Does acoustic wave therapy kill fat cells or lead to a reduction in circumference of the area treated?

No I would not offer AWT for reduction of fat cells. I don't believe it reduces circumference of the thigh

It does not kill fat cells although it can reduce the circumference of an area that has extensive subcutaneous fat by reducing edema and acoustic lipolysis. It's felt to be a more natural way of reducing subcutaneous fat than via injections or radiofrequency.

Acoustic wave therapy is an effective, pain-free, non-invasive treatment which helps to reduce the appearance of cellulite and soften and firm the skin. There have been studies showing a reduction in circumference in thighs in particular treated with this modality. However, it does not "kill" fat cells. It does improve blood flow and lymphatic drainage, and can aid in the process of lipolysis- which is the shrinking of fat cell size (not the same as fat cell death). A recommended treatment course for quick improvement would be twice per week x 8 to 12 sessions. Thereafter, a maintenance session every month or two is a good idea to prevent recurrence.