Emsculpt: Muscle Machine – The New Paradigm of Plastic Surgery

Dr. Franco: All right team, welcome back to Plastic Surgery Untold. I’m Dr. Johnny Franco, also known as Austin Plastic Surgery. I have the privilege and penance of being surrounded by our Celebrity crew today, we have Celebrity anesthesia.

Travis: What’s up guys?

Dr. Franco: And of course Austin’s formerly most beautiful man, Gilbert. And then we have our special guests, Mitch from Emsculpt too, who we’re gonna come back to and introduce and let you know a little bit more about him. He’s taken a little time out of his day to tell us a little bit about Emsculpt, and we’ll kind of get into it in a minute why we picked this topic post quarantine 15 if you will.

Mitchell: It’s god to be here

Dr. Franco: Mitch, tell us a little bit about you. We met a couple years ago and have known each other thorugh different stuff in the medical world if you will. Now you’re the spokesperson, the liason, if you will, for Emsculpt. And don’t get too much into what Emsculpt is because we’re gonna dive in that too a little bit, but just a little bit about you just…you’re here in Austin. You’ve also been competing for Austin’s most beautiful man. And then I thought that you and Gilbert we’re gonna have a dress off today, but I almost feel like Gilbert was scared and just threw in the towel and he said, “Oh, I thought I was gonna wear scrubs,” so that way he wouldn’t be shown up. So, don’t think we didn’t notice what you did there, Gilbert. You folded like a wet noodle?

Gilberto: It’s more like an effortless kind of…

Dr. Franco: Thank you wet noodle Gilbert. Mitch, it’s your turn to talk.

Mitchell: I will say on Gilbert’s behalf he dresses pretty dapper. So, I had to come with, you know, a little flair, just in case he was trying to show me up.

Dr. Franco: For those of you who wanna check out our YouTube channel, you can see that Mitch, what is that that you got into your suit there? Is that a rose?

Mitchell: It’s a feather.

Travis: Oh, my God.

Dr. Franco: I don’t think that I have ever seen Gilbert bring the feather, so…

Travis: I was about to say the same thing. I have not seen Gilbert bust the the feather out.

Dr. Franco: For those of you that are only listening, I got my hat on, I got glasses, and the 5:00 shadow. Mitch has got a feather in his suit. So…

Gilberto: [inaudible 00:02:13.612] sartorial suggestions.

Dr. Franco: Tell us a little bit about you, Mitch, because you’ve been in aesthetics industry for years.

Mitchell: Yep. Since two weeks out of college, I was with one company for seven years, joined BTL about two years ago and Emsculpt are the manufacturers. My mom worked for a well-known plastic surgeon in Los Angeles, where I’m from, for six, seven years. She’s always been an aesthetic so kind of…since I was a kid, it’s always been something I’ve loved and had interest in. And Emsculpt was one of the most exciting technologies I’d ever seen from the first month that it came to market.

Dr. Franco: Before we jump into Emsculpt here can we get a little catch up on on Celebrity anesthesia. I think you took your first vacation and that’s why this this podcast taping got pushed back a week because I appreciate you fitting us into your busy schedule as the only man in america traveling on a weekly basis.

Travis: Yes, we did. We actually just got back from Santa Fe, just made a quick little road trip, a long weekend. But we hadn’t done anything since Mary’s injury to her knee and then with COVID we’ve been pretty much locked down around the house. So, we haven’t done anything since January…

Dr. Franco: Except for the trips.

Travis: Yeah, except for the the trip that Mary got hurt on in January, but my wife is doing a lot better. My wife is @yourtrendytherapist, blogger, fashion blogger extraordinaire, and she broke…

Dr. Franco: Just for those of you who are wondering, we don’t get any money, funds for all these shameless plugs that we do for Your Trendy Therapist. So, I’m just just gonna put that out there for any fashion bloggers that would like to take Your Trendy Therapist’s spot for plugs, shameless plugs on this show.

Travis: I might get in trouble for that at home, but yeah, we always want to make some money.

Mitchell: Like wise.

Dr. Franco: Gilberto, what about you? Are you still Austin’s most taken man or has things changed on the home front, what’s going on? I feel like it’s been a couple of weeks since we’ve heard from you. So, who knows what’s happened?

Gilberto: It’s been a little while, yeah.

Dr. Franco: But the fact that you’re not wearing a six-piece suit I feel like you’re still taken.

Gilberto: No, everything’s good, everything’s good. Yeah, still Austin’s most taken man.

Travis: There you go.

Dr. Franco: And and things on the home front are good or has quarantine beat you guys up what’s going on there?

Giberto: I’m sorry, can you repeat that.

Dr. Franco: Yeah, I mean, are you guys still good on the home front or has quarantine beat you guys up a little bit?

Gilberto: Oh, no, no. Things are good. Quarantine’s been fun, as much fun as it can be. We, you know, we’ve been spending a lot of time together and dreaming of taking weekly vacations like one Celebrity anesthesia. Maybe we’ll be able to take a little trip here soon. But yeah, just working hard.

Dr. Franco: Okay, you know, the reason I thought that this would be a great topic is…I don’t know about you guys and I know Celebrity may talk to us a little bit about the marathon he’s training for that he’s not actually running, but for the rest of the world, you know, I think the quarantine 15 is a real thing. And I’ve definitely put on a few pounds. You know, I don’t know where the rest of our listeners are in this, and hopefully I’m not the only one. But here in Austin, Texas, gyms and other workout facilities have slowly open but at some capacity. I’ve talked to a lot of people who have still been a little hesitant about gyms. If you’re like myself, by this point you got every inch of Town Lake memorized because you’ve gone through this so many times. So it just is great to get out, get some cardio, but there’s kind of some muscle functions and other things that maybe are lacking a little bit with the gyms closed. And I think for anybody who’s tried to go on Amazon, I think there’s a three month backlog on ordering weight equipment.

So, I thought, well, this would be a great topic to talk about Emsculpt, which Mitch alluded to a little bit ago. And we’ll let him kind of tell us a little bit about Emsculpt. But this, for me was the first large device that we actually purchased in my office because I think it’s super unique. When it came on the market, there was nothing like it. This was truly the first device that focused on muscle. And in the the world of plastic surgery, we’ve done everything from, you know, the initial plastic surgery with skin removal, skin movement, skin rearrangement, and then we transitioned to fat reduction, fat removal, and now fat transfer. But we’d never really done anything for muscle per se. And I think this was just a huge new paradigm of plastic surgery. And I’ll tell you, when we first got the device, I think it was a little confusing to people because people didn’t realize the difference between CoolSculpting and some of these other fat reduction devices to Emsculpt.

It was such a new and kind of innovative way of treating the body that I think it’s taken people a little while to understand exactly the benefits of this. Mitch, you wanna hit us up and give us kind of the cliff-notes of Emsculpt and what it does and and how it’s used?

Mitchell: Yeah, I mean, that was very well said. And, really, to your point, it was the first machine ever that went beyond skin and fat, even deeper to target muscle. And kind of what we found as Emsculpt was evolving is that when you’re able to positively grow and target and affect muscle, you can also reduce fat and as a [inaudible 00:07:37] a three in one, two and one type machine you’re really adding a lot of value and you’re truly sculpting and toning the body in a way we have never seen before. And for a very well established plastic surgeon like Dr. Franco, being able to use this as an option for people that aren’t a plastic surgery candidate but especially post-surgery to continue to enhance results and have the patient feel stronger and have better function is just an enormous opportunity in a really holistic approach to wellness and anti-aging.

Dr. Franco: Can we go over what areas people can use this because, correct me if I’m wrong, its initial push was for basically abs and glutes and we do a lot of butts BBL stuff, so we’ll circle back to whether you can do with it or not, but that’s not the only places. And I’ll tell you my my number one place that I love using this is for my arms. You know, I don’t wanna embarrass Celebrity and Gilberto, but you can’t even fit these arms in the entire screen here.

Travis: I knew that was coming. Good Lord.

Gilberto: Well, it’s funny because Dr. Franco is actually is our after-photo for all of our arm Emsculpt pictures. So, he’s the Emsculpt spokesperson for the guns.

Travis: There you go.

Dr. Franco: And it’s funny because Travis has been making a push to be the calf specialist. It’s not Gilberto because if you listen on previous episodes, he’s actually interested in getting calf implants, but maybe he doesn’t need to get calf implants, he could just Emsculpt these legs.

Travis: There we go.

Mitchell: Absolutely. So to your point, yep, biceps, triceps are the newest addition. They’re actually completely different applicators and there’s actually pulses specifically for that muscle. The calves were the next addition, there’s a separate algorithm again. What I mean by that is because the muscles are so different, there’s different contractions to maximize how they’re targeted and affected. And we can also do the thighs, stomach, glutes, and even off label hamstrings, lower back for back pain, pretty innovative with how you can treat the body.

Dr. Franco: You hit on a point there because I know some of our patients worry about this is that for like the ab…because you have different settings because for the abdomen, you can set it to not only build muscle but also do a little bit of fat reduction. But for, like, our butt patients who don’t
wanna lose any fat, you can actually change the settings so that you’re only focusing on muscle building and not fat reduction. So, that’s something where going to the right provider can help tweak the settings depending on what you’re doing and so forth.

Mitchell: Exactly. And something kind of cool that just came out a week ago was studying for Emsculpt and visceral fat. So, people were really looking at this as just a muscle machine, fat as a byproduct. And we had a study released CT and MRI, which Dr. Franco can tell you is very good science and imaging to really test and look at changes to the body. And there was about a 15% reduction in visceral fat, which is kind of the deadly scary fat we all want to avoid. A lot of men have it in particular. So, I think as more research comes out, Emsculpt is gonna start being used in so many different ways that we really haven’t seen, just due to the non-muscle capabilities prior.

Dr. Franco: Gilberto is Austin’s most beautiful man. If you don’t mind give me…giving away some of your beauty secrets, you’ve actually had Emsculpt. Can you tell us a little bit about your experience, pain, comfort, you know, the experience itself?

Gilberto: Yeah, it was an amazing experience. I actually had it done at your office, thank you very much. And it was really interesting, you know, I would go in…

Dr. Franco: You’re welcome ladies Austin?

Gilberto: I’d go in and your staff was really really helpful, they would set everything up for me and I basically would just, you know, lay down on the table, get the Emsculpt paddles attached to me and they’d just turn it on and…30 minutes and the treatment was over. You know, it was it was pretty interesting. It was a little unique sensation to have to get used to, but it was pretty interesting and the results were pretty incredible too.

Dr. Franco: That’s what’s almost kind of interesting to me a little bit is because you can actually turn up the intensity depending on what people can tolerate and so forth. And the broad range of what people tolerate or don’t is actually pretty interesting. And I may get some backlash from this, but
men don’t seem to have as high a threshold for the Emsculpt as women. Women tend to not care. They’re like, “If I’m gonna get some nice abs, you turn that all the way up, I do not care.” The all time record is actually one of my best friends is named Fernando for anybody who knows and so I’m calling him out on the on the podcast. He has the all time record for the lowest threshold, and I think he only got to 27% and I’d never have heard or would have believed that, but I saw with my own eyes.

Mitchell: Gilbert, what did you get up to?

Gilberto: I mean, I don’t want to come off as boastful, but I got all the way up to 100%.

Mitchell: I think Dr. Franco, I did too pretty quickly.

Dr. Franco: Yeah, no, no, I’m tough. I’m tough as nails. Yeah, for sure. Let’s recap a little bit just so people kind of understand. So, with Emsculpt basically, it’s an office procedure, you can come in, each treatment’s about 30 minutes. Obviously, some people will do multiple areas, so it could take longer if you did abdomen and butt or so forth like that. So, you can do different areas in the same day, but each treatments about 30 minutes. And then you can go home the same day because you may have a little bit of soreness, you feel that muscle cramping tightening when you’re doing the procedure. But basically, when it’s done, you might have a little bit of soreness, maybe not, it just depends on the specific areas. And that’s kind of interesting too how different areas…my arms were really sore. I felt like my abdomen didn’t get quite as sore maybe because my abdomen is already so strong, but you never know why for different things. But one of the great benefits about it is that you can go about your day right after the procedures. So, it’s not like there’s a ton of downtime.

Mitchell: Exactly. And I think there’s, you know, with the whole shift for non invasive. Obviously, there’s certain procedures where you want changes surgery, you know, breast augs, things that you’re doing, Dr. Franco, you know, the nose etc. But I found that there’s this difference between true non-invasive and like an Emsculpt non-invasive. And Emsculpt non-invasive meaning you can literally get the treatment, put on a bathing suit or bikini go to the pool and no one will know you had anything done. So, it’s literally as non-invasive as it comes. No creams, no numbing, no gels, zero. And that’s one of the things I think people especially in Austin, a city where everyone’s out and about, active, you know, a lot of sunshine, they can appreciate this because it’s truly not impacting the day at all besides making you feel, you know, tighter and stronger.

Dr. Franco: Or someone like Celebrity this isn’t gonna hinder any of his travel plans so he could still go on his 12th vacation of the quarantine next weekend if he would like to.

Mitchell: Exactly. His calves may be stronger to hit the gas pedal a little harder when he is driving to get there quicker.

Travis: Sign me up. My wife actually @youtrendytherapist, I don’t know if I mentioned that already, she actually had Emsculpt done and she had her abdomen done. And she went and had four treatment sessions. I was jealous because she went in and I have not had it done. Clearly, I’m not a good enough friends with Franco. But you could see results and, I mean, visibly I could see that her abs were tighter and more defined and she was super happy with the results afterwards, and here I was working out at the gym like a sucker.

Dr. Franco: And I think you bring up an important point is that typically with the first treatment, you’ll do a session of four in the first two weeks and so, you know, something…if you did like a Monday, Thursday, Monday, Thursday or something to that effect, and we can play with those days a little bit, but it’s a good initial to get that first treatment. I think the other part that Mitch brings up here is realizing that it’s not a BBL, it’s not liposuction, it’s not liposculpting. So ,like any of these other things, there’s some trade-offs, right? So, you can go about your daily business, you can do those things. Those other treatments also don’t treat muscle, but you also can expect Emsculpt treatment of the butt to be equivalent to 1300 cc of fat transfer. You know, try to be realistic about what we do and don’t do because I don’t want people to have false expectations and be disappointed, but it does help augment those results. Also, for people who aren’t a fat transfer candidate, or don’t have the downtime to not sit for six weeks, you know, there are some some alternatives.

The other flip side that I think it’s important for people to understand is, you know, I think this is a great jump-start for those that are trying to get back into working out and jump-starting. But I tell people, any exercising or working you do on your own is only gonna help augment and enhance your treatment. Also to remember, people can have results out for a long time, but because it’s building muscle, it’s not like you’re gonna see some something overnight . When you go to the gym and you kill it. It’s not like your body changes the next day. Those changes take gradual time. And so, you know, it’s one of these things you got to kind of keep doing, the more you do, the better your results are gonna be just like the gym. Toss to Gilberto or Mitch on that?

Mitchell: I was gonna say the cool thing too is…and I know you just recently started implementing this, Dr. Franco, is you can do almost like a muscle membership program where after those initial four, you wait out maybe six to eight weeks, let the results kick in, come in for an after photo, talk about, you know, your progress. But then you can repeat sessions on a monthly basis just to enhance and elongate the results. Emsculpt has very robust long-term data even out to one year. No non-surgical body machine has ever published one year data. So, it’s profound in terms of not just permanently killing fat, but the longevity of the muscle and people just love to take it a step further and come in every month because it’s so easy. They feel strong their workouts are enhanced, you know, Celebrity you’re a runner this would only actually make you probably run faster. We’ve had a lot of people say that.

Dr. Franco: I don’t think that’s possible.

Mitchell: Is he that nimble?

Dr. Franco: He’s pretty fast. I mean, he does…

Travis: [inaudible 00:18:16.246] I need all the help I can get, man.

Mitchell: Hey, any competitive edge, right?

Travis: That’s right.

Mitchell: And it’s legal.

Dr. Franco: And I agree 100%. I think people who do…and that’s why we switch to more of a membership program because I think the…just like any workout, you don’t get a gym membership and only go once. That doesn’t really make sense. I mean, some people get memberships and only go once that doesn’t make any sense. But the idea is that the more you do, the better you’re gonna be, the better you’re gonna be in terms of this. So, I think that that’s super important. Gilberto, any thoughts about after your treatment, stuff you liked, stuff you didn’t like about about the Emsculpt?

Gilberto: No, I really liked the results. What I didn’t like was not being able to go back as often as I would have wanted to keep up with everything, just because my schedule is so busy and, you know, you’ve been using using the machine a lot with your practice, so it’s hard to get in there sometimes.

Dr. Franco: Well, I thought that you didn’t come back because the girlfriend said, “No, no more tight abs for you. We don’t want that floating around pool season in Austin.” That’s not true, that was that was made up by Celebrity?

Mitchell: That’s a conflict though, right? Because you gotta be Dr. Franco’s wing man. I mean what’s happening now is this enhancing it or hurting it now that he’s, you know, got a girlfriend.

Dr. Franco: Well, he’s been MIA. This is the closest I’ve seen to him. I sometimes drive by his condo and wave. And I’m like, “I’m outside,” you know. And so, people are like, “Hey, you don’t have to stand outside the glass window anymore.” I was like, “Oh, I don’t even know if he’s home, I’m just waving.”

Gilberto: We wave back at you.

Mitchell: You give him one six pack and then he just leaves.

Dr. Franco: Mitch, can we talk a little bit about the difference between Emsculpt and CoolSculpting. Because when we first got the device, that was a question that people always ask, “So, is this like CoolSculpting?” And my answer was always, “No, this is a completely different target.” While it does have some fat reduction, the main focus of the Emsculpt is the muscle. And I think this is a really important paradigm shift in plastic surgery for people.

Mitchell: Yeah, absolutely. Well, CoolSculpting did a great job of creating this non-surgical body contouring market. The device is about 12 years old now, which a lot of people don’t realize. It’s been here for quite some time. But to your kind of overview, Emsculpt took it a step further by really going after muscle, and that’s the FDA clearance and indication is firming, toning, lifting, creating that thickening of the muscle tissue. And then as a byproduct, pretty robust fat reduction. Some of our studies close to 30% across the entire abdomen, which is actually more than most of the devices that just focus on fat. So, what I love about it is you’re getting a two-for-one treatment in a sense. And then you’re able to do things with Emsculpt that no other system can even target whatsoever. For example, abdominal separation called diastasis recti, Emsculpt came out and it reduced it about 15% just by thickening the muscle.

And then with the butt lift beyond a BBL from Dr. Franco there’s no other option or there never was for a non-surgical lift. When you’re doing a fat machine, specifically like CoolSculpting, you avoid the butt at all costs. You also really aren’t treating the biceps like you can do with Emsculpt or the calves. And then the last real important point I think, is the pain relief and functionality. We have so many patients that have better posture after Emsculpt, reduce lower back pain, again, can weight lift more, can run faster. So, you’re getting on top of the fat and the muscle, extra advantages of performance. So, it really kind of becomes a device that is really taking the lead in the body contouring market and has just continued to run with it.

Dr. Franco: And because usually we have Celebrity reign in right now about anesthesia, pain control, those types of things during this procedure, but this isn’t even like an Althera or anything like that where people are taking Celebrex or Xanax or anything prior to it. Because as far as I know I’ve never taken anything prior to this. There’s no numbing cream, there’s no need for any types of pain medications or muscle relaxants prior to this. So, I kind of…that’s been one of my favorite things about the device is that it’s made the need for Celebrity anesthesia to be zero, which has been pretty amazing.

Mitchell: Yeah, that peace of mind. You can’t put a price on it right?

Gilberto: Hey, Mitchell, I don’t think this has been addressed, but are there any areas that can’t be treated with Emsculpt?

Mitchell: You know, we haven’t…

Travis: Gilberto, that requires surgery, man.

Mitchell: Yeah, exactly.

Travis: Well, I was asking for a friend, of course, I get it, I get it.

Gilberto: To the chest.

Dr. Franco: I mean, Celebrity is right here, dude.

Mitchell: Yeah, we haven’t come out the chest yet because of the, you know, the heart. And even though we don’t target smooth muscle, there’s…we’re still at about only 40% of Emsculps kind of plan. So, there’s gonna be more areas more indications. I think there’s another six or seven studies still in progress right now. There is the attachment to Emscupt, which treats the pelvic floor. So, you can treat muscles, you know, from post pregnancy, male, female incontinence and things of that nature, which is usually utilizing what we call the high intensity focused electromagnetic energy. But between that and all the other body parts mentioned that’s what we have right now. And I’m assuming we’ll hopefully have more areas in the future.

Gilberto: I was asking on Travis’s behalf.

Mitchell: Got it. Dr. Franco you did your packs off label once right?

Dr. Franco: I did. I did. But I…

Mitchell: And how was that?

Dr. Franco: … could barely fit in the shirt so Celebrity was like, “Damn dude the nurses won’t stop staring at you, stop working out so much.” I was like, “Okay, I don’t want to distract them.” Celebrity you’ve been awfully quiet any any comments, thoughts, things you’d like to…

Travis: I’m just taking notes for when I get to use this thing. It sounds pretty cool. I’m actually…I’ve talked to Dr. Franco already and I’m excited to check it out and try it. I wanna put it to the test.

Mitchell: That’s a cool thing.

Dr. Franco: I was gonna say…and honestly Celebrity if you ever wanna see, you know, you can check out his wife’s Instagram and he’s often on there without a shirt. So, you can see why he’d be a good candidate for it. But one of the things is important is making sure that you’re a good candidate for this okay? And you have realistic expectations that one, it’s not surgery, two, you know, it’s not a…and really no plastic surgery other than if you’re seeing a gastric procedure that type of thing. It’s not a weight reduction type treatment and so, you know, if you’re looking for a weight reduction, this is not it. You know, this in combination with the healthy lifestyle, diet, exercise, those things can be part of that regimen, but stand alone, it’s not. And plastic surgery in general should not fall in that category. Outside of our bariatric friends in terms of those surgeries. I think also too, if people have a tremendous amount of loose skin, that’s where I’ve seen people be disappointed with Emsculpting.

And this is where you kind of got to be real and whether you we’re talking about butt, arms. If you’ve lost 100 pounds and you just have a ton of loose skin, I mean, if you think about it, you’d need Arnold Schwarzenegger arms to fill all of that loose skin. And so, it’s just again being real and this is where I think going to a an office, someone that has a trained practitioner to help guide you a little bit because Emsculpt has a lot of great benefits. But obviously like any surgical procedure, any device, it needs to be for the right candidate. And so it’s not replacing a tummy tuck. It’s not replacing, you know, full-body lipo and it’s definitely not replacing, you know, a bariatric surgery, if somebody is trying to lose a ton of weight. And those are the some of the the areas we’ve seen in our office where people have come in and we’ve tried to redirect them to to a better position because I think then you would spend money and be disappointed because you’re not gonna see the results.

If you’re in the overweight or obese category, it’s gonna be really hard to see that muscle definition, that change in your abdomen if we don’t do some of those things. So, I think discussing that is, I think is super super important with your your practitioner.

Mitchell: Absolutely. I mean, we are…one of the nice things is for Celebrity, you know, if you’re a runner, you probably wouldn’t be a candidate for a lot of body contouring treatments, but because Emsculpt is building muscle, you know, anyone in that lower body mass index can benefit from this. And then those people that just need a little bit more definition, you know, if they’re basically the Hulk, like Dr. Franco, and they just wanna, you know, have even more gains. But, you know, we’ve seen a good mix of some of the larger patients for the visceral fat study. What we did there is we put two applicators on the stomach just to treat a wider area and had successful results. With regards to the skin tightening, you know, there’s other devices that we have for tightening, but again, this is not FDA cleared for any tightening and if it’s severe laxity, you definitely are probably looking at a surgical option first, and then maybe Emsculpt post.

Dr. Franco: And that’s something, that’s a good point you bring up. There’s people who wanna do this for strength training, they’re getting back into the gym, maybe they have back issues, they’re trying to re-ramp up after an injury. And they know that they’re not gonna visually see a huge difference because they have some of this extra weight they’re trying to work off. But their ideas just to really kind of restrengthen after getting back into the gym, and we’ve had people that are in that category. And as long as we’re on the same page about what the goal is, then I think it’s fine because we do have people say, “Hey, I’ve seen real gains since I started do this, even though I know I got a…I feel a little quarantine 15 and I don’t see my abs like I’d like to, I feel that I’m making improvements to the gym.” And we hear that a lot. But just trying to be real with people and make sure that we have the same kind of end goal that’s realistic for them.

Mitchell: Even, like, athletes are getting it now too, which is really cool. Rob gronkowski, Deontay Wilder, US Women’s National Soccer Team. So, there’s been a lot of, you know, performance enhancement with Emsculpt legally. I think there’s gonna a frontier for that potentially with building so much muscle, 20% muscle thickness in abdomen alone…

Dr. Franco: Until Emsculpt gets banned by the Olympics being an unfair advantage.

Mitchell: Delete this podcast, delete this.

Travis: It’s a really really cool piece of technology though because you spoke to the visceral fat loss in this study from Emsculpt and visceral fat is one of the toughest things to break down and lose. And that is the last type of fat that gets broken down in fat loss in general. So, to be able to do that, A, to me is super impressive. The other point I wanted to make is, I think this is a great opportunity for people post injury or post surgery to come in and have something done. Because my wife…me and my wife were talking about it the other day, she had an ACL repair in January and she hasn’t been able to hit the gym like she normally does. She’s a workout rat too. So, without being able to do that she wants to do something, and she could still lay on a table for 30 minutes and have her abs or arms done with Emsculpt in the meantime. I think that’s pretty cool, you don’t lose.

Mitchell: Yeah, I would do her quads and calves actually. So if you’re looking at true functionality, ACL, MCL, you put those on the quads and the calves, that’s gonna just rebuild that area so her physical therapy can work even faster. Someone with back pain, do the stomach and glutes to really support the core, you know, shoulder pain, do your biceps and triceps to maybe alleviate and build some muscle to kind of allow you to actually work out and have better mobility. So, these are all kind of off label but after, you know, thousands, I think 300,000 treatments performed close to 350,000 now, we’re starting to get some really unique feedback about all of this, which is amazing.

Dr. Franco: And see, I needed this back, you know, seven years ago when I was in college and I hurt my knee. You know, as a college athlete, you know, every day is precious. And so to have that downtime and not have something like this to help get me back into to the game faster, you know, it’s…

Mitchell: Which part did you fall down at that hurt your knee Dr. Franco? It was it was one of those East 6 bars, I know it.

Dr. Franco: It was trying to sneak in and Gilbert’s Condo, you know, trying to climb the fence, get in the window, his girlfriend’s locking it she had oiled up the the, you know, the stairs trying to keep me out, but that’s cool. I battled through it and dragged myself and still.

Mitchell: You’re a better man because of it, right?

Dr. Franco: Well, any any kind of closing stuff that we should make sure we hit up and people know about Emsculpt from Celebrity, Gilberto, or Mitch?

Gilberto: I mean, I just wanna say that I really enjoyed going through the process of the treatment myself. Again, I wish I had a little bit more time to come in and keep doing more treatments or even hitting up other other muscle groups. Maybe sometime in the future we can we can talk about doing that. I joked around with Dr. Franco once about maybe doing a body by Emsculpt challenge where we, you know, hit up all these different muscles…

Dr. Franco: Could we do a TikTok body by Emsculpt challenge? Mitch, can we talk about that? Can we can we talk about this?

Mitchell: Absolutely. I’m gonna put my money on, I’m gonna have to go with Dr. Franco…

Dr. Franco: That’s what I’m taking about.

Mitchell: …just because he’s so competitive, I think he’ll make the time to do it if it’s to beat you two.

Dr. Franco: I mean there’s only so much room for Celebrity to go up, you know, he always says the sky’s the limit but I just, I don’t know, I don’t know. I feel like maybe he’s already there. Maybe he’s already floating his hot air balloon.

Travis: There’s always work to be done.

Dr. Franco: I remember I was in the operating room and Celebrity is always like, “The sky’s the limit Franco, just keep working.” I was like, “Damn. Okay, man.”

Mitchell: You’re working on Saturdays. I mean, you’re like non-stop. It’s amazing.

Dr. Franco: Well, I got to reach the sky since that’s what Celebrity always tells me.

Travis: That’s right. That’s right.

Mitchell: It’s great advice.

Dr. Franco: It’s like one of his favorite quotes. I’m like, “God dammit, Celebrity.”

Gilberto: One thing I did want to add to just with COVID and, you know, everything happening and like you said, the gyms, I mean, I’ve had my gym membership on freeze even with it reopening. And the Emsculpt cord is actually 6-feet long. So, a lot of doctors have been talking about the 6-foot distancing. And the fact that you can come into a room, be by yourself, the operator won’t even be your near face. You can both be wearing masks if that’s the protocol in the clinic. Once you’re kind of getting going and you’re comfortable, the operator can leave the room and just let you relax and enjoy the treatment. So, it’s about as safe and sterile as it comes. And there’s a lot of data now coming out that, you know, after 10 days of not working out, you start to lose you over 10% muscle. So, it atrophies quickly, you can do Emsculpt and get long lasting muscle in a safe way, little fat reduction as part of it. It’s kind of an ideal solution for the times.

Dr. Franco: And someone who’s never, or people who are just listening, seen the Emsculpt machine to your point. It’s very sleek in terms of there’s not a lot of moving pieces, so it’s very easy to clean, very easy to wipe down. The paddles are very smooth, like very limited, you know, type paddle thing that you can wipe down extremely easily. So, 100% I think…

Mitchell: I feel like Vanna White right now.

Dr. Franco: Because just kind of closing there’s a couple other devices out there that have obviously…once there’s something that sets the tone of something, you know, very unique and innovative like this, it’s not gonna be long before people come out and [inaudible 00:34:51] you see there’s Botox and there’s like four other different toxins on the market now. Emsculpt has felt a little bit of that pressure and there’s…I don’t even know that names of all of them. But there’s some other devices on there, but some of them are a little bit different than yours. And I’ve seen some of them are just a little bit different in terms of application, how you put them on, difference in terms of some intensities and other things. And so, I think something discussed with your provider stuff, but there’s definitely some plus and minuses to everything like anything else in life.

Mitchell: Yeah, and they still…the big thing with Emsculpt, which is probably most important since we’re talking medical is Emsculpt is the only device that actually has data. All these other machines come to the market, seeing kind of what Emsculpt has done, but have no published peer reviewed studies, which is the gold standard, you know, no effects on fat. Maybe 10 before and after photos, Emsculpt has almost 1,000. So, you know, when you’re going into a provider, obviously, you’re going because of the doctor’s office reputation but, you know, those are important questions to ask. And if a doctor is investing in equipment that’s not fully validated 100% that maybe just has a clearance that says it won’t kill you, but it’s not necessarily benefiting you, that’s, you know, a little moment of pause perhaps. So, I think part of the reason Dr. Franco invested in this beyond being cutting edge is there’s a lot of data behind it. And we continue to produce more and more data on all different indications, which is fantastic.

Dr. Franco: What’s funny is that the hardest decision our patients have when they come in for the Emsculpt is they can’t decide which body parts they wanna do, because they’re like…

Mitchell: I want everything.

Dr. Franco: They want everything because they wanna do more sessions on their butts and their butts keep getting better, but they also, you know, wanna do other things. Because we have a lot of BBL patients that…our current protocols, we wait about two months and then we let them start doing Emsculpt because with, you know, some of the BBL safety, and not to get us off topic, we only inject fat into the fat. So, I tell people, “Fat goes into fat and we completely avoid the muscle because of the risk of fat emboli and a lot of safety things that Celebrity and I have talked about in past issues about this. And so, you know, there’s a whole layer that we’re not treating during a BBL that now you can treat that’s only gonna enhance it because that muscle grows. I tell people, “You’re gonna push that butt out and lift that because we didn’t do anything to that muscle during the surgery.”

Mitchell: That’s a great combination and with your membership, Dr. Franco, is it kind of easier now for patients to get more areas early assimilate if they wanna add more body parts?

Dr. Franco: 100%. It’s definitely easier for people to do more body parts, it’s easier for people to come in monthly. It’s also easier because we’ve made it a little bit easier where people can trade out like a facial and upgrade to an Emsculpt treatment or do some other things, so depending…and then also let’s say, like, because Emsculpt, as we’ve talked about, is going to help build you over time. So, let’s say if you had a wedding in two weeks you need to get ready for and you wanna trade Emsculpt in for for a facial to get ready for that wedding because you’ve already been doing that, the Emsculpt, for six months, you can do that. So, we’ve basically tried to set it up to give people a little bit more flexibility in this day and age over all the craziness and rollercoaster rides going on to make it easier for people, and I feel like people have appreciated that.

Mitchel: So, now Gilbert can go get his glutes done because he told me offline that he has been really wanting to get the glutes done at your office.

Dr. Franco: His shorts keep falling down. I thought he was just trying to bring like the ’80s back and I was like, “Damn,” I was gonna get him a belt for his 50th birthday coming up and, you know, maybe he doesn’t need it if he does an Emsculpt.

Mitchell: It was his girlfriend’s request.

Gilberto: [inaudible 00:38:37] coming in to get my butt done, okay?

Dr. Franco: Well, Mitch, we always like to do a little something that I call fact or fiction. So, we’ll share the heat a little bit. But fact or fiction, you were at one point considered the most eligible rep in Austin?

Mitchell: I’m going to say fact.

Dr. Franco: Fact or fiction…a few of the other reps have told us about some incidences with you and them being like, “That is a good looking man.” Is there any truth to those rumors? I know that those were a while back as you’re now taken man, but back in the day?

Gilberto: Welcome to my world, Mitch.

Mitchell: That would be fact and Dr. Franco had brought this to my attention, so he knows that this is fact.

Dr. Franco: So, you didn’t even know it was like the Austin world was surrounding. So, between you and Gilbert being taken off the market and maybe Celebrity and I are gonna get a move up the ladder here.

Mitchell: Sorry, Mary. Dr. Franco if there’s anything we can do for you, you know, if you need to borrow anything you wanna borrow my little feather pen.

Dr. Franco: I need a feather.

Mitchell: I’ll bring you some to the office.

Travis: That’s the move right there. The feather.

Dr. Franco: Mitch, we do we do a little segment we like to call behind the bovey. If you could tell us one thing that people would never really like expect or know about Emsculpt, what would it be? One little like hidden nugget.

Mitchell: I would probably say the one year study in data that the muscle can last for a year after four treatments and not atrophy because it’s growing new muscle fibers. And I think that’s just because people are used to gym workouts and think, you know, “Oh, I work out four times for 30 minutes. How long is this really going to last?” But because this is activating 100% capability versus the gym being 30% activation, we’re getting really long-term effects. Then when you start coming in for that extra monthly sessions, it’s just gonna propel it even further into the future. So, when I mentioned that to people, they always have that double take, like, what do you mean it can last a year without declining? And that’s what the MRI, CT, ultrasound data has undoubtedly shown.

Dr. Franco: I think the other one, and you touched on it briefly earlier was, was the diastasis, treating the relaxed to muscles. Because we definitely see a lot of women who don’t have skin that don’t…aren’t a good tummy tuck candidate, they look great. It just drives them crazy that they got that little bit of a pooch of their belly, which is all visceral, all internal, just those muscles relax. So, to that point, I think that’s a great nugget. And we have someone who I think had had four kids. And I don’t know if we have her pictures up on our website yet, but pretty amazing the difference after just four treatments in about six, eight weeks later. So, that’s when I really kind of became a believer. Again, not the same as us going in surgically and tying your muscles, but there’s a difference of 30 minutes, you know, and going back to the office versus a four-hour surgery and being out for six weeks. So, I think for the tradeoff, it was a pretty good result.

Mitchell: Oh yeah. And obviously, I mean, if you can…diastasis for a lot of people that don’t know if you can basically fit a finger to, in between your abdomen, that’s the separation. If you’ve had one kid, you have a high probability of having some two or more, you’re almost guaranteed to have a fairly severe diastasis. If you can almost kind of stick your fist into it, you need surgery at that point. But for most people that have that mild to moderate Emsculpt is a very good option. Plus your abs can look better, again, a little fat reduction. It’s kind of like, “Oh, and you get this as an extra,” which no one is gonna complain about.

Dr. Franco: No. Can we do our a quote of the day? Do we get a quote of the day?

Gilberto: Yeah.

Travis: I’ve got one if Gilberto does not.

Dr. Franco: Oh, you think Gilberto is not ready?

Travis: No, no, no. I wouldn’t say that.

Mitchell: He didn’t wear a suit, so I don ‘t know.

Travis: I’ve got one just in case.

Dr. Franco: G, would you like to take this or would you like to pass it off to El Capitan?

Gilberto: I kind of wanted to piggyback on what you said was one of Travis’s favorite quotes earlier about the sky’s the limit.

Dr. Franco: He says all the time. He says that all the time.

Gilberto: I wanna challenge that as a matter of fact.

Dr. Franco: What?

Gilberto: Yeah.

Travis: Against the grain. All right, let’s hear it.

Gilberto: A little quote from Paul Brandt, “Don’t tell me the sky’s the limit when there are footprints on the moon.”

Dr. Franco: Damn. Travis, Travis, I’m not listening to any more of your quotes, dude. No more of my listening to your quotes. Because then I’m gonna be like, “Oh, Franco, sky’s the limit.” I’ll be like, “Why am I gonna settle? I’m going with Gilberto.”

Travis: That was a good one, man. I can’t lie. That that was very good. I was trying to piggyback on our Emsculpt muscle building with a quote from The Rock. I do love a little Dwayne Johnson.

Dr. Franco: We’ll go ahead. We’ll do two. The fans want to hear a second one since, you know, footprints on the moon isn’t enough. Go ahead and try one up him with The Rock.

Travis: I didn’t say that, but The Rock did say, “Success isn’t always about greatness, it’s about consistency. Consistent hard work gains success, greatness will come.”

Dr. Franco: And that’s how you get footprints on the moon. Damn, you guys are like little Twinkies. You guys are like little Twinkies. I love it.

Travis: Brought it all together.

Dr. Franco: Mitch, I can’t thank you enough for coming on especially on short notice. I appreciate you. I just thought that the timing was perfect as people are trying to get back into it. And I’ve heard a lot of people being a weary about getting into gyms and I thought this was a great, you know, alternative options supplement. And so, I appreciate you dropping a few pearls of knowledge on us for it. So thank you.

Mitchell: Thanks for having me and for everyone for not wearing a sports coat. Gilberto I know that you were going to wear your tux.

Dr. Franco: I love that Gilberto just chickened out of the fashion off because I already had so many good lines for that and he showed up in a T-shirt and I was like, “Damn, just like that.’

Mitchell: He took pity on me. He’s like, “This guy, it’s his first time here, you know. I’m just gonna let them have this one.” I appreciate it.

Dr. Franco: Well, I wanna thank everybody who’s been listening to our podcast over this time. Remember, you can download us on iTunes, iHeart, Spotify, or wherever you get your favorite podcasts. You can also find us on YouTube. I also want to thank producer Donald who we can mute on the background, so that’s pretty phenomenal for us. But in all seriousness, we appreciate his help. And thanks for listening to the greatest podcast in the world as voted by us, “Plastic Surgery Untold.” Boom. Thanks guys. See you.

Travis: See you guys.

Mitchell: Take care.

About The Author

Dr. Johnny Franco
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