An open-label comparative gluteal study reported greater average muscle-thickness increases with HIFEM plus gentle RF than with HIFEM alone, without significant fat reduction in the studied protocols.
Why the gluteal treatment story differs
The gluteal protocol in this article addresses muscle and contour outcomes. Its measured muscle changes should be kept separate from fat-reduction claims from abdominal protocols. The treatment region and programme matter when interpreting the result.
Why does the EMSCULPT NEO treatment plan change between body areas? · Muscle size, strength and everyday function: what do the measurements mean?
Study at a glance
Design: Open-label, two-arm MRI comparison.
Participants: 67 enrolled, 34 combined/33 HIFEM-only; three months 27/27.
Research protocol: Four bilateral 30-minute sessions, five to ten days apart; gentle RF in combined arm.
Follow-up: One and three months.
Evidence visual: Glute muscle: compare the actual treatment arms
A three-month MRI comparison using gentle RF, not an abdominal fat protocol.
Muscle comparison
HIFEM + gentle RF: 24.7 % thickness increase; HIFEM alone: 15.9 % thickness increase.
27 participants per group at three months. The arithmetic difference is 8.8 percentage points.
Fat result
No significant fat reduction was reported. No numerical zero or universal fat-preservation guarantee is implied.
Protocol purpose
Both groups used the NEO platform. RF was off in the HIFEM-only arm; the combined arm used gentle, subapoptotic RF.
Source for the visual: [S03]. Open-label comparative study, not described as a blinded randomised trial. Group means do not predict an individual result.
Why the glute protocol deserves its own explanation
The goal of treating the gluteal region is not necessarily the same as treating abdominal fat. A person may want a more defined muscular contour while wishing to preserve the fat that contributes to the area's shape. It would be misleading to assume that every EMSCULPT NEO protocol is designed to maximise fat reduction.
The gluteal MRI study examined HIFEM combined with gentle, subapoptotic RF and compared it with HIFEM alone. In other words, the heating approach was deliberately different from a fat-reduction protocol. [S03]
That detail matters more than a generic claim that the machine “builds muscle and burns fat”. The purpose, applicator setup and settings have to match the area and the intended outcome.
For treatment background, read What is EMSCULPT NEO?. This article focuses on the specific research question.
How the two groups were treated
The study enrolled 67 participants: 34 in the combined HIFEM-plus-RF group and 33 in the HIFEM-only group. The participants received four bilateral, 30-minute gluteal treatments, spaced five to ten days apart. Both groups used the NEO platform; the comparator had RF switched off. [S03]
The study was an open-label, two-arm comparison. This article does not describe it as a blinded randomised trial. At three months, 27 participants in each group contributed MRI follow-up. [S03]
These design details define the comparison. It was not a trial of treatment versus a gym programme, nor a comparison with surgical buttock augmentation.
What the MRI measurements showed
At three months, the reported average increase in gluteal muscle thickness was 24.7% with HIFEM plus gentle RF and 15.9% with HIFEM alone. The study did not find significant fat reduction in either protocol. [S03]
The clearest way to present the comparison is to show the two percentages side by side. Their arithmetic difference is 8.8 percentage points. That is not the same as saying every patient gains 8.8% more muscle, nor is it an adjusted estimate that can be applied to any other treatment setting.
Avoid converting the finding into a larger-sounding relative marketing percentage. The direct figures communicate the observation without introducing another layer of interpretation.
Why gentle RF is not a contradiction
In this research, RF was used gently in the gluteal protocol, rather than with the intention of producing the same fat response pursued in abdominal contouring. The observed lack of significant fat reduction is therefore an important part of the study's context. [S03]
For a patient, the useful question is not simply whether RF is “on”. It is what the treatment protocol is trying to do. A glute-focused discussion should clarify whether the objective is muscle contour, reduction of a separate fat concern or something that the proposed procedure cannot reliably address.
No public article can specify safe settings for an individual or replace device-specific training. This evidence explanation is about why the research protocols should not be treated as interchangeable.
What “more muscle thickness” can and cannot tell you
MRI muscle thickness is an anatomical endpoint. It does not directly establish a percentage change in total gluteal muscle volume, a particular lifting height or an improvement in sporting performance.
“Lift” can be a vague word. In a photograph it may refer to shape or projection; in surgery it can imply repositioning tissue. Those meanings should not be blurred. The study supports a discussion about gluteal muscle measurements, not equivalence to a surgical lift.
It also does not establish that a patient with hip pain, weakness or a rehabilitation need should follow this cosmetic protocol. Those concerns require relevant functional assessment. An imaging result can inform a conversation without being stretched into a different clinical claim.
Building a useful treatment conversation
A good glute consultation begins with a clear description of the person's goal. “I would like more definition” is different from “I want to remove fat” or “I cannot climb stairs without pain”. The treatment discussion should preserve those differences.
Ask which outcome will be tracked and how. Standardised photographs may help document external appearance, but their interpretation depends on consistent pose, camera position and lighting. A change in stance should not become a treatment claim.
It is also reasonable to discuss exercise and other options without framing them as competitors that must be dismissed. This study did not test a resistance-training programme. It therefore provides no basis for telling a patient that exercise is unnecessary or that several appointments reproduce a stated number of weeks in the gym.
Follow-up, safety and source context
The principal comparison highlighted here is at three months, with 54 participants returning across the two groups. The original enrolment of 67 should not be used as the denominator for that later result. [S03]
No adverse events were reported in the study, but that does not make gluteal treatment universally risk-free. Screening for implanted devices, metal and other relevant factors remains necessary, and RF retains the capacity to cause heat-related injury. [S03, G01]
The research was BTL-sponsored and the authors were clinical investigators. That disclosure does not replace interpretation of the methods; it is part of understanding the source. The defensible takeaway is that this particular combined protocol produced larger average MRI thickness changes than its HIFEM-only comparison, not that every glute treatment or every patient will reproduce that difference.
Frequently asked questions
Will EMSCULPT NEO remove fat from my glutes?
The gluteal study used gentle RF and did not report significant fat reduction. That does not establish fat preservation with every possible setting or protocol. The planned approach and goal must be clarified with the clinician. [S03]
Was the comparator an older EMSCULPT machine?
Both study groups used the NEO platform, with RF turned off in the HIFEM-only arm. Describe the comparison by the energies delivered rather than assuming it was a comparison of two different machines. [S03]
How much more muscle was reported with combined treatment?
The three-month average thickness increases were 24.7% with HIFEM plus gentle RF and 15.9% with HIFEM alone. The arithmetic difference is 8.8 percentage points, not a guaranteed extra result for an individual. [S03]
Is this equivalent to a surgical buttock lift?
No. The study measured gluteal muscle thickness and did not compare treatment with surgery. It cannot establish the amount of lift, tissue repositioning or surgical equivalence.
Does this replace glute exercises?
The study did not compare treatment with exercise. It gives no basis for a claim that exercise can be replaced or that a course equals a fixed number of gym sessions. [S03]
Sources
[S03] DiBernardo B, Chilukuri S, McCoy JD, Katz B, Goldberg DJ. High-Intensity Focused Electromagnetic Field With Synchronized Radiofrequency Achieves Superior Gluteal Muscle Contouring Than High-Intensity Focused Electromagnetic Field Procedure Alone. Aesthetic Surgery Journal Open Forum. 5:ojac087. 2023. DOI: 10.1093/asjof/ojac087. https://academic.oup.com/asjopenforum/article/doi/10.1093/asjof/ojac087/6979899
[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.