A multicentre outer-thigh study reported reduced local fat thickness on MRI and smaller thigh circumference after combined HIFEM and RF treatment, with the two outcomes measured in different ways.
How to interpret the measured result
The outer-thigh region and measured tissues belong to this particular protocol. Do not transfer an inner-thigh result or a whole-body weight-loss claim onto the lateral-thigh measurements.
Study at a glance
Design: Multicentre, uncontrolled lateral-thigh MRI study.
Participants: 93 enrolled; three-month MRI n=51.
Research protocol: Four bilateral 30-minute HIFEM+RF sessions.
Follow-up: One, three and six months.
Evidence visual: Thickness and circumference are different measurements
Thickness and circumference use different measurements and are presented separately.
MRI fat layer
Lateral fat, 3 months: -18 mm thickness change.
Three-month MRI n=51. A local tissue measurement, not the distance around the thigh.
Average circumference
Mean across three levels: -2.3 cm circumference change.
External circumference at three predefined levels.
Largest measured level
10 cm below infragluteal fold: -3.5 cm circumference change.
This is one measurement level, not the average effect across all levels or a personal promise.
Source for the visual: [S06]. Final published three-month data. The study had no concurrent sham group; six-month denominator not verified from the abstract.
Why the location of a fat measurement matters
The outer-thigh area sometimes described as “saddlebags” is a local contour concern, not a diagnosis. Research on that area should be read as evidence about the treated region, rather than as a claim about all thigh tissue or whole-body weight loss.
Palm and colleagues investigated the lateral thighs using MRI and external circumference measurements. This makes the paper useful for understanding how an internal change in a fat layer and an external change around the leg can be documented separately. [S06]
The measurements answer related questions, but they do not share the same unit or meaning. That is the central distinction in this article.
For treatment background, read What is EMSCULPT NEO?. This article focuses on the specific research question.
What the researchers studied
The multicentre study enrolled 93 participants and used four bilateral, 30-minute treatments combining synchronised RF and HIFEM. MRI and circumference measurements were used to assess changes, with follow-up extending to six months. Fifty-one participants contributed the three-month MRI result. [S06]
There was no concurrent sham comparator described in this report. It is therefore an observational treatment-result study rather than a controlled estimate of how much change was specifically caused by the intervention.
The enrolment number remains important, but it should not be placed beside the three-month MRI result without explaining the smaller analysis group.
The main published findings
At three months, the study reported an average 18 mm reduction in the measured local fat tissue in the saddlebag region. Average thigh circumference decreased by 2.3 cm across three predefined levels, with the largest reported circumference change, 3.5 cm, at the level 10 cm below the infragluteal fold. The authors described maintenance at six months. [S06]
The 18 mm figure is a local MRI measurement. The 2.3 cm figure is the average circumference change across the measured levels. These should not be merged into a single claim or used interchangeably.
This article uses the final publication's reported absolute measurements rather than importing an unverified percentage from an earlier graphic.
Millimetres of fat are not centimetres around the leg
A thickness measurement runs through a tissue layer at a particular place. A circumference measurement runs around the outside of a body region. It is not valid to multiply a local fat-thickness change by a simple geometric formula and announce the expected circumference reduction for a patient.
The leg is not a uniform cylinder, and the study did not offer a personal conversion calculator. The evidence summary therefore presents each outcome on its own scale, with its own label.
This may seem like a small technical detail, but it changes the patient conversation. An accurate statement explains what was measured. A misleading one lets a large number travel from one endpoint to another without permission.
Does this research establish cellulite improvement?
The primary findings highlighted here concern local fat and circumference. They do not establish a quantified cellulite result, treatment of lipedema or resolution of painful swelling. Those are different clinical concerns with different assessment requirements. [S06]
A person with pain, unusual swelling or another symptom should not have the issue automatically relabelled as an outer-thigh contour concern. The appropriate next step is to understand the problem before choosing a treatment.
Similarly, the study should not be used to promise a particular clothing size or silhouette. Clothing fit is meaningful to a patient, but it is not the same endpoint as the MRI measurement reported by the researchers.
What a patient should ask before proceeding
Begin with the treatment target. Is the clinician assessing a local fat concern, muscle contour, skin change or another issue? Then ask how the proposed protocol relates to the one used in this paper and whether the relevant applicators are available.
The next question is how progress will be documented. A tape measurement needs consistent landmarks. Photographs need consistent positioning. Surface scans, where used, should be explained as surface measurements rather than presented as direct proof of an internal tissue change.
Finally, agree on the review decision. A useful programme should define what would count as worthwhile benefit and what will happen if the original concern is not meaningfully improved. It should not rely solely on comparing a patient with the most favourable image in a study.
What does the six-month finding mean?
The authors reported that results were maintained at six months. The accessible abstract does not provide the complete six-month participant count, so this article does not assume that all 93 participants, or all 51 with three-month MRI, contributed at that later point. [S06]
The practical interpretation is limited to observed follow-up in the study. It does not prove permanence or prescribe a six-month maintenance treatment.
A later review can be useful precisely because individual experience may differ from the group average. The purpose is to reassess the person, not to treat the calendar as a diagnosis.
Safety and the ¹EM interpretation
No adverse events were recorded in the study, but a finite study sample cannot demonstrate the absence of all potential harms. RF and magnetic stimulation still require screening and appropriate treatment delivery. The complete funding and disclosure statement was not verified from the accessible abstract. [S06, G01]
The useful conclusion for ¹EM is that the outer-thigh literature includes MRI-documented local fat findings, rather than only photographs or testimonials. The next step is a clear assessment of whether that evidence matches the patient's concern, followed by a plan with measurable goals and honest review points.
Frequently asked questions
What was the MRI result for the outer thighs?
The final published abstract reported an average 18 mm reduction in local saddlebag-region fat tissue at three months, based on 51 MRI participants. This is a local thickness measurement. [S06]
What was the circumference result?
Circumference decreased by an average 2.3 cm across three predefined measurement levels. The greatest reported change was 3.5 cm at the level 10 cm below the infragluteal fold. These are circumference outcomes, not fat-layer thickness. [S06]
Can the millimetre result be converted into my expected clothing size?
No. The research did not provide a validated conversion from local MRI fat thickness to clothing size or individual appearance. Such a conversion would be an invented prediction.
Does this study show that EMSCULPT NEO treats lipedema?
No. The study discussed here concerns local outer-thigh contouring measurements. It does not establish a lipedema-treatment outcome. Pain or swelling needs assessment rather than an automatic cosmetic explanation.
Does maintenance at six months mean the result is permanent?
No. Maintenance during an observed follow-up period is not proof of permanence, and the accessible abstract does not provide a complete six-month analysis denominator. [S06]
Sources
[S06] Palm MD, Halaas Y, Kinney BM, Goldfarb R. Spot Reduction of Localized Fat Deposits on the Lateral Thighs by Simultaneous Emission of Synchronized Radiofrequency and High-Intensity Focused Electromagnetic Energy: Magnetic Resonance Multicenter Study. Dermatologic Surgery. 49(1):48–53. 2023. DOI: 10.1097/DSS.0000000000003663. https://pubmed.ncbi.nlm.nih.gov/36533796/
[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.