A multicentre abdominal MRI study reported less subcutaneous fat and greater muscle thickness after three combined HIFEM and RF treatments; those imaging findings should not be mistaken for weight-loss or strength measurements.
How to interpret the measured result
MRI thickness and cross-sectional area describe the scanned tissues. They are not whole-body weight-loss measures, direct strength tests or proof of metabolic benefit.
Study at a glance
Design: Multicentre, uncontrolled MRI evaluation.
Participants: 41 enrolled; complete timepoint-specific analysis counts not available in accessible abstract.
Research protocol: Three weekly abdominal HIFEM+RF treatments.
Follow-up: One, three and six months.
Evidence visual: One abdomen, four different measurements
The sections below explain exactly what each measured result describes.
Fat thickness
Subcutaneous layer: -30.8 % change.
Three-month local thickness change. Not total body-fat percentage.
Muscle thickness
Abdominal muscle: 26.1 % change.
Three-month MRI thickness change. Not a direct strength test.
Muscle separation
Measured separation: -18.8 % change.
A distance endpoint, not proof of hernia repair or complete diastasis resolution.
Waist circumference
External circumference: -5.87 cm change.
An external circumference measure. Do not put this centimetre result on a percentage axis.
Source for the visual: [S02]. All values are study averages at three months; 41 enrolled, full per-endpoint denominator not verified from the abstract.
An inside view of the treatment area
An abdominal contour is made up of more than one tissue. A change in the layer of fat above a muscle is different from a change in the muscle itself. MRI allows researchers to examine those structures separately rather than trying to infer everything from a photograph. [S02]
The abdominal study by Jacob, Kent and Ibrahim is valuable for that reason. Its principal contribution is not simply a large percentage. It is the use of internal imaging to examine several distinct anatomical measurements after the combined EMSCULPT NEO procedure.
The right question is therefore not only “did the abdomen become smaller?” It is also “which structure changed, how was it measured, and what does that measurement actually tell us?”
For treatment background, read What is EMSCULPT NEO?. This article focuses on the specific research question.
The study in practical terms
The researchers enrolled 41 adults in a multicentre study and used three weekly abdominal treatments combining HIFEM and synchronised RF. MRI assessments were scheduled at one, three and six months. The published abstract reports the main outcomes, although it does not provide the full endpoint-specific participant counts at each visit. [S02]
There was no concurrent sham group in this report. It contributes a detailed anatomical observation, while the separate sham-controlled trial answers a different question about comparison with low-energy treatment. These two types of evidence should be read together rather than described as identical study designs.
Four outcomes that should stay separate
At three months, the study reported an average 30.8% reduction in subcutaneous fat thickness, a 26.1% increase in muscle thickness and an 18.8% reduction in the measured abdominal muscle separation. Mean waist circumference decreased by 5.87 cm. The authors reported maintenance at six months. [S02]
The first two are tissue-thickness measurements. Muscle separation is a distance between structures. Waist circumference is an external measurement around the body. None is an interchangeable substitute for the others.
For example, a reduction in circumference does not tell you how much was attributable to fat, muscle, posture or measurement conditions in a particular patient. MRI gives additional information about tissue layers, but it still does not turn an average study result into a personalised forecast.
Does a change in muscle separation mean diastasis is cured?
The MRI paper included a measurement of abdominal muscle separation. That is not the same as demonstrating complete clinical resolution of diastasis recti, repairing a hernia or proving that abdominal wall function returned to normal. Those would be different clinical claims requiring appropriate assessment and outcomes. [S02]
A patient concerned about a gap, bulge, pain or instability needs the problem identified before a device programme is discussed. An attractive percentage should not bypass the question of what is actually causing the concern.
This distinction is particularly useful after pregnancy or previous abdominal surgery. The study is evidence about its measured anatomical endpoints, not permission to assume that every postoperative or postpartum abdomen has the same treatment needs.
Why MRI and a 3D surface scan answer different questions
MRI examines internal anatomy. A 3D optical scan records the external surface. A photograph documents appearance under particular lighting and positioning. Each can have a role in documentation, but they should not be presented as the same test.
A surface scan cannot independently verify the percentage increase in internal muscle thickness reported in this MRI study. Nor can a heat-map display of surface change diagnose the tissue responsible for every contour difference. This is a measurement distinction, not a reason to dismiss surface tracking.
The sensible approach is to explain the tool being used and its limits. At a ¹EM consultation, ask what will be documented, how repeatability will be maintained and which questions would require examination or a different test. There is no need to order research-style MRI routinely just to imitate a published paper.
Understanding the timing
The study assessed changes after the treatment course rather than treating the final session as the final outcome. Its largest reported changes were at three months, with later maintenance described by the authors. [S02]
For a patient, this supports the value of a planned review rather than repeatedly comparing the abdomen from one day to the next. It does not establish an exact personal result date. It also does not justify a rule that every patient needs a top-up at six months.
A useful review separates what you can measure from what you feel or notice. Both matter, but the record should make clear whether a conclusion comes from circumference, photographs, a scan, function or the patient's own goals.
What this adds to the ¹EM evidence picture
The abdominal MRI study gives a complementary view of the same broad treatment concept examined in controlled ultrasound research. Together, these papers support a discussion about local fat and muscle measurements, with different strengths in design and measurement. [S01, S02]
Do not average the 30.8% MRI fat result with the 28.3% ultrasound result to create a new “¹EM expected result”. They came from different study populations and measurement methods. A simple average of published percentages is not a valid combined estimate.
The practical message is that EMSCULPT NEO has published anatomical evidence worth discussing. Whether that is the right intervention for your own concern still depends on the diagnosis, treatment goal, alternatives and willingness to accept uncertainty.
Safety and transparency
The accessible abstract describes the treatment as well tolerated, but a small clinical study cannot exclude uncommon harms or establish suitability for every patient. Magnetic stimulation and RF require screening, and RF carries heat-related risks. [S02, G01]
The complete funding and disclosure statement was not verified from the accessible abstract used for this article. Accordingly, the paper is not labelled independent. The result is presented at the level supported by the source: a multicentre imaging study with reported changes, rather than a guarantee of outcome or a universal treatment protocol.
Frequently asked questions
What did the abdominal MRI study actually measure?
It assessed subcutaneous fat thickness, abdominal muscle thickness and muscle separation on MRI, with waist circumference as an additional external measurement. These are different endpoints and should not be collapsed into a single percentage. [S02]
Was the MRI study the same as the sham-controlled trial?
No. The 41-person MRI report and the 72-person sham-controlled ultrasound trial are separate publications with different designs. One should not be described using the other study’s control group or participant count. [S01, S02]
Does the 18.8% separation result mean a hernia can be treated with EMSCULPT NEO?
No. A measured change in muscle separation does not establish hernia repair or suitability for a person with a suspected hernia. A clinical examination is needed before considering treatment. [S02]
Can a ShapeScale scan prove I gained 26.1% muscle?
No. A surface scan does not reproduce the internal muscle-thickness measurement made by MRI. It may document external shape, but that is a different endpoint.
Should everyone have an MRI before and after treatment?
This paper does not establish that routine clinical MRI is required. The clinician should choose documentation appropriate to the question, rather than ordering a scan simply because one was used in research.
Sources
[S02] Jacob C, Kent D, Ibrahim O. Efficacy and Safety of Simultaneous Application of HIFEM and Synchronized Radiofrequency for Abdominal Fat Reduction and Muscle Toning: A Multicenter Magnetic Resonance Imaging Evaluation Study. Dermatologic Surgery. 47(7):969–973. 2021. DOI: 10.1097/DSS.0000000000003086. https://pubmed.ncbi.nlm.nih.gov/34001694/
[S01] Samuels JB, Katz B, Weiss RA. Radiofrequency Heating and High-Intensity Focused Electromagnetic Treatment Delivered Simultaneously: The First Sham-Controlled Randomized Trial. Plastic and Reconstructive Surgery. 149(5):893e–900e. 2022. DOI: 10.1097/PRS.0000000000009030. https://pmc.ncbi.nlm.nih.gov/articles/PMC9028295/
[G01] US Food and Drug Administration. Non-Invasive Body Contouring Technologies. Patient information. 2026. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/non-invasive-body-contouring-technologies
Practical information
Start with an individual assessment
General information cannot determine whether treatment is right for you. Request a private assessment with the ¹EM team.
General educational information, not individual medical advice. Published research findings are not ¹EM patient-outcome data. Suitability, experience and results vary.