Emsculpt & Emsculpt Neo: What You Need to Know

Emsculpt Neo is a next-generation, FDA-cleared device that combines enhanced HIFEM technology (delivering up to 20% more electromagnetic pulses than the original) with radiofrequency (RF) energy in the form of heat, to burn fat more effectively.

"If you have greater than one inch of fat or have a higher BMI, you may prefer the Emsculpt Neo, as more fat reduction may be seen with this due to the additional radiofrequency component," says Dr. Sanjay Grover, a plastic surgeon in Newport Beach, California.

Emsculpt Neo can treat all the same areas as the original device, and it recently gained FDA clearance for lipolysis (fat reduction) of the thighs. Treatment of the butt, arms, and calves is typically done without heat, to avoid volume loss from fat reduction.

In September of 2022, Emsculpt Neo will also offer a new applicator called the Edge. It’s designed to tone the oblique muscles on each side of the abdomen, to improve posture and core strength while reducing back pain.

According to Dr. Grover, four 30-minute sessions over two weeks are recommended with the original Emsculpt device, whereas the recommended treatment plan for Emsculpt Neo is one 30-minute session each week for four weeks.

Both devices can also reduce diastasis recti, a condition where your abdominal muscles separate (usually during pregnancy) and create a belly pooch. In fact, these are the only nonsurgical treatments shown to be effective in treating abdominal separation. While doctors on RealSelf still recommend a tummy tuck for people with significant separation, they say Emsculpt can be a good option for avoiding surgery.

RealSelf Tip: Emsculpt can be combined with Emsella for a treatment called Core to Floor therapy, which strengthens and tones the whole core—both the abdominal and pelvic floor muscles. The combination boosts core strength and balance while reducing urinary incontinence and back discomfort.

Related: My Unfiltered Emsculpt Review, from Cost to Pain to What Results Were Really Like

Pros

• These nonsurgical treatments require no anesthesia and come with no downtime afterward.
• Both treatments come with the dual advantage of toning muscles and reducing fat. They're a good option for people who want a more sculpted, defined physique and stronger muscles.
• Emsculpt Neo improves on the original device, offering even better muscle building and fat reduction results.
• They're suitable for all skin types and tones, with no reported side effects other than some temporary muscle soreness (like you'd feel after an intensive workout).
• Just four treatments can yield visible results, and a majority of RealSelf members who've had the treatment say it's “Worth It.” Many report seeing an impressive increase in muscle tone, and some also say they felt a boost in strength that helped them achieve more during their workouts. 

Cons

• People with more than an inch of pinchable fat may not see as much of a change from the first-generation device. The fat can act as a barrier between the magnetic coil and the muscles, reducing the strength of the muscle contractions during treatment. Those with a higher BMI should seek out a provider with the more powerful Emsculpt Neo device. 
• Like other muscle building and fat reduction treatments, they're not intended for weight loss. 
• These aren't one-and-done treatments: your treatment plan will likely include multiple sessions in quick succession—four within a two-week period—for optimal results, followed by maintenance treatments.
• You won't see optimal results until about three months after your last treatment. That's how long it takes for the new muscle fibers to develop and excess fat cells to break down. 

RealSelf Tip: Neither type of Emsculpt treatment is intended for skin tightening. If you have skin laxity, a nonsurgical treatment or plastic surgery to remove excess skin will be more effective options. It also doesn’t get rid of cellulite. If that’s your primary concern, Emtone would be a better option.

• Average Cost:
• $3,000

• Range:
• $1,000 - $6,000

You can expect to pay $750 to $1,000 for a single Emsculpt treatment. For optimal results, providers recommend an initial series of four weekly Emsculpt sessions. 

You'll also need to budget for maintenance treatments every six months, to keep up your results.

You can finance your treatment with CareCredit.

See our complete guide to Emsculpt costs

The Emsculpt photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Emsculpt

• One 30-minute Emsculpt session produces nearly 20,000 muscle contractions (similar to crunches that you‘d do in the gym)
• Contracting repeatedly without rest stresses the muscles, triggering cellular changes that lead to rapid muscle growth. 
• To supply energy for so many muscle contractions, neighboring fat cells break down via a process called lipolysis. 
• The damaged fat cells release their contents as free fatty acids, and the cells themselves eventually die. The body's lymphatic system naturally eliminates them over the coming weeks and months.  

Emsculpt Neo

• This second-generation device produces up to 24,000 muscle contractions during a treatment session, thanks to enhanced electromagnetic energy. 
• It pairs these contractions with radiofrequency heat, using a patented electrode found in no other device. The RF heat boosts blood supply to the muscles, which helps increase the number of muscle fibers and overall muscle volume. According to one study, Emsculpt Neo “activates muscle-derived stem cells similar to a 12-week resistance training.”  
• The thermal energy also heats the fat layer to just above 42°C, the temperature at which fat cells begin to break down. Severely damaged fat cells are metabolized and eliminated by the body over the next several weeks, leading to permanent fat loss.
• This combination of muscle building and fat burning creates stronger, more defined muscles and a leaner physique.

Both treatments keep working after you finish your last session: your muscles should continue to grow and your fat to shrink for about four months after you finish your last procedure.

RealSelf Tip: Emsculpt is a popular nonsurgical butt lift option. It creates a firmer, more shapely butt via muscle building (minus the fat cell destruction), so it won't create the same degree of projection as what you'd get with a surgical Brazilian butt lift, which transfers a significant volume of fat cells into the butt. That said, it can be a good option for athletic patients that want a rounder, higher butt.

Emsculpt works best for those who have less than an inch of pinchable fat in the treatment area, according to Dr. Kinney’s research. “The ideal candidate is really anyone who’s looking to get stronger muscles and a stronger core, who wants to be tighter and burn fat,” says San Diego dermatologic surgeon Dr. Eugene Nowak. 

Emsculpt Neo, on the other hand, can treat patients with a BMI up to 35—higher than most other nonsurgical body contouring treatment options. 

Both treatments are suitable for all skin types.

Emsculpt

• Expect the session to last about 30 minutes for large areas and just 20 minutes if you’re having smaller areas treated.
• First, you’ll lie down, and the applicators will be strapped onto the targeted treatment area. 
• If it’s your first Emsculpt procedure, your doctor will start the device on its lowest setting. 
• As it begins sending high-intensity electromagnetic energy to the target muscles, you’ll feel them contract powerfully. 
• The feeling can be strange—like you’re in the middle of an intense workout, though your body isn’t actually doing anything—but it shouldn’t hurt. In fact, some people find the feeling so unusual that they laugh.

Emsculpt Neo

• An Emsculpt Neo treatment is similar, but you’ll also feel the RF heat, which should reach its full intensity within the first four minutes. 
• A sensor in each applicator will monitor your skin temperature in real-time to prevent burns, but your provider will still check in regularly to ensure that you’re comfortable. 
• Your provider will gradually increase the intensity as much as you can tolerate, asking you if you’re comfortable as it ramps up. Most people in Dr. Kinney’s clinical study were able to endure close to the maximum level of intensity by the end of their first session, which doctors encourage for best results. Over time, you may be able to start your sessions at higher settings.
• The Emsculpt machine will contract your muscles hundreds or thousands of times, in just a few seconds. 
• The supramaximal contractions will cycle through different phases. Some will be rapid and light, and some will be more powerful. 
• During the last phase of treatment, the muscle contractions will be slow but intense, to flush out any toxins or lactic acid released during the procedure and help reduce soreness.

You won’t need recovery time afterward, but don’t be surprised if you feel sore, like you pushed yourself through a tough workout. The soreness should resolve within one or two days. You can resume regular activity—including exercise—right away, though you may want to rest if your muscles feel tired.

Related: Beauty in Focus: Body Contouring with Emsculpt and Emsculpt Neo

Most patients need four 30-minute treatment sessions, spaced two to three days apart, for optimal results. 

Additional sessions beyond the initial four won’t hurt, but they may not improve your results. 

“Current studies have shown that results tend to plateau after four sessions,” says Dr. Nicole Hayre, a dermatologic surgeon in McLean, Virginia. “Therefore, extra sessions will likely not increase the benefits of the treatment.” 

You’ll see the best results from living a healthy lifestyle after your Emsculpt treatment series (including regular exercise) and returning for maintenance treatment sessions every six months.

Emsculpt results

Clinical studies conducted by Emsculpt’s manufacturer, BTL, show reductions in waist size and fat and increases in muscle mass with the original Emsculpt device.

Research led by Dr. Brian M. Kinney, a plastic surgeon in Beverly Hills, California, showed that muscle mass increased by about 16%, while fat decreased by nearly 19% after four sessions. 

In amulti-center study involving both Dr. Kinney and BTL medical advisor Dr. Carolyn Jacob, a dermatological surgeon in Chicago, patients who originally weren’t happy with the shape of their buttocks reported an 85% improvement after four Emsculpt treatments, noting that their butt felt more lifted and firm. 

Dr. Jacob’s study also found that the treatment reduced people’s waist circumference by an average of 1.5 inches (3.29 centimeters) after four treatments. Three months later, their waist size had shrunk even more: his Emsculpt patients had lost 1.7 inches (4.37 cm) in total.

“I think overall, patients are very pleased with it,” says Dr. Grover. “I’ve also done treatments on myself, and I feel like it’s definitely increased my tone and improved my muscle definition.”

Emsculpt Neo results

Clinical trials funded by BTL show an average fat loss of 30% in the treated area, a 25% increase in muscle mass, and a waist circumference reduction of up to 2.3 inches (5.9 cm), one month after treatment. 

They also demonstrated a 19% reduction in abdominal muscle separation, a boon for people with diastasis recti.

Like other body contouring treatments, this one isn't intended for weight loss. 

You can expect to see an average fat loss of nearly 19% in the treated area with Emsculpt and 30% with Emsculpt Neo, but you’re unlikely to see a change in weight, according to a 2019 study in the Journal of Aesthetic & Reconstructive Surgery. 

It's also important to keep in mind that good candidates for the classic version of the treatment are already at or very near their ideal weight, while Emsculpt Neo can treat patients with a BMI up to 35.

People who are relatively fit may start to see some improvements within a few days of their first treatment session. 

After the recommended series of four treatment sessions, all good candidates should feel stronger and see more muscle tone and reduced fat in the treated areas, with the most results visible after three months.

Final results can take even longer to appear, especially in areas with more fat. “Building muscle takes time. We can’t go to the gym once and say we’re toned and strong,” Dr. Nowak says. “The muscle builds over the next couple of months. Apoptosis—the breakdown of fat cells—takes a couple of months to happen.”

Related: How to Speed Up Your Lymphatic System Post Body Contouring

As with other nonsurgical treatment options, Emsculpt results aren’t permanent: they will last as long as you maintain them with regular exercise (including strength training) and follow-up treatments every six months.

No Emsculptside effects have been reported. That said, this noninvasive treatment is still relatively new, having launched in mid-2018, so we don’t know much yet about its long-term effects—including how high-intensity electromagnetic energy might affect your organs over time. 

Emsculpt Neo is even newer, but no serious side effects have been reported.

“So far, Emsculpt is shown to be a very safe treatment,” Dr. Nowak says. However, doctors say that you shouldn’t have this treatment if you’re pregnant; have a pacemaker or other implanted electronic device near the treatment site; or have heart issues, a history of seizures, or any other medical conditions that could make the device’s electromagnetic field dangerous for you.

Avoid Emsculpt if you have any type of metal, such as a copper IUD or a hip implant, near the treatment zone. The high-intensity focused electromagnetic energy of Emsculpt can heat up the metal or dislodge it.

	Emsculpt & Emsculpt Neo nonsurgical	CoolTone nonsurgical	CoolSculpting nonsurgical	Liposuction surgical
Worth It Rating	75%	45%	68%	87%
Average Cost	$3000	$1975	$2275	$6825
Downtime	No downtime	No downtime	Minimal downtime	1–2 weeks of downtime
Anesthesia	No anesthesia	No anesthesia	No anesthesia	Local or general anesthesia

Many fat reduction treatments are available using cold, heat, or ultrasound waves. Because Emsculpt is the only one that both reduces fat and tones muscle, it can be used as a complement to other fat-loss treatments.

• CoolTone, just cleared by the FDA in 2019, similarly uses magnetic energy to firm, tone, and strengthen the abs, buttocks, and thighs by stimulating muscle contractions. It has a significantly lower Worth It Rating than Emsculpt.
• CoolSculpting uses intense cold to freeze away pockets of fat under the skin. It’s FDA-approved for trimming fat in the belly, upper arms, thighs, and back; around the bra; and under the chin. The biggest difference between the two is that CoolSculpting doesn't build muscle: it's only intended for fat reduction. It also has a lower Worth It Rating than Emsculpt. 

Related: CoolSculpting vs. Emsculpt: What’s The Difference?

• Liposuction is a surgical procedure that suctions out fat with a thin tube. It requires anesthesia and incisions, which means you’ll have some downtime afterward. But the results are more dramatic, and it has a slightly higher Worth It Rating than Emsculpt. 

RealSelf Tip: At-home muscle-building devices, such as the Flex Belt, use electromagnetic energy at much lower levels than those of Emsculpt, for significantly fewer, weaker contractions—think 150 per 30-minute session vs. 20,000. Doctors on RealSelf say there is no comparison between these devices and Emsculpt.