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How Can I Build Muscle and Burn Fat Without Surgery or Downtime? Meet Emsculpt!
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How Can I Build Muscle and Burn Fat Without Surgery or Downtime? Meet Emsculpt!

Episode 28: How Can I Build Muscle and Burn Fat Without Surgery or Downtime? Meet Emsculpt!

What is Emsculpt?
What is Emsculpt? Emsculpt is a noninvasive treatment that builds muscle and burns fat. It's painless. And it has no downtime. When you have an Emsculpt treatment, you are positioned comfortably on a table, like a massage bed, or something equivalent to that. And your provider straps the Emsculpt applicators, which look like big paddles, to the area that is going to be treated, then sets the strength of the treatment. And you're off and going.


How does Emsculpt work?

How does strapping a paddle to the outside of your body build muscle and burn fat? Well, what those paddles are doing is, they're actually providing magnetic energy, or to be specific, HIFEM, H-I-F-E-M, which stands for High Intensity Focused Electromagnetic Energy, to the muscle group that you're focusing on during your treatment. By providing this HIFEM to the muscle group, Emsculpt is able to trigger what is called a supramaximal muscle contraction. And these are muscle contractions that are more powerful than anything that you would be able to produce on your own during a workout.

Your body responds to this powerful stimulus by actually increasing the size of existing muscle fibers, and building new muscle fibers. At the same time, because this process is such an intense draw on local energy supplies, your body actually breaks down local fat cells near the treatment area. The end result is that muscle strength and tone increases, and the amount of fat covering the muscle in the area decreases, which is a win-win situation, in most cases. There is one notable exception to this, which we'll cover a little bit later in the episode.

Does Emsculpt work?

You've heard me say in the past that I'm a very data-driven person. I like to have the latest and greatest technology in my practice, but I only bring things into the practice once they have been extensively tested and studied, not only to ensure that they're safe, but also to make sure that they actually work, that you're going to get the great results that are promised.

This is really where Emsculpt stands out in a world of noninvasive body contouring treatments. Emsculpt takes its origins from a collaboration with NASA. So why was NASA interested in noninvasive body contouring? Well, the truth is, they weren't, but what they were interested in is solving another problem that they had, which is that when people, or specifically, astronauts, are in low gravity or zero gravity situations for long periods of time, they experience muscle atrophy or weakness, a lack of muscle definition.

So NASA collaborated with BTL, the company that now makes Emsculpt, to develop devices, to essentially provide physical therapy and muscle strengthening for astronauts, if they found themselves in situations where they did have a degree of muscle atrophy. So the scientists at BTL recognized the potential of the technology that they were developing for NASA and thought of other applications.

One of the major applications for this HIFEM technology was the aesthetic industry. That technology was further honed and evolved into the modern treatment that we know today as Emsculpt. And this technology has undergone extensive testing. It's FDA cleared, and there's a great deal of scientific literature documenting the results of this treatment.

Aside from scientific validation, the public has received Emsculpt extremely well in its own right, with the average patient satisfaction after an Emsculpt treatment being at 96%. Emsculpt, though, is not right for everyone, and a key to achieving excellent results with Emsculpt, and making sure that people are happy with this treatment, is patient selection. So that's something that we're going to get into a little bit later in the episode as well.

What kind of results will I see with Emsculpt?

So what kind of Emsculpt before and after results can you expect to see? Well, as we mentioned, Emsculpt is going to tighten and tone the muscles in the treatment area. The most popular areas for treatment with Emsculpt or the abdomen and the buttocks. And we've also seen great results in great applications for this device with the arms, for the biceps and triceps, as well as for the calves. So we can really see great definition in a lot of different body areas with Emsculpt.

At the same time as Emsculpt is tightening and toning the muscles in the treatment area, and achieving better muscle definition, it is also decreasing the amount of fat covering that muscle. You can have the best muscle definition in the world, but if there's too much fatty tissue covering the muscle, nobody's going to be able to see it. So Emsculpt helps from that perspective as well.

I did mention before that there is an exception to the general rule that Emsculpt will build muscle and burn fat. And that is for the buttocks. And a lot of people that come in for Emsculpt are looking for a noninvasive butt lift, a way to build, sculpt and lift the buttocks without having surgery, without undergoing something like a Brazilian butt lift or fat grafting to the buttocks.

So it wouldn't be very helpful if, at the same time that Emsculpt built the glutes, to lift and shape the buttock, it decreased the amount of fat on the buttocks. Because fat is very important in defining the shape of the buttock. So there are several different Emsculpt treatment protocols that we might use. And the one that we use to build the buttocks and do this noninvasive butt lift is designed not to break down fat.

Since Emsculpt really is rooted in science, and it comes out of that collaboration between BTL and NASA, it may not surprise you to hear that Emsculpt has great applications and results outside of body contouring. Because Emsculpt improves muscle definition, and builds strength, we've actually had a lot of patients, and heard from a lot of patients, that see improvements in back pain after undergoing Emsculpt treatments.

We think that's because as your core is better able to support itself, a lot of the pathology and anatomical issues that might be causing back pain could actually be alleviated. Emsculpt can also come in very handy after pregnancy, after childbirth. And that's because, and we discussed this in detail in earlier episodes, after pregnancy, the abdominal tissue, specifically the abdominal muscles, the rectus abdominis muscles, are often separated from one another in the midline to make room for the expanding uterus.

After the baby is delivered, you can be left with a space between the rectus diastasis muscles, a weakening in the muscle wall called a rectus diastasis. And Emsculpt has actually been shown to decrease the size of the rectus diastasis. So in addition to having an aesthetic benefit to decreasing the rectus diastasis, this can also contribute to improved core strength after pregnancy.

Who is a good candidate for Emsculpt?

This is a very important question, because Emsculpt is not for everyone, and if someone who isn't a good candidate has an Emsculpt treatment, they may not see results. So, to see really nice Emsculpt results, we are looking to treat individuals who are at their ideal body weight, or close to their ideal body weight, and are primarily interested in increasing their muscle tone and definition.

Because, while Emsculpt will get rid of a certain amount of fat in the treatment area, its primary purpose is to build muscle. So the fat reduction aspect of Emsculpt should be viewed as a happy accident in the process of building more muscle. So if you're looking primarily to decrease the amount of fat you have in a body area, Emsculpt is not the right treatment for you.

If, on the other hand, you're looking to build muscle mass and muscle tone, then Emsculpt could be perfect. So, for individuals that are looking to improve their muscle tone, but may have a little bit of extra fat overlying those muscles, that goes beyond the capacity of what Emsculpt can treat, we often end up pairing Emsculpt with liposuction to achieve really stunning results.

Where should I have my Emsculpt treatment?

This leads us to the next point of, where should you be going to get your Emsculpt treatment? Who should be doing these treatments? Now, because Emsculpt is so safe, and the treatment itself is so easy to perform, you can find Emsculpt in all kinds of different doctor's offices. And even, sometimes, not in doctor's offices, like in spas or at other facilities.

While this may seem appealing, because yeah, pretty much anybody can strap an Emsculpt paddle to someone, turn the machine on, and perform a treatment, this doesn't mean that a great result is going to be achieved. So we recommend that you go to body contouring experts, real board-certified plastic surgeons, to have Emsculpt treatments.

Because even though this isn't surgery, in fact, it's a totally noninvasive treatment, you should really have someone who is expert in the art and science of body contouring, and the underlying anatomy involved in this process, to design the ideal treatment for you. And also, so that they can be in a position to say, "Well, maybe Emsculpt isn't the right thing for you, but here are some other options that we can offer."

The old saying, "When all you have is a hammer, everything looks like a nail," comes into play here. So if you're going to providers that don't have other instruments for body contouring at their disposal, such as liposuction, or even excisional surgical procedures, it may be more likely for you to find yourself as an early scenario. "Well," we'll say, "okay, well, we have Emsculpt, so let's give it a shot."

How much does Emsculpt cost?

This also gets into the question of how much does Emsculpt cost, how much is an Emsculpt treatment? In general, while you will find some geographic variability, you can usually expect to pay approximately $3,000 for the full Emsculpt treatment regimen. And that treatment regimen to achieve the best possible results consists of four rounds of Emsculpt, performed over a two-week period.

With so many other things, you often get what you pay for. And the less expensive Emsculpt treatments may not include a consultation with a body contouring expert, to ensure that you're a good candidate for the procedure, and to design a treatment plan that will bring you results that you're going to be happy with. And while going to an under-qualified EMS called provider may be less expensive on the front end, it certainly becomes more expensive if you don't get the results that you're looking for, and then just have to have other treatments to achieve what you were going for in the first place.

When will I see results of my Emsculpt treatment?

The results of Emsculpt are generally not immediate, although a lot of people report feeling an improvement in their muscle tone, and feel better during their workout sometimes right after an Emsculpt procedure, it really does take about four to six weeks to see the final treatment results. And that's because, just like when you're working out and building muscle, it does take time for muscle to respond to that stimulation, and build itself up.

Is Emsculpt permanent?

This leads us to another very popular question about Emsculpt, which is, are Emsculpt results permanent? And the answer is no. Again, just like with working out, if you aren't maintaining the results, they will eventually fade. And you can maintain your Emsculpt results by keeping up with an active diet and exercise routine. And some folks like to have a touch up Emculpt treatment every six to 12 months. And those touch up treatments don't generally consist of the four round of Emsculpting treatments, but just one round of Emsculpting every six to 12 months, some people find helpful in maintaining their results.

Will Emsculpt tighten skin?
We're also sometimes asked if Emsculpt will tighten skin. And the short answer is no, but the longer answer is that in some instances, by building muscle mass underneath areas that have very mild skin laxity, that mild skin laxity may appear to improve a little bit, because by bulking up the muscle, you're taking up some of the slack from that skin. But in general, Emsculpt should not be looked at as a treatment that tightens skin.

What can I do to enhance my Emsculpt result?

And again, this really points to the importance of going to a true body contouring expert to have your Emsculpt treatment, because someone like this can start to offer combined procedures that will really get you excellent results. For example, something that we really love to offer is a combination of Emsculpt to build muscle mass, if necessary, liposuction, to get rid of some of the extra overlying fat, and also a radiofrequency skin tightening with a body tight device, to essentially shrink wrap the skin to this kind of new and improved underlying tissue structure.

I also wanted to bring up another great combination treatment with Emsculpt, and that is the combination of Emsculpt with another treatment called Emsella. And Emsella is another device by BTL that uses the same HIFEM technology, but it is designed specifically to treat the pelvic floor.

And while it's actually FDA cleared to treat stress incontinence in both men and women, Emsella, we have found, to provide some really nice other benefits, as well, by building and strengthening the pelvic floor musculature in terms of sexual satisfaction, and also improving core strength. Because the abdominal musculature and the pelvic floor musculature really functions in concert to provide that core strength. So this has led to the term core to floor treatment.

So we're looking at Emsculpt to treat the core directly, by focusing on the abdominal musculature, and Emsella to focus on the pelvic floor musculature. And this core to floor training idea is particularly relevant now, since this episode is being recorded during the COVID-19 pandemic.

Something else we're seeing a lot with Emsculpt and Emsella is that people are opting to come to us, for essentially what is a medical gym, to get in their workout in a clean, safe, private medical grade environment, instead of going to crowded gyms or classes to do their conditioning. So while Emsculpt has always been a really great treatment, a lot of people are finding it especially helpful right now.


  • Darren M. Smith MD
  • Darren M. Smith MD
  • Darren M. Smith MD

All photos are of models except before and after images.

© Darren M Smith MD. All Rights Reserved. How much is Liposuction?, Emsculpt Neo

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