Muscle Toning and Contouring

Summary and Key Features

• Enhancement of muscular tone is a new frontier in noninvasive body contouring, with both cosmetic and functional implications.

• Treatment of the muscle must be always considered in context with the overlying adipose layer—an excess amount of adipose will reduce or obscure the cosmetic effect of treatment.

• Electromagnetic muscle stimulation (EMMS) utilizes electromagnetic muscle induction to stimulate motor nerves and induce repetitive and maximal muscular contraction

• Neuromuscular electrical stimulation (NMES) utilizes applied electrical current via surface electrodes on the skin to directly stimulate motor nerves, resulting in maximal contraction of skeletal muscle fibers.

• Muscle toning and contouring devices can be combined with other technologies such as cryolipolysis for a synergistic effect.

Introduction

A “toned and tight” physique has traditionally been the hard-won outcome of a long-term healthy diet, consistent strength training regimen, and a little bit of genetic luck. Attrition rates for those attempting a disciplined diet and exercise program can be high due to waning motivation and lack of time, and the goal of “chiseled abs” is frequently replaced by other pursuits. Alternatively, those who either approximate or achieve their body goals are frequently interested in gaining an esthetic edge.

Until recently, the field of noninvasive body contouring has focused on the reduction of subcutaneous fat by inducing adipocyte apoptosis. As interest has grown to further enhance body contouring by inducing muscle hypertrophy and improving tone, established technologies with historically functional applications have been repurposed for novel esthetic applications.

With a maturing body of supporting literature and growing practitioner experience, two technologies, electromagnetic muscle stimulation (EMMS) and neuromuscular electrical stimulation (NMES), have emerged as options for patients interested in toning the underlying muscle layer as an alternative or supplement to traditional resistance training programs. Available EMMS (EmSculpt® and CoolTone®) and NMES (truSculpt flex®) devices provide patients with a more firm and toned appearance with favorable risk-reward profiles. The goal of this chapter is to review these emerging technologies with emphasis on their mechanisms, clinical results, side effect profiles, and patient selection so as they may be best applied in the clinical setting to further improve esthetic body contouring.