MRI Assessment of Arm and Calf Muscle Toning With High-Intensity Focused Electromagnetic Technology: Case Study

May 2020 | Volume 19 | Issue 5 | Case Reports | 556 | Copyright © May 2020

Published online April 17, 2020

Bruce Katz

Juva Skin and Laser Center, New York, NY

The largest increase in the CSA was observed for the biceps brachii muscle as the average increase was 17.1%, while for triceps brachii it was 10.2%. The CSA of the gastrocnemius muscle was increased by 14.5% on average. Detailed results for each subject can be seen in Table 1. Examples of MRI images after the segmentation are shown in Figure 2.

The arm fat thickness for the male subject was decreased by 20.6% from 4.6 ± 2.3 mm to 3.7 ± 2.0 mm. The female subject lost 5.3% of her arm fat thickness as it decreased from 10.0 ± 3.8 mm to 9.5 ± 3.8 mm. The fat thickness on the calf was decreased by 11.9% for the male subject, from 4.6 ± 1.3 mm to 4.1 ± 1.2 mm. The female subject showed a reduction of 8.0%, from 12.3 ± 2.6 mm to 11.4 ± 2.5 mm.

Patients reported mild muscle fatigue after the treatments while no adverse events were reported. Digital photographs demonstrated aesthetic improvement in the treated area. The demonstration of the improvement in the biceps muscle observed for the female subject is shown in Figure 3.


The MRI images showed an increase in muscle mass and a reduction in fat thickness after four HIFEM treatments, comparable with the results reported in previous studies.10,11 Validation of observed results on a larger sample size is necessary.

The applicator placement appears to play a crucial role in the outcomes. It is interesting to note the anatomic individuality of each patient and the importance of proper applicator placement to achieve the largest muscle response, which differed subject to subject. Since HIFEM technology is based on stimulating motor neurons, the improper placement may not trigger contractions strong enough for the induction of a hypertrophic effect. It is thus important to pay special attention to the placement.

Based on the observed results, HIFEM technology appears to be feasible for arm and calf toning. Although it is necessary to collect data from a significantly larger sample size, the initial results provide a trace of what outcomes could be expected with a larger study population.


The author has no conflict of interest to declare.


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Bruce Katz MD