Thomas D. Berg, MD

While you shouldn’t incur any side effects or negative results performing Botox 1 week before our center always recommends performing EmFace first as you may require fewer units of Botox and your provider can more adequately assess your Botox needs. EmFace is essentially attempting to create a younger face (more lift, fewer wrinkles, more tone, improved fat pad position and maybe even preservation or restoration of bone mineral density) to be treated.

EmFace is not painful. In fact many of our clients describe it as a relaxing (albeit unique) warm massage. We turn the lights down and ask clients to relax and close their eyes while the machine quietly pings in the background. There are involuntary light contractions on the elevator muscles of the face as well as warmth from the RF tech imbedded in the temporary applicators across your forehead and cheeks. Any discomfort would be an indicator that the RF or muscle stimulation or both should be easily readjusted to a level that is comfortable. We’ve had several clients almost fall asleep during the procedure. Take care and good luck!

Coolsculpting Elite offers several advantages over earlier models. The applicators are more ergonomic allowing more tissue to be treated and improved skin contact which translates to better results and better ease of use. The Elite also allows dual sculpting which allows two areas to be treated simultaneously with smaller applicators, Some centers are reporting earlier results with the Elite as early as 3 weeks. We have noticed more consistent results averaging approximately 24 percent in the volume treated as well as assistance in client education the campaign “it takes two which emphasizes to clients they will likely be happier undergoing two treatments on the same area reducing fat by up to 48 percent in the area / volume treated which is obviously much more noticeable than 20-24percent. We believe it is very beneficial to add transform body cream from Alastin to supercharge your results and help with skin tightening.
In summary the Elite is more ergonomic for ease of use and allows more tissue to be treated, faster with dual sculpting and delivers more consistent results in our experience. Thanks for the question and Good luck !!

The Transversus abdominis is the deepest muscle layer of the abdomen wrapping from front to back like a support sleeve extending to the pelvis. While it does attach near the pubic symphysis anteriorly (in front) it is unlikely to receive enough stimulation during a Emsella session to result in any noticeable difference in waist size. That said, I like where you are going with the question though as BTL and our center U.S. Bodycontour and Wellness continually beat the mantra that our goal is to strengthen you from CORE TO FLOOR!! There are certainly important relationships between the abdominal core and pelvic stabilizing muscles which we should never ignore!!

Short answer - we would allow you to undergo the procedure at our office.

Long answer - Any metal can be a serious issue given the electromagnetic fields produced in emsculpt. Absolutely no wired devices (can induce electrical currents and burn, or deactivate or deflect the device, or result in arrhythmia and fatal events). Metal in the soft tissues has the potential to heat up and cause local tissue discomfort and burns or in rare cases can deflect / move (typically ok after 6 weeks of scarring in). As in MRI scanning we would ask the patient to monitor the area and report if there is any discomfort or abnml sensation in the area of the metal while proceeding (unless the metal is in a critical location near vital structures - ie aneurysm clips and of course not in the immediate treatment area). For clients with metal in the bone (following fracture repair as in this case or total joints etc ) at our practice we advise similar warnings to monitor the area for ANY discomfort or unusual sensations and do not recommend treating directly over the implanted metal unless it is at perceived safe depth beyond the range of penetration of emsculpt devices. Absolutely no ferromagnetic earrings or other superficial piercings in the area treated. The performing practice / physician on site or providing oversight should individually ok or monitor each instance on a case by case basis to ensure a safe treatment environment. Emsculpt and emsella produce a localized magnetic field which is different than an MRI suite where the magnetic field is diffuse and always on. Emsculpt and emsella are dependent on the depth of penetration of the magnetic field which can result in greater safety than originally thought in many cases.

These are not blanket rules for every site and clinical decisions regarding treatment are ultimately the responsibility of the performing physician / practice who should institute guidelines for their site they and their staff are comfortable adhering to… And review each case on a cases by case basis!

You can help your local provider by providing as much DETAILED information about the device, location and characteristics exactly how you have done for us in this case with the radiograph.

Alternative muscle stimulation therapy devices such as TruSculpt flex which is direct bioelectrical stimulation device with limited penetration may be an alternative option in difficult cases.

After undergoing CoolSculpting, you can begin using pure muscle stimulation devices like Emsculpt Classic or TruSculpt Flex immediately. In fact, this can even aid in the breakdown and removal of fat cells. However, we recommend delaying the use of Emsculpt Neo until you have full sensation in the treated area, assuming it's the same spot, to minimize the risk of thermal injury. Alternatively, you can opt for the low radiofrequency (RF) setting, which provides muscle warming without inducing lipolysis. Nonetheless, most clients prefer the maximum RF setting for optimal results. Get the most out of your treatment and achieve your desired outcome. #CoolSculpting #Emsculpt #MuscleStimulation #OptimalResults#usbodycontourandwellness#iowacity

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1. Emsculpt, Emsculpt Neo, EmFace, Emsella chair, should all have the logo “BTL” displayed on their consoles. Have your provider give you the name of their BTL rep. If they won’t, it’s not real! There are many ways to check but these are the most a couple of the quickest. Take care. Good luck on your self care journey!!

The transverse abdominis or transversalis muscle is the deepest muscle layer of the abdomen underling the ext and int obliques. Modalities such as emsculpt target the central abdomen muscles primarily rectus abdominis due primarily to positioning of the paddle but there is some involvement of the onliques and transversalis more so if the client is petite. If two paddles are used in a larger client the paddles are more centered at the border of the rectus and transversalis which more directly stimulates the transversals. Emsella will not treat the transversalis simply because of the distance away from the point of stimulation. Take care and good luck on your wellness journey!

A better option for specifically targeting the transversus abdominis / transversalis might be emsculpt neo with the edge paddles or if larger client simply two large paddles on abdomen. TruSculpt flex is worth mentioning as a direct electrical muscle stim device which can “selectively “ target the trasversalis and external and internal obliques placing electrodes directly over them. The majority of the central portion is aponeurosis / fibrous tissue between the medial and lateral portions of the transversalis therefore the best way to stimulate is off midline. Of course you will have some increase in muscle bulk in general but your abdomen will be overall tighter. Take care and good luck on your journey!

Epilepsy is a still as a listed contraindication on the consent form. Proceeding would require clearance from your treating epilepsy physician and the medical director at the site you hope to obtain the service and obtaining both will be an uphill battle and would require at an minimum additional informed consent information. Unfortunately alternatives such as Cutera’s TruSculpt flex also list epilepsy as a contraindication. Overall, personally I would defer to the manufactures (BTL) recommendation and an abundance of caution as I’m not certain the benefits would outweigh the risks.