Sponsored by BTL Aesthetics
The word is out, Emsculpt Classic and Emsculpt Neo by BTL Aesthetics (Boston, Mass.) deliver unique, non-invasive aesthetic body shaping modalities. According to a market analysis conducted in September 2021, by market research firm Medical Insight (Aliso Viejo, Calif.), the Emsculpt brand reached 1 million treatments faster than any aesthetic device before it.
With more than 25 billion media impressions and over 3,400 units installed globally to date, it is no surprise that both doctors and patients worldwide are reveling in the fruits of BTL’s innovation and labor.
The high intensity focused electromagnetic (HIFEM) technology powering Emsella was introduced in 2017, followed by the launch of Emsculpt (now Emsculpt Classic) about six months later. The company claims an average monthly treatment volume with Emsculpt Classic and Emsculpt Neo of approximately 21 and 39 per unit, respectively, with global accretive provider revenue surpassing $700 million.
According to David E. Kent, MD, a dermatologist and founder of Skin Care Physicians of Georgia (Macon, Ga.), the real value isn’t measured in dollars but in how many lives have been changed. “What Emsculpt means to people cannot be understated,” he expressed. “We take our basic health, mobility and functionality for granted until we start to lose it. Many want improved musculature and reduced fat, but for some, Emsculpt means restored function. They can again go out with friends, take walks with loved ones, or safely get in and out of the bathtub or a chair. It is where the rubber meets the road.”
Transcending the constant battle between hype and substance, Emsculpt technologies are a breath of fresh air – remarkable results and safety established and repeatedly proven by a constantly evolving body of published science that currently exceeds 30 peer-reviewed papers.
“BTL has always been committed to science-based results,” said dermatologist and cosmetic surgeon Suneel Chilukuri, MD, medical director of Refresh Dermatology (Houston, Texas). “As such they employ more than 300 engineers and scientists.
“BTL maintains a conservative approach to developing and marketing its devices by standing on the science, safety and results,” Dr. Chilukuri continued. “Despite facing a global pandemic, they have reached milestones with Emsculpt and Emsculpt Neo because they are careful and transparent regarding the foundation of their research.”
The power of the technology promotes itself, but BTL’s support of their physician partners elevates the brand. Examples include the Emsculpt bus tour that was launched in 2020, celebrity brand ambassadors, and maximizing the impact of social media.
The Power of HIFEM
Delivering coordinated electromagnetic pulses, the HIFEM power provided by Emsculpt and Emsculpt Neo non-invasively stimulates the targeted musculature causing supramaximal contractions over the course of a treatment session. The effect is heightened via software algorithms that modulate the pulses, specifically and thoroughly stimulating different muscles in the area for a workout that manual exercise could never achieve.
With four 30-minute sessions of Emsculpt Classic, the result is scientifically demonstrated muscular hypertrophy and hyperplasia, with muscle mass density increasing by more than 20%. Evidence provided by histology, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound revealed 16% greater muscle mass.
The newer Emsculpt Neo allows the simultaneous emission of synchronized radiofrequency (RF) energy with HIFEM, resulting in even greater muscle growth and fat reduction of up to 25% and 30% on average, respectively.
The Emsella chair applicator is designed to focus on the pelvic floor, which has been shown in studies to relieve incontinence and improve female sexual function. Other applicators allow for treatment of the extremities so that any smaller or curved body area can be treated safely and effectively, even in those with a higher BMI.
“Emsculpt technology works for individuals of any age or size – from very fit to those with a BMI over 30,” Dr. Kent noted. “It is everything our patients want. Patients always want to know three things: does it work, does it hurt and does it last? Emsculpt Classic and Neo undeniably answer these questions by reliably and consistently building muscle and burning fat safely and non-invasively for any of the major body regions. The Classic device works wonders, and Neo takes it to the next level with concurrent RF to burn more fat.”
According to Paul Jarrod Frank, MD, a celebrity cosmetic dermatologist based in New York City, N.Y., and author of The Pro-Aging Playbook, and creator of The Pro-Aging Podcast, first and foremost, Emsculpt opened up a new category of not just aesthetic, but general medicine: the ability to deliver muscle growth by increasing muscle mass and the number of fibers.
“Now, the second-generation Emsculpt Neo provides greater improvement coupled with localized fat reduction,” he continued. “And just as with exercise-based improvement in the musculature, we see improved strength, mobility, stability and overall health. There are certain cosmetic improvements we all desire, but it is the functional medical benefits that are most impressive.”
“It is extremely safe and comfortable for the patient,” Dr. Kent added. “The predictable half-hour sessions are easy to work into your schedule, and there is no downtime. For the business owner, it is dependable and easy for staff to use, is not labor intensive and does not require expensive consumables.”
“We have never before had a device that can honestly and realistically work out your whole body while you lean back and exert zero effort,” said Amanda Holden, MD, medical director of Holden Timeless Beauty (San Diego, Calif.).
“Emsculpt Neo is scientifically shown to safely and successfully treat nine different areas of the body effectively, with dramatic muscular improvement and visible fat reduction,” she explained. Patients of all fitness levels and age groups can experience customized results and functional improvement of some kind with Emsculpt Classic or Neo.”
The International Perspective
As Rita Rakus, MD, an aesthetic physician based in London, U.K., explained, “These devices are in countries all over the world. The consumer demand makes the return on investment attractive to practices of any size or location, and treatment is relatively affordable, making it accessible to most people if they want it. Furthermore, it is safe, effective and incredibly consistent.
“It is not just the results, but the rapid, dramatic transformations that some patients experience,” she continued. “Treatment makes you feel good, and you will begin to see the change in several weeks, with fuller results over a few months. It is real and predictable.”
More physicians from around the globe eagerly weighed in with their experience and excitement about Emsculpt technology, echoing the opinions and enthusiasm of their U.S.-based counterparts.
Ting Song Lim, MD, medical director of Clique Clinic (Selangor, Malaysia), embraces a holistic philosophy toward body contouring. “The Emsculpt technologies fit perfectly into our holistic approach,” he explained. “We call it ‘Slim, Sculpt, Tone and Firm,’ combining cutting-edge technologies and lifestyle changes. We reduce the total body fat percentage and sculpt unevenly distributed pockets of unwanted fat. Next, we tone and increase muscle mass, especially in difficult or critical areas such as the core, and then tighten skin. Emsculpt Classic and Neo help build muscle and combat muscle depletion. The RF component of Emsculpt Neo improves muscle growth and recovery while further reducing the fatty layer superficial to the musculature.”
Dermatologic surgeon Shirlei Borelli, MD (Sao Paulo, Brazil), also uses Emsculpt technologies daily. “Patients are generally seeking a well- defined musculature, mainly in the abdominal and gluteal regions with a primary focus on the appearance,” she shared. “However, I look at the whole body even if this isn’t the initial complaint of the patient, so that I can explain the importance of muscle strength and emphasize the role of core musculature in addition to the aesthetic possibilities.”
Cosmetic physician Saras Sundrum, MD, is medical director of several clinics in metropolitan Sydney, Australia. Having practiced for more than 25 years, with a strong interest in body contouring for ten years, she was among early adopters of body contouring technologies and has enjoyed success with the most recent and major modalities available in her area. However, it wasn’t until introducing Emsella, Emsculpt and Emsculpt Neo that the body shaping arm of her practices’ business began to explode.
“These technologies attracted patients in record numbers because they have the capability of building muscle and reducing fat at the same time, which has never been offered before,” Dr. Sundrum stated. “Emsculpt Neo consistently provides results for the patient wanting to trim stubborn inches as well as the fitter individual looking for a better physique with enhanced muscle definition.”
Dr. Sundrum also attributes a sizable portion of Emsculpt’s heightened appeal to the rise of social media. “All of us want to improve our health and appearance, and in that arena, we can’t help but compare ourselves to others. With this popularity and range in prospective patients, we are treating every day. Most patients start with a full course of four sessions and follow this up with additional touch up sessions six months post treatment.”
Predictable similarities aside, diverse cultures may have distinct ideals for body image. “Brazilians are generally concerned with body issues, worshiping well-defined bodies with reduced fat percentage,” Dr. Borelli stated. “Typically, both men and women are already in the habit of practicing sports and healthy eating, so the possibility of enhancing the definition of musculature with Emsculpt is welcomed.”
“Most of our patients want a nice, healthy- looking silhouette as well as some definition,” Dr. Lim agreed. “In Asia, body aesthetics is all about the right curves in the right places to fit into tight dresses and traditional costumes. Building core muscles and having lean-looking arms and thighs are very important. Emsculpt and Emsculpt Neo are perfect for this.”
“Increasingly,” Dr. Sundrum began, “our patients are looking for a fresh, healthy, fit look rather than an exaggerated ‘ripped’ physique, but it doesn’t matter because both Emsculpt Classic and Emsculpt Neo can help individuals toward their aesthetic and functional goals. In fact, using the Emsella chair for complete Core-to- Floor improvement is growing in popularity,” she added, “because patients want to exercise more efficiently, harnessing the full benefits of greater core strength and improved overall stability.”
While most would not expect the U.K. and U.S. to have drastically different cultural aspects to their aesthetic ideals, Dr. Rakus shared a surprising fact. “There is an extremely popular designer jacket in the U.K. with very narrow arms and we have generated a lot of business by offering arm slimming and toning treatments with Emsculpt Neo.
“This is an area where the reality of 25 billion media impressions comes into play because we don’t even have to tell patients about this, they already know,” Dr. Rakus continued. “Famous footballers, both active and retired, are known for using the device to take their health and performance to the next level.” The universal appeal of Emsculpt technology is revealed even more starkly by diversity. “We treat patients from all over the world in London, and everyone wants Emsculpt.”
According to Dr. Lim, the sound science backing the technology and solid public awareness about Emsculpt Classic and Neo, are keys to its rapid ascent. “Delivering observable outcomes comfortably with little or no downtime drives patients to come back for more and tell others about it.”
“Emsculpt is easy for both doctors and patients,” Dr. Sundrum expressed. “People can easily fit treatment into their schedule, there isn’t much to do before or after a session, and they don’t even have to remove their clothes! For doctors, treatment is quick and uncomplicated, and the turn-around is rapid.”
Health and Wellness
Worldwide, the potential effect of Emsculpt on quality of life is a major draw for any demographic group, Dr. Chilukuri advised. “All strength relies on core strength; any trainer will tell you that. Regardless of level of activity or need for performance, any age category or gender group, the core is the basis for strength, mobility, range of motion and stability,” he stated.
Of particular benefit is the full-body capability of Emsculpt and Emsculpt Neo. “Since day one, we were doing torso after torso, but most women see the inner thighs and saddlebags as problem areas and are thrilled to discover that these can be treated,” Dr. Rakus noted. “But more than the aesthetic aspect, patients are taken with the wellness benefits of Emsculpt. The functional aspect of treatment brings more men into the fold. In addition to better abdominals, they are often looking to improve their core for overall strength, mobility and posture, or to help improve or preserve strength after a sports injury.
“After age 40, we begin to lose muscle mass and it is almost impossible to keep it by just going to the gym,” she continued. “HIFEM’s ability to improve not only strength and tone, but muscle mass, helps us combat problems that also affect mobility, range of motion and overall wellness. Age-related concerns like bone density, posture, joint health and others depend on movement and at least modest weight-bearing exercise to maintain. Improved health and mobility allow people to do that more effectively by helping them be healthy and active longer, so they don’t become old and frail so quickly.”
“I’ve shared this before,” Dr. Chilukuri said, “but we gave my elderly father-in-law three sessions in two-weeks while he was visiting. We hadn’t seen him in a while, and he had lost an alarming amount of mobility. When he left, he could walk around the block (about a half-mile) versus the 30 yards when he first arrived, even after three sessions. It affected not only his health but his attitude.
“Additionally, we treated the abdomen for a professional horse rider and added the buttocks because we thought it would further improve her core for riding. She liked the effect so much she decided to get her inner thighs, biceps and triceps treated,” Dr. Chilukuri added.
According to Dr. Holden, a patient in her mid-40s using this technology after knee surgery claimed to have better upper leg strength than ever before because of these treatments. “She feels like she can suddenly walk again, that has been a miracle for her,” she explained. “Several others in our practice look to Emsculpt to keep their core strong so they can sustain function through back problems of various kinds and help them maintain a healthier spine with good posture and balance. The elderly can improve their functional musculature to restore strength without stressing joints that may be functionally compromised. Improved strength, stability and mobility keep them healthier and safer longer.”
Even the elderly seek aesthetic augmentation and get Emsculpt or Emsculpt Neo, according to Dr. Rakus. “I had a 70-year-old woman come in and ask if she could have a ‘bum’ because she never felt she had one. We were able to treat her successfully and she is very satisfied! Scientifically proven improvement in muscle volume has a visible effect that people are extremely pleased with. They do not need movie actor perfection, they are quite thrilled with visible, real, lasting improvement achieved safely and non-invasively.”
Unlike many energy-based and more superficially focused aesthetic technologies, there is no concern about seasons or sun exposure affecting patients undergoing treatment. “We are treating several patients every day with Emsculpt, Emsculpt Neo and Emsella,” Dr. Kent reported. “It doesn’t matter how sunny or which season it is, Emsculpt remains a workhorse, and among the most utilized devices we have.”
This is especially applicable in countries around the world whose climates are warmer and/or sunnier on average than seen in many parts of the U.S. “Weather in Australia is terrific most of the year,” said Dr. Sundrum, “so it is advantageous that my patients can receive treatment with Emsculpt technologies without needing to cover up after. They can enjoy the outdoor life year-round wearing figure-hugging exercise gear or swimwear. This, plus the lack of downtime, makes Emsculpt Classic and Neo even more attractive.”
A Practice Builder
According to Dr. Frank, Emsculpt is a practice builder. “It is an excellent stand-alone therapy but also complements everything we do, a powerful adjunct to virtually any other body treatment,” he stated. “By pairing it with other related therapies, you improve results consistently and predictably, piggybacking on its universal appeal to maximize satisfaction. For example, I use Emsculpt about one month after most liposuction procedures to enhance results. It is a safe, effective, easy, no-down- time treatment. It is that simple.
“And, Emsculpt has broadened our patient base by attracting those who wouldn’t otherwise have come to us, and exposing them to our armamentarium,” Dr. Frank continued. “There is something for all genders or ethnic backgrounds, any body part. Patients have a wonderful experience with these technologies, and it boosts their confidence about what else we can do.”
Dr. Chilukuri believes Emsculpt brings in the men like no other therapy. “Overall, approximately 10% of our patients are men, but with Emsculpt Neo, about 40% are men. It is not just about abs but improved functionality and health. Emsculpt sells itself.”
Dr. Rakus harnesses this appeal as a simple and remarkably effective marketing tool. “We give vouchers for a free treatment to everyone who comes in. For every ten we hand out, three people return for a full course of treatment – not every ten used, every ten handed out,” she expressed. “We encourage them to give away their voucher if they don’t want them. Given the high return on investment (ROI), we make a lot of money on that exposure with a conversion rate of 30%.”
“It is so easy to promote Emsculpt technology because it is consistently effective,” said Dr. Holden. “With Emsella, it has revolutionized our mommy makeovers, and we promote it that way, positioning the mommy makeover as the safe but profound restoration it can truly be. We can rely on scientifically demonstrated, non-invasive core-to-floor muscle improvement that enhances the look and function, and it may also provide relief from common post-partum issues such as incontinence. BTL’s Emtone can be a huge part of that as well.
“BTL’s Emsculpt technologies are the key piece of the puzzle making the concept of a true medical gym come to life,” Dr. Holden added. “The patient can relax, they don’t have to be around anyone else, and they obtain excellent results safely. I do Zoom meetings and other clerical tasks while getting treated, which allows me to relax and receive treatment while maintaining productivity. Emsculpt Classic and Neo are a wonderful supplement to a traditional gym membership and overall wellness plan, helping us take our bodies to the next level of health and fitness.”
Additionally, physicians agree that Emsculpt technologies have lent themselves well to success during the COVID-19 crisis. “In addition to the abundance of precautions we and other practices have taken during the pandemic, we have seen Emsculpt business thrive,” said Dr. Chilukuri. “The length of the hose between the user and patient is six feet, so we are easily able to maintain the recommended distancing on top of the many other precautions we take.”
Dr. Rakus has been doing six to eight sessions per day, even during COVID-19. “Emsculpt technology adapted well during the pandemic because it requires minimal contact with others to use safely. After the first session, patients are comfortable and safe by themselves during treatment, and nobody is in the room with them for the majority of that time. With other aesthetic treatments someone is in close proximity for 30 to 60 minutes.”
The issue of consumables is an even larger factor due to potential pandemic-related shortages and slower, less reliable resupply capabilities across the U.S., and the world, Dr. Kent indicated. “Unlike most companies, BTL is committed to minimal- or no-consumable, non-invasive technology; the Emsculpt devices are no different. BTL also manufactures everything they need themselves and is in control of their entire supply chain. They don’t have to depend on a part from another region of the world not arriving.”
The BTL name means a lot to physicians around the world. “With BTL, you know you have research-backed technology, excellent support and education programs, and robust devices that don’t need constant service,” noted Dr. Sundrum. “We have never had a problem with BTL devices. As a cautious and conservative person by nature, I especially value the safety and reliability of Emsculpt technology.”
“There is so much on the immediate and farther horizon for Emsculpt technology,” Dr. Kent hinted. “BTL is not done developing this, and we have so much to look forward to. BTL’s truly peerless Emsculpt and Emsculpt Neo have changed the game forever, making this an incredibly exciting time to be in this field.”
“I can sum up this amazing technology by saying that Emsculpt is a rare instance of a non- invasive device being everything it is hyped up to be and more, with plenty of science behind it and continued development driving further innovation,” said Dr. Chilukuri. “It does something that everyone wants and does it well.”