices that have been able to tone muscles in addition to fat, so there is a lot of interest.”

Clinical results are impressive, and patient satisfaction ranks high, but the science behind the technology truly sets it apart, say clinical investigators and early adopters. “We've done ultrasound studies as part of the trials that we are doing with the device to show that there is reduction in the thickness of the fat and also thickening of the muscles. There's toning and tightening of the muscles, too,” Dr. Katz points out.

Use of 3D photography has allowed investigators to quantify reductions in fat thickness and increases in muscle mass. The assessments have been done in an objective manner not previously seen in the field of contouring, Dr. Katz maintains.

First in Results

Emsculpt is nothing short of a game changer, experts suggest. “This is the first technology that we've had that targets anything other than skin and fat. It targets muscle,” Dr. Kent says.

“It's incredible,” that patients achieve results with just four total treatments (twice per week for two weeks), says Chicago dermatologist Carolyn Jacob, MD.

The high intensity focused electromagnetic energy induces super-intense muscle contractions or supramaximal contractions. “You get almost 20,000 forced muscle contractions in a 30-minute session,” Dr. Kent observes. “That's an unimaginable number of muscle contractions in that short period of time.”

Supramaximal contractions lead to an increase in the number of muscle fibers (hyperplasia), and growth of existing muscle fibers. Additionally, there is intensive lipolysis after treatment.

“The fat loss is undeniable because we've documented it by CT, ultrasound, as well as MRI,” Dr. Kent says. “You can measure the reduction in fat thickness, and you can actually see the increase in muscle mass, as well.”

Patients begin to notice significant results about two to three weeks after treatment, says Dr. Jacob. This makes sense, she says, because “you don't grow muscle overnight.” Patients tell her that they see and feel the results at around three weeks. For example, one Pilates enthusiast reported she could hold positions much better, while another patient noted that doing a plank, “was a breeze compared to how it used to be.”

“Definitely people are starting to see something around three weeks or so,” Dr. Jacob says, “but I would tell them to wait for three months, because that's the first set of data that we really used in terms of the CT studies and the MRI studies.”

More recently reported data show continued improvements through six months after the first treatment series. “The data show that patients continued to improve on the abdomen in terms of increased thickness of muscle and decreased fat. There also was a decreased width of the rectus sheath, the sheath that goes between the two sets of your six packs—the rectus abdominis muscles,” Dr. Jacob says. Many practitioners now urge maintenance treatments at six-month intervals.

Emsculpt could have “big implications for mommy makeovers,” Dr. Kent suggests. “After pregnancy, women are instructed not to exercise their abdomen, because the rectus sheath has been so thinned out. And, when they do exercise, it increases the inter-abdominal pressure, and that pushes on the muscle, thinning it even more.” But Emsculpt can target these very muscles, prompting the supramaximal contractions that improve muscle tone and reduce diastasis recti.

Emsculpt treatment may appeal to a wide range of patients. Those in their 40s and 50s who are in good shape but seeing a loss of muscle tone or who note a new accumulation of abdominal fat are obvious candidates for treatment, says Dr. Kent.

Dr. Jacob finds that younger patients who are already working out and focused on fitness are interested in Emsculpt treatment. But older patients are certainly candidates, too. “I would add that you can get some core strengthening in this device that's also going to help, in the long run, older patients who maybe are losing core strength. Lost core strength then leads to poor posture, which then leads to a whole host of other concerns and issues, including back problems and neck problems.”

First in Practice

A potentially significant proportion of the adult population in the US could be candidates for Emsculpt treatment. Based on her experience, Dr. Jacob especially recommends Emsculpt for practices that currently offer energy-based treatments, with a “clientele who's fairly fit, but wants to be more competitive with their fitness or wants to take it to the next level.” Emsculpt is ideal for fit patients who “can't get enough definition with all the workouts that they do…They have a little bit of fat, but it's not enough to use any of the other devices,” she says.

Because it targets muscle and not just fat, Emsculpt is well suited to patients who do not have enough fat to warrant use of devices that only target adipose tissue. “Believe it or not, having patients seek treatment who are too small for other devices is as big of a problem as the people who are too big for those devices,” Dr. Jacob shares.

“You're seeing three results when using Emsculpt in the abdomen,” Dr. Kent says. “You're seeing increasing muscle, definition of the rectus. Two, you're seeing reduction in fat. Three, the documentation of the reduction of the diastatis of the separation of the right and left rectus sheet.” That makes it a win-win-win for practices, he suggests.

“If you want something noninvasive, completely noninvasive, then this device is really ideal,” Dr. Kinney offers. “It is noninvasive, delegate-able, painless, easy to use, and pleasing to the patients who feel like something happened to them right away.”