I’ve never been a trend chaser. When I bring a new technology into my clinic, it is because I have studied it, trained in it, and confirmed that it can safely improve my patients’ lives. My responsibility is to protect your safety and your trust, and to deliver long-term results. This is why I am proud to announce that EmSculpt Neo and EmFace treatments are coming to MMMD.
These devices strengthen muscles, improve structure, and enhance skin texture in a truly exciting, cutting‑edge way. I chose these technologies because they are regenerative treatments that target the physiologic changes that drive signs of aging. These treatments also feel good (for the most part), require no downtime, and offer an alternative for patients who want improvement without needles or surgery.
Aging is not just a surface process. It begins within our muscles, connective tissue, and the collagen network that supports our skin. To understand why I am so excited about these regenerative treatments (and you should be too), let’s begin with the physiology of muscle loss and skin aging.
Understanding Muscle Loss and Sarcopenia
Sarcopenia is the age-related progressive loss of muscle mass and strength. This muscle atrophy is primarily caused by the natural aging process, and understanding how to maintain healthy muscle mass is one of the most important aspects of aging well.
What many do not realize is that muscle loss begins earlier than you think it does, and it accelerates every decade. Muscle loss is influenced by age, genetics, hormonal shifts, and nutritional intake, all of which determine how quickly or slowly an individual loses or builds muscle. Some people naturally hold onto muscle more easily because their bodies respond better to exercise and repair muscle more efficiently. Others lose muscle mass faster due to genetic differences that affect how well their cells produce energy and recover.
How Sarcopenia Changes the Body and the Face
Sarcopenia affects far more than strength. It changes the way the body holds itself. It influences the curve of the spine, the stability of the pelvis, and the strength of the core. It also affects metabolism. Muscle is a metabolically active tissue. When we lose muscle, we burn fewer calories at rest, and fat becomes easier to accumulate. Sarcopenia also affects the face. As the deeper muscles weaken, the midface droops, the brows feel heavier, and the skin loses its natural support system.
This is one reason why two people of the same age can look dramatically different depending on how well they have maintained their muscle mass over time. It is also why strengthening the deeper tissues can create visible improvements in facial lift, contour, and vitality without adding volume or altering expression.
Maintaining Muscle Health as We Age
Maintaining muscle as we age takes more than exercise alone. Your muscle health also depends on nutrition, sleep, hormones, stress, and your baseline physiology. These factors determine how efficiently your body can repair, rebuild, and preserve muscle over time. When any of these systems weaken, sarcopenia accelerates. When they are supported, muscle is easier to maintain.
Baseline Muscle Mass and Metabolism
Every patient begins with a different baseline. Genetics, early life activity levels, and long-term lifestyle patterns determine how much muscle you start with and how quickly you lose it. People with naturally higher muscle mass have a metabolic advantage. They burn more calories at rest, maintain better insulin sensitivity, and experience slower age-related decline.
For patients with lower baseline muscle mass, sarcopenia can appear earlier and progress more quickly. Strengthening the muscular foundation through exercise, nutrition, and regenerative treatments helps protect long-term metabolic health.
Nutrition and Protein Intake
Protein is the raw material your body uses to repair and build muscle fibers. As we age, our muscles become less responsive to dietary protein. This means older adults need more high-quality protein to stimulate the same level of muscle repair that younger bodies achieve more easily. Without adequate protein, the body cannot rebuild the muscle it loses each day, even with exercise.
Healthy muscle maintenance depends on consistent protein intake throughout the day, high-quality protein sources such as lean meats, fish, eggs, dairy, legumes, and plant-based proteins, and adequate micronutrients like magnesium, vitamin D, and B vitamins. Balanced carbohydrates and healthy fats also support training and hormone production. When your body receives the building blocks it needs, it can respond more effectively to treatments like Emsculpt Neo and EmFace.
Sleep Quality and Recovery
Muscle is not built during the workout. It is built during recovery, and sleep is the most important recovery tool we have. During deep sleep, the body releases growth hormone, repairs damaged muscle fibers, and restores the nervous system. Poor sleep disrupts these processes and accelerates muscle loss.
When sleep is consistently inadequate, muscle protein synthesis decreases, cortisol levels rise, appetite changes, hormones shift, and energy levels drop. Supporting sleep through consistent routines, maintaining hormone health, stress management, and healthy sleep hygiene directly supports muscle preservation and healthy aging.
Hormonal Balance and Stress
Hormones are powerful regulators of muscle health, and as we age, they decline. Hormones determine how quickly we recover and how much fat we store. Chronic stress can lead to elevated cortisol levels, which break down muscle tissue, increase abdominal fat storage, and interfere with sleep and recovery.
Even active patients can lose muscle if their stress load is consistently high. Regenerative treatments like EmSculpt and EmFace are valuable because they stimulate muscle activity and collagen production even when hormonal shifts make traditional exercise less effective.
Why Regenerative Treatments Are Essential for Healthy Aging
Traditional aesthetic treatments tend to focus on the surface levels of the skin. They smooth and fill, but they cannot address muscle laxity and collagen building. When the foundation is weak, surface treatments can only go so far.
Regenerative treatments work by stimulating the tissues that aging weakens. When your nutrition, sleep, hormones, and recovery are supported, your body responds more efficiently to these treatments. Muscle fibers thicken more easily, collagen production increases more robustly, and results last longer.
These treatments are not a replacement for healthy habits. They are an accelerator. They help patients who struggle with muscle loss, hormonal changes, or genetic predispositions build a stronger foundation so they can age with more stability, strength, and visible vitality.
Even active patients can lose muscle if their stress load is consistently high. Regenerative treatments like EmSculpt and EmFace are valuable because they stimulate muscle activity and collagen production even when hormonal shifts make traditional exercise less effective.
Emsculpt Neo
Emsculpt is one of the most advanced tools we can use to address the loss of muscle strength and tone in the body that occurs over time.
What is Emsculpt?
EmSculpt Neo is a non-invasive treatment that combines radiofrequency and high-intensity
muscle stimulation to support muscle building and fat reduction in targeted areas. The device creates deep, involuntary muscle contractions that remodel and thicken muscle fiber. These contractions are far more intense than what you can achieve voluntarily, which is why they are so effective for patients who struggle to build or maintain muscle through exercise alone.
The clinical data for Emsculpt Neo are strong. Studies conducted for FDA Clearance of the technology revealed the following at three months post-treatment:
- 31% reduction in subcutaneous fat
- 26% percent increase in abdominal muscle thickness
- 30.5% percent reduction in flank adipose tissue at three months.
- Patients also experience a 25% increase in core muscle strength
- 97% report stronger core muscles.
What Emsculpt Treats
We can use Emsculpt for the abdomen, flanks, glutes, thighs, arms, and calves. It is particularly helpful for patients who feel they cannot achieve a desired level of tone despite exercise and healthy eating habits. It is also valuable for postpartum patients and for those experiencing age‑related muscle loss. The treatment can be precisely targeted through applicator placement to activate specific muscle groups. These placements ensure that the correct muscles are stimulated without engaging surrounding tissues, which is essential for both safety and results.
Who Is a Good Candidate
The best candidate for Emsculpt is someone who is relatively close to their healthy weight and wants to improve muscle tone and strength. Emsculpt Neo is ideal for patients who want both fat reduction and muscle building in the same area. It is not a weight loss treatment. It is a sculpting and strengthening treatment. It is also an excellent option for patients who are genetically predisposed to faster muscle loss, have difficulty building muscle despite regular exercise and adequate nutrition, or have pockets of fat that do not respond to diet and exercise
What to Expect During Treatment
A session lasts 30 minutes. Patients describe the sensation as similar to holding a plank or performing an intense workout. There is no numbing and no downtime. You may feel sore afterward, but you can return to your day immediately. The treatment feels rhythmic and powerful, and, depending on the intensity, many patients find it surprisingly pleasant once they settle into the pattern of muscle contractions. It is also important to be well hydrated before and after treatment for optimal results.
How Many Treatments Are Needed
Most patients complete a series of four sessions, spaced about one week apart. Maintenance sessions every few months help preserve results, especially for patients addressing sarcopenia or those using GLP‑1 medications. In fact, research suggests that patients who combined Emsculpt Neo with GLP‑1 therapy, which can decrease muscle mass, saw an increase in muscle mass equivalent to 8 weeks of regular resistance training. This makes Emsculpt an important adjunct for patients who want to protect their metabolic health while using medications that can accelerate muscle loss.
Why Patients Should Be Excited
You should be excited about Emsculpt because it treats something most aesthetic treatments ignore. It strengthens your body and supports your long‑term health. And you also achieve meaningful fat reduction in the same session.
Studies show that patients reported 94% satisfaction, 91% improvement in comfort during physical activity, and 83% improvement in muscle function after 4 treatments. It is one of the few aesthetic treatments that improves both appearance and physical performance.
How Emsculpt Is Different From Other Treatments
Most aesthetic body treatments focus on fat alone. They cool it, heat it, or otherwise damage fat cells to contour it. Emsculpt Neo is different because it focuses on muscle contractions and muscle tone as primary goals. Treatment encourages your body to adapt and grow stronger.
Downtime
There is no downtime. You may feel sore, similar to a workout, but you can resume all activities immediately. Because treatment is quick, you can also fit it into your busy schedule easily.
Results
Some patients may notice changes within a few weeks, with continued improvement over time. We also recommend maintenance sessions to support long-term results. The following factors can affect results:
- Nutrition and protein intake
- Sleep quality and recovery
- Hormonal balance and stress load
- Consistency with treatment sessions
- Baseline muscle mass and metabolism
EmFace
Emface is a treatment we can use to support the deeper facial muscles that lift the cheeks and brows and improve skin quality. Emface can also treat the under the chin, under the eyes, and relax the muscles that cause TMJ. Many patients seek out aesthetic treatment when they feel that their face looks heavier or more tired, even when they cannot identify exactly why. Often, the issue is weakening of the underlying muscles combined with collagen loss. Emface allows us to address both at once. It is also an excellent option for patients who want visible improvement without needles.
Emface Treatment
Emface is a non‑invasive facial treatment that strengthens facial muscles using synchronized electrical stimulation, while radiofrequency energy improves fine lines and skin texture. The treatment works by activating specific facial muscles through carefully positioned applicators on the forehead, cheeks, under the eyes, and chin.
The clinical data are compelling. Studies revealed peak changes 2-3 months post-treatment.
- 37% wrinkle reduction
- 33% increase in collagen, and a
- 113% increase in elastin.
- MRI analysis showed a 36% reduction in double‑chin volume and a 10.77‑milliliter reduction in submental fat.
- Patients also experience a 1.31‑millimeter eyebrow lift at six months and significant improvements in facial symmetry, including a 3‑ to 4‑millimeter increase in mouth corner movement.
Who Is a Good Candidate
Emface is for patients who notice midface descent, brow heaviness, loss of cheek volume, or skin laxity. It also improves fine lines and overall skin texture and can treat the under eye area and the under chin area. Because it strengthens the muscles that naturally lift the face, it creates a refreshed, supported appearance.
The best candidate for Emface is someone who wants a natural, subtle lift without needles or surgery. It is also ideal for patients who already use injectables and want to support the underlying structure of the face. It is equally effective for all genders, and many of my male patients appreciate that it enhances facial structure without needles or fillers.
What to Expect During Treatment
During treatment, you will feel rhythmic muscle activation and warmth. No numbing is required, but you will also feel a tingling sensation that we will manage by finding the right level of treatment intensity for you. Afterward, your skin may appear slightly pink, but this fades quickly. In our treatment trials, many of us fell asleep – it’s that comfortable!
How Many Treatments Are Needed
Most patients complete four sessions, spaced one week apart. Results build gradually as the muscles strengthen and collagen increases. Six sessions may be recommended for older patients to allow more time for muscles to build and skin to rejuvenate. Some results are visible a month after treatment, while others take longer to develop. A maintenance treatment is recommended every 6-12 months. Individual results will vary.
Why Patients Should Be Excited
You should be excited about Emface because it strengthens the muscles that lift the face while improving your skin. It does not freeze expression or add volume. It enhances your natural structure. After four treatments, study patients reported 95% satisfaction, 93% overall improvement, 81% improvement in skin laxity and 1.31 mm eyebrow lift at 6 months.
How Emface Is Different From Other Treatments
Most non-surgical facial treatments relax muscles, add volume, or resurface the skin. Emface is different because it strengthens the muscles that lift the face while improving the skin with RF energy. It is a regenerative treatment that helps boost the regenerative power of your own body.
Downtime
There is no downtime. You can return to work or social activities immediately. Do not use retinols or vitamin A while undergoing treatment. After treatment, excellent at-home skin care is recommended to boost the regenerative potential of treatments.
How EmFace and Emsculpt Treatments Work Together
When I look at Emsculpt and Emface treatment, I see a comprehensive toolkit for regenerative aesthetics. Emsculpt strengthens the deeper muscular foundation. Emface lifts the facial muscles and improves the skin. Together, they allow me to address muscle loss, structural support, and skin quality in a coordinated way.
My Commitment to You
My priorities at MMMD are safety, training, and bringing the best technology to my patients. I offer treatments I believe in, have studied, and have seen work in real patients. If you are curious about Emsculpt or Emface treatment, I would love to see you for a consultation so we can evaluate your goals and create a personalized plan that respects your body, your time, and your vision for how you want to age.
Melinda Menezes, MD
Dr. Menezes is one of Hawaii’s most experienced aesthetic practitioners. She earned her Doctorate in Medicine from the University of North Carolina School of Medicine and completed her residency at the University of Missouri. In 2015 she transitioned fully into Aesthetic Medicine and opened her clinic in Lihue, a space designed for patient comfort, safety, and advanced aesthetic care.
