Body
What Can HIFEM Do for You?
HIFEM stands for high-intensity focused electromagnetic technology, which uses a magnetic field to stimulate muscle contractions. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, discusses its use in original Emsculpt, the pelvic floor treatment Emsella and the then-new Emsculpt NEO.
In this episode.
Episode summary
HIFEM stands for high-intensity focused electromagnetic technology, which uses a magnetic field to stimulate muscle contractions. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, discusses its use in original Emsculpt, the pelvic floor treatment Emsella and the then-new Emsculpt NEO.
The recording connects these treatments through their muscle-stimulation technology while distinguishing the body areas and goals involved. It also explains what radiofrequency adds to the NEO discussion.
Key takeaways
🔬 Original Emsculpt focuses on body muscles.
Dr. Smith describes electromagnetic stimulation in the context of muscle tone and body contour.
🔎 Emsella targets the pelvic floor.
The episode describes a clothed, chair-based treatment and discusses urinary leakage. This is a different clinical concern from changing abdominal or limb contour.
🔎 Emsculpt NEO combines technologies.
The recording explains the addition of radiofrequency heating to electromagnetic muscle stimulation, with fat reduction included among the treatment goals discussed.
🔎 The intended result depends on the area and protocol.
Dr. Smith distinguishes buttock treatment aimed at muscle and contour from protocols intended to reduce fat.
🔎 The episode introduces a combined approach.
He describes coordinating abdominal and pelvic floor treatments under the term core-to-floor. That discussion does not establish that every patient needs both.
Questions this episode answers
Are Emsculpt NEO and Emsella the same treatment?
No. In the recording, NEO is discussed for body muscles and contouring, while Emsella targets pelvic floor muscles. Shared electromagnetic technology does not make the treatments or their goals interchangeable.
Does every protocol discussed aim to reduce fat?
No. Dr. Smith specifically describes a gluteal protocol designed to emphasize muscle and buttock contour without targeting fat loss. A current consultation should identify the exact device, treatment area and intended effect.
ℹ️ Current context for this 2020 recording
The contraction comparisons, percentages and protocols in the audio are historical claims, not promised individual results. For body-contouring applications, the FDA explains that noninvasive contouring does not treat obesity or provide weight-loss health benefits and that magnetic-field treatments require screening for contraindications. Pelvic floor symptoms also need their own assessment; the episode does not diagnose the cause of leakage or guarantee continence or sexual-wellness outcomes.
🔗 Related information
Explore Emsculpt NEO information, Emsella information, nonsurgical treatment information, or request a consultation with Dr. Smith in New York City.
Originally released December 2, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.
Original show notes
Board certified NYC plastic surgeon Dr. Darren Smith explores the possibilities of HIFEM, high-intensity focused electromagnetic energy.
Read the conversation.
[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. What is HIFEM and how can it help me? HIFEM, H-I-F-E-M, stands for high-intensity focused electromagnetic energy. This is a relatively new technology in its application to the aesthetic space and it first came on to the scene in a real way with the introduction of Emsculpt a couple years ago and as we've mentioned in previous episodes that is a device that was designed primarily to build muscle mass using HIFEM and a happy side effect of this was some destruction of the surrounding fatty tissue.
[01:11] So HIFEM works by triggering what are known as supramaximal muscle contractions using a targeted electromagnetic field. So electromagnetic energy is used to make your muscles in the treatment area contract much more intensely than could ever be achieved in the course of a voluntary workout. And Hi-Fem in the form of Emsculpt saw great success in toning the abdomen, the glutes, and the arms and legs. Hi-Fem then was introduced for the purpose of tightening and toning and building the pelvic floor musculature in the form of a device called Emsella, which we've also mentioned in a bit more depth in prior episodes. But suffice it to say, this is a completely non-invasive procedure that is performed completely clothed that is FDA cleared to treat stress incontinence and also we found as a nice side effect of this procedure that intimate wellness is often improved because the pelvic floor musculature is strengthened and gets an improved blood supply after the workout from HIFEM. So in both the example of Emsculpt and Emsella, we are producing the equivalent of many, many supermaximal muscle contractions in the course of a treatment period. So for Emsculpt, we're able to trigger 20,000 muscle contractions in just 30 minutes. And in the case of Emsella, a single 30 minute session of Emsella is equivalent to performing 11,000 Kegel exercises.
[03:02] HIFEM has now really entered its next iteration with the recent introduction of Emsculpt NEO. In addition to having HIFEM, NEO also offers radiofrequency energy, and the effect of the radiofrequency energy is that it heats the tissue in the treatment area, both the muscle and the fat, and this will raise the metabolic rate of the muscle in the treatment area, making it more susceptible to a heavy workout. So whereas with the previous version of Emsculpt, muscle mass could be increased by 16%, with Emsculpt NEO, it's actually increased on average by 25%, which is just remarkable for a completely non-invasive technique. Additionally, the heat generated by the radiofrequency energy in Emsculpt NEO is a very even and comfortable heat that brings the fat in the treatment area to a critical temperature at which natural cell death occurs. So this allows for an average fat reduction in the treatment area of 30%. So when you combine that 30% reduction of fat with an average muscle build of 25%, you're really looking at some stunning results. And like Emsculpt, Emsculpt Neo is great for use in the abdomen, the arms, and the legs, as well as the glutes. And it's worth noting that when you're treating the glutes with Emsculpt Neo, the treatment program is such that Fat is not targeted with the therapy so that we can actually achieve a net increase in buttock volume and buttock contour. We love combining Emsella and Emsculpt Neo Treatments to really achieve this core to floor training so that you're building your core, you're building your pelvic floor, and the two of these structures are intimately involved in your overall wellness and state of conditioning.
[05:06] So Hi-Fem is a really cool new modality that's constantly evolving, and we invite you to check it out and see what it might be able to achieve for you. Thanks for listening, and don't forget to subscribe, share the show, and head over to darrensmithmd.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-12-02. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS