Is the 6-Pack Ab Machine For Real?

Dr. Furnas (00:07):
Abs, abs, abs, everybody wants them. And now there are machines to get 'em. Welcome to Skintuition. I'm Heather Furnas.

Dr. Korman (00:20):
And I'm Josh Korman. From pimples to wrinkles, our skin affects how we feel about ourselves. As two plastic surgeons, we discuss what's new, what's safe, and what to look for when you're ready to hit refresh.

Dr. Furnas (00:33):
So what are those machines that build up abs?

Dr. Korman (00:38):
Well, I'll tell you, there is a machine that, um, I saw at a conference a few years ago and I thought it was interesting. It was non-surgical called EMSculpt. And I thought it was interesting and it was 30 minutes, and I was excited about how it felt. And then I did the four treatments, and then a week after that I was at the gym and somebody said to me, "Hey, look at your abs." And no one had ever said that to me before, and that's when I bought the machine. I found it's, it's really good. I mean, EMSculpt, or any of these truSculpt or CoolTone, these are muscle building machines that, um, obviously not magic and do not take away all the layers of fat. They help some, which we'll talk about in a second, but it, and it's used for lots of, of areas in the body, which we'll talk about.

(01:34)
But what it does is it's like doing thousands of sit-ups in 30 minutes and it's, it's, uh, it does produce results that people find, um, interesting, exciting and satisfying in an area where, you know, the diet and exercise are determined a lot of humans, what's in the middle and that spare tire and all those other things. And, and here's a, a lot of people say, oh, well I have good abs under there, but I can't see 'em. Or I never really had good abs. So this gives a, a, a chance to do it. And it's very popular.

Dr. Furnas (02:15):
EMSculpt actually is a clever name because the M is EM. And those first two letters stand for electro and then the M, magnetic, because it's electromagnetic energy that is directed into the abs muscle. We can also use it in the buttocks and it's like doing 20,000 supra maximal muscle contractions in 30 minutes. There's no way you could do that in the gym.

Dr. Korman (02:48):
Well, I try to work hard in the gym, but you're right, of course you can't do that many <laugh> um, <laugh>, that's a joke. You can't do that many <laugh>. But a lot of people kind of want to know is that like those little tens units that you can get online where you just make your muscles contract more? This is a little bit different. And how does it work, Heather, with the nerves and the muscles and how, how do we do that?

Dr. Furnas (03:12):
Well, you have this energy that goes through the entire muscle, and so the contractions are much more profound than you would see with a tens unit. And because it stimulated so intensely, the muscle reacts by building up bulk. And so you build up muscle and therefore you build up definition. And so with the abdominal muscles, you can develop a six-pack if you don't have the fat covering it, and with the buttock muscles, you can sort of raise the high point of the curve so you get sort of that youthful fit, rounded buttock shape.

Dr. Korman (03:56):
So I think this is a good example where in general, men and women's bodies are somewhat different, but EMSculpt is, is really helpful for both men and women and also for every configuration in between. We are a species where we tend to collect fat that a lot around our middle. And as we age, we tend to collect more of that. And it is, we would like to be lean and yet, uh, what we eat and when we eat it and how we exercise really does come into play. But there are many people who the same way, they'll say, I've tried everything and I'm really pretty lean, but I still have that pocket of fat on my tummy or pocket of fat on the sides, or my buttock is really smaller than I want it to be, and I I really don't want to have surgery and what can I do? And I would say one thing that surgery doesn't really do except for, unless you're doing pectoral implants, for example, you're not building muscle and yet here is a non-surgical way to actually build muscle. So Heather, would you have it on your arms? Would you have it on your tummy? Would you have it on your buttock? Where where do you think is a, is a good place to have it?

Dr. Furnas (05:22):
Well, it's FDA cleared for the buttock and the abdomen. It's FDA cleared specifically for strengthening, toning and firming of the abdomen and butt. And then there is now EMSculpt Neo, which adds radiofrequency. And we discussed radiofrequency in a previous podcast and we know that radiofrequency heats up tissues in this case specifically fat. And so it can actually drop the amount of fat while it builds up muscle. So the layer of fat is thinning and the thickness of the muscle is thickening.

Dr. Korman (06:03):
Not only is it good for uh, taking some fat off at the same time as building muscle is that it's also really helpful for women who've had children where the muscle, the abdominal muscle is somewhat separated. There's some, uh, recent studies that you can get up to 17% of narrowing of that space. So it's actually been, uh, really helpful for that. And also I find it really helpful also, it's not just for aesthetic purposes. There are lots of patients as they age that don't have as much core strength and it really does help to build core strength. And I don't know, the world seems to be interested in pickleball, um, but you know, you probably can play better pickleball if you have a stronger core. And there's many things that a stronger core can do. and EMSculpt is one of the things that can do it. So it's about building muscle, but not just for how it looks, but how it feels and how, not just how it feels at the time, but we're gonna talk in a second about how does it really feel when you do it. But it is, it's been shown to be useful for a lot of, a lot of uses, a lot of people of many ages.

Dr. Furnas (07:17):
It's also used after injury. So athletes after a sports injury love it to recover. And you mentioned the core muscles. So we know that when we see women with separated muscles interested in an adominoplasty, one of the functional benefits of an adominoplasty is that we can tighten those muscles in the midline. And a lot of those women actually incidentally notice that their lower back pain feels better. So tightening the core muscles is really, uh, key to, uh, facilitating your activities and protecting against back issues.

Dr. Korman (07:58):
So Heather, as a patient, as a clinician, as a person in the world, how do you direct your patients when they say, okay, well should I have CoolSculpting or should I have EMSculpting? Because EMSculpt with the radio frequency is supposed to reduce some of the fat. So I want the muscle, I want the fat gone, so why shouldn't I just do EMSculpt?

Dr. Furnas (08:25):
Well, CoolSculpting cools the fat as we talked about in another episode. So it freezes the fat cells, but it doesn't do anything to the muscle. So if you don't have muscle in the area, for example, in the area under the chin or you mentioned the arm, if you've got some fat all around the arm, that might be more of a, something you would consider CoolSculpting for the, uh, saddle bags, these areas that are primarily fat. However, with the buttock, the framework of that muscle really sets off the contour. And the same with the abdomen. If you're fatty layers thin enough and you can see those abs, that's great. Plus there's a functional component. If you have a thicker layer of fat of the abdomen, that is probably more a CoolSculpting job until a certain point. What would you say, Josh?

Dr. Korman (09:24):
Well actually I think a lot of times they're good together. I think as I've said before, some of these non-surgical technologies are synergistic with each other. So what I find is that, um, pinchable fat is what is good for CoolSculpting. And sometimes I'll do, I'll recommend CoolSculpting first followed by EMSculpt. And that often really does help because if you're just doing the, the waves for EMSculpt go in three inches. Well, if you have three inches or more of a fat layer on top, they're not gonna reach the waves aren't gonna reach the muscle. And so to just, you're kind of wasting the EMSculpt waves to try to reduce some of the fat. So I think I find that EMSculpt works best, the leaner you are. So I would say CoolSculpt first followed by EMSculpt in many situations.

Dr. Furnas (10:18):
Exactly. If you have that thicker layer of fat, I completely agree. And then you get the benefit with that thinner layer of fat of what EMSculpt can do. There's also something called EM Face, which is by the same company that uses high intensity facial electrical stimulation. What do you think about that, Josh?

Dr. Korman (10:42):
Yeah, so I tried that, I just tried it for about five minutes at a conference. It's little tapes that are connected to these little wires and you have different settings and they, the treatment is about 35 minutes, 35 or 40 minutes, and it contracts, and the muscles of your face contract. And the general idea is to have more tone. And I think they're getting good results. The, the part that I'm somewhat skeptical about is, I, I think about it is that, you know, I remember lots of jokes about, oh, if you just smile a lot, is that good or is that bad? I mean, it makes you feel good, but does that give you more wrinkles if you do a lot of smiling or if you do a lot of frowning, does that give you more, more wrinkles? So here you have these on purpose, uh, energized tapes that that cause you to contract.

(11:38)
Now these are, I think four or five treatments and I think just like you mentioned before, it puts water in the muscle and then that fills out the area. And I think it's just getting started in, uh, different practices that have the, have the technology. I think time will tell. I think one of the things that's challenging is that it, with skin especially, it's hard to know like where you start and what is the result of what and for whom would it work best on. You know, if you, if it's for  a young person, is that gonna work as well as an old person or maybe it's a combination. What do you think?

Dr. Furnas (12:17):
Yeah, it's supposed to lift and tighten the face, along with ironically decreasing wrinkles. When we use neuromodulators to weaken and relax the muscles in order to decrease the, the wrinkles, it may be that as the muscle thickens, it rejuvenates the look of the face. Our muscles atrophy as we age. And so it may be that by thickening the muscle, it gives a more rejuvenated and lifted look.

Dr. Korman (12:49):
So then I guess, what, what would you do with a patient that has, likes that thinner, it's very popular on Instagram where you have that thinner face, that more angular face. So if you saw a patient that has, that feels like their, their face is a little fatter, they're angular and they're young, how do you go about explaining, well, what would work? Do you think EMFace would work or would that make it too big or do you want Botox to make it narrow, but, or do you want to take out the buckle fat pad? But then as we get older, we atrophy. So it's like building a, a house first at a certain time. It's like we keep changing. So how would you suggest your patients? What's the order of operations?

Dr. Furnas (13:36):
These things do different things and, and people with very full faces really benefit from buckle fat removal. I think a lot of them will point to their familial tendency for full face. EMFace is gonna be something more subtle and it can thin slightly, but it's not going to be as dramatic as buccal fat. Uh, Botox is gonna be, or neuromodulator is gonna be, uh, very different and not really make a lot of difference in the width of the face. Uh, there's filler that can better define the bony angles along the jaw, and that can help create sort of a more youthful sharpness to the, to the jawline.

Dr. Korman (14:26):
So I think you're highlighting the point that it's good to figure out what bothers you, but it's also important to ask a, it's, it's, it, internet university is not always gonna give you the answer of what it is that you need to try to achieve your goals. I think it's important that you seek out, um, people who have a lot of experience in non-surgical and surgical and to see which things might be best. Because I think everybody wants to have the least expensive, least invasive, longest lasting result, uh, easiest recovery and all in one. And that's called the magic wand, which last time I looked I couldn't find it. But I think there's, and because of the high demand for non-surgical treatments, EMSculpt, uh, EMSculpt Neo, EMFace, CoolTone, truSculpt, lots of different technologies are around to try to make things better. And I think what's interesting about these muscle building devices is that surgery is not, that this is not what surgery can do, and here is a way to actually help build muscles along with good, healthy living.

Dr. Furnas (15:44):
There are some people who won't be candidates for, for example, for EMSculpt or EMFace or EMSculpt Neo, and that would be people with metal plates or implants. And it's a little bit like having an MRI. You just can't go in the machine when you have a metal part. So it could be that whatever you want, you may actually not be a candidate for. And so when coming in for consultation, I like to focus on a patient's complaint. If it's hyperpigmentation or wrinkles or whatever it is, rather than focusing on what they say they want, neuromodulator or filler, or in this case EMSculpt, sculptor, EMSculpt Neo or EMFace. And by starting at the problem, then you can work with a practitioner, uh, knowledgeable experience practitioner to develop the ideal treatment plan that will fit you and your health status and any other concerns that could impact the the result.

Dr. Korman (16:54):
The other thing to remember is also a lot of guys have tried to say they'd like EMSculpt or EMSculpt Neo, you know, over the chest for the pecs, but there is a little electronic device inside there called your heart. And you don't wanna do that <laugh>?

Dr. Furnas (17:09):
No, no. This is a, you know, it's a serious machine. It does really great things like a lot of things we use in medicine. It does really great things when it's used in the appropriate place and the appropriate method. Just like neuromodulator, it's a toxin. And when used in the wrong way, it's deadly. And when used in the, in the right way, it's just wonderful.

Dr. Korman (17:34):
Well, wonderful is what we're always looking for. Wonderful abs, no fat. Wow. It sounds like the magic wand, but I think there is a lot of benefit from these devices that are increasing on the market and are being proven to be very popular.

Dr. Furnas (17:55):
Thank you for listening to Skintuition. This is Heather Furnas.

Dr. Korman (17:59):
And I'm Josh Korman.

Dr. Furnas (18:01):
See you next time.