For decades, there has been a search for an elusive fat-blasting, muscle-boosting device. “Slimming massage belts” and “fat slimming machines” have been around for decades for those who were seeking noninvasive alternatives to surgery such as abdominoplasty, also known as an old-fashioned “tummy tuck.”

“None of them really worked until Coolsculpting came long around a decade ago,” says Dr. Kate Dee, owner of Glow Medispa in West Seattle. A self-described “physics nerd,” Dee shifted from being a breast cancer specialist and a radiology career to medical spa services back in 2014, fascinated by the science of anti-aging and aesthetics.  

She’s not alone in her interest — in 2019, 386,557 noninvasive fat reduction procedures took place in the U.S., using methods ranging from freezing to heating to ultrasound technology.

Coolsculpting works by sucking fat between cooling plates or into a cup. This causes the fat cells to freeze and die — a process called apoptosis. After the cells die, they release lipids (or fats) into surrounding tissues; the lipids are later excreted in the urine. However, Coolsculpting can have a few side effects, potentially resulting in enlarged tissue areas, which could require additional interventions. “It’s not common but can lead to a lot of unhappiness,” Dee says. “It also can’t address many body contouring issues, and can yield uneven results.”

The next wave of technology involved a host of radio-frequency heat devices, which warmed fat versus cooling it. To work, the devices would have to heat the fat up a bit higher than the skin can tolerate, so some surface cooling was needed. At times, even this could be a bit warm and uncomfortable for some patients. Some devices used cold, low-level lasers or ultrasound to liquefy fat cells.

About five years ago, the Vanquish ME device came on the market, using specific frequency RF waves that target fat cells to tackle love handles, outer and inner thighs, flank and abdomen, without touching the skin. The Vanquish was the first body-sculpting device to really interest Dee. At her medical spa, she combined it with the Exilis Ultra, which uses radio-frequency and ultrasound to tighten sagging skin, which can often be left behind after fat removal.

In August 2018, Dee’s spa obtained the Emsculpt, an innovative device that works by creating rapid muscle contractions through high-intensity focused electromagnetic energy (HIFEM). The process sets off a chain reaction that contours the body by killing fat cells and simultaneously building muscle tissue.

“In studies on Emsculpt, they found that muscle increase is sustained on average, and people were stronger and doing more than they were before,” she says, and adds that studies showed improved posture.

The Emsculpt device uses powerful, localized magnetic waves which cause involuntary muscle contractions (over 20,000 of them) in a 30-minute session. “It’s a massive workout you could never achieve on your own, in a half-hour,” she says. It’s like doing thousands of sit ups — while just lying down, under the Emsculpt’s ovoid-shaped paddles.

Dee has experienced the Emsculpt — she doesn’t treat patients with anything she wouldn’t do herself. “It doesn’t hurt,” she says. At first, muscle contractions can feel intense, but as you relax, the movement actually feels good, she notes, without hurting or cramping.

Most recently, Glow added the Emsculpt Neo in November 2020. The Neo uses the same high-intensity electromagnetic energy, but combines it with radio-frequency to heat fat cells until they die. The process also tightens the skin a bit, leading to a 25% increase in muscle, and a 30% decrease in fat. Laying the Emsculpt paddles on a warm muscle is more effective, Dee says — so the machine kills more fat and builds more muscle in a series of four half-hour treatments.

“Being under the Neo can get warm, causing some to sweat,” Dee says. “However, unlike earlier machines, the Neo is constantly monitoring skin temperature and modulates radio frequency to decrease heat.” Typically, a session lasts 30 minutes, with 4 sessions in a series of treatments.


There’s no recovery period, and the Emsculpt is often used to treat the abdomen, buttocks, thighs, saddlebags, arms (biceps and triceps) and calves. The most popular areas are the abs and buttocks, she says.

“Fat loss is permanent,” Dee says. After the belly-fat cells die off, you won’t grow new ones. However, you can still gain weight — if you gain 20 pounds after enjoying too many Christmas cookies, you will just see it accumulate in other areas where you still have fat cells.

As well, you can’t Emsculpt your way to skipping leg day forever — to sustain your muscle growth, you’ll need to get serious about your squats or might need to return for further treatments. To keep your new muscle, you’ll have to use it!

Who uses Emsculpt?

The Emsculpt is applicable in a wide variety of situations. Emsculpt can help athletes who can’t rehab muscles on their own, or who deal with chronic back pain, she says. Male clients who already are reasonably fit request the Emsculpt to get that elusive six-pack, as the machine’s induced contractions are reported to lead to a 25% increase in muscle mass.

Women who’ve given birth can firm the belly area and help treat diastasis recti, a separation of abdominal muscles that happens naturally in pregnancy. Very few people aren’t good candidates — primarily those who’ve had a metal device implanted, such as the few people with copper IUDs or a pacemaker.

“Every body is different, but we have devices to approach any issue,” Dee says. “We see a full range of body types.”

Glow’s staff use the devices in various combinations, depending on the treatment area. Emsculpt Neo targets many areas of the body, but for the belly it works in a limited area at the center of the abdomen. So, the Emsculpt might tone the stomach around the belly button, but can’t address love handles or the back — so she uses the Vanquish in those spots.

“People tell me that they notice a difference right away — they went to do yoga and could hold a pose longer,” she says, due to the increased muscle strength. “Clients say they feel better, stronger, and often went down a pant size or two, depending on the body part targeted.  I call the Neo my 99% happy machine.”

Dr. Kate Dee, Glow Medispa

At Glow Medispa, we are driven by science, and everything we do is informed by the latest information and data available. We make a personalized assessment for each patient and strive to bring out your natural beauty.