Body Contouring in Houston

Overview

Body contouring: fat, muscle, skin, and cellulite

Body contouring in 2026 is five distinct problems that patients often mash together: subcutaneous fat, muscle tone, skin laxity, cellulite architecture, and weight-loss skin redundancy. No single device solves more than one or two. CoolSculpting and SculpSure reduce fat but do nothing for skin. Emsculpt Neo builds muscle and modestly trims fat but cannot tighten loose skin. Morpheus8 Body and Renuvion tighten moderately lax skin but will not remove a post-pregnancy pannus. Avéli addresses the fibrous bands that pull cellulite dimples but leaves overlying fat untouched. Abdominoplasty remains the only way to excise a redundant skin envelope or repair rectus diastasis.

The most important screening question is whether the primary complaint is fat, muscle, skin, dimples, or redundancy. Mistaking one for another is how patients spend $4,000 on CoolSculpting and finish dissatisfied because the underlying issue was always skin laxity.

Three forces are colliding in the Houston market. GLP-1 weight-loss medications have reshaped who walks into consults — ASPS 2024 data show over 800,000 aesthetic patients used GLP-1s and 41% are now considering non-surgical procedures [27]. Non-invasive fat reduction volume declined roughly 40% nationally in 2024 as patients realized their real problem is often skin rather than fat. And a wave of newer FDA clearances — Morpheus8 Body soft-tissue contraction (K240017, July 2024) [5], Renuvion APR [10], Avéli 12-month durability [6], Emsculpt Neo — gives physicians and med spas genuinely better tools than existed five years ago. Simultaneously, paradoxical adipose hyperplasia after CoolSculpting has turned out to be 6- to 100-fold more common than original manufacturer data suggested [14][15][16][17], Renuvion carries an active FDA safety communication [8], and QWO — the only FDA-approved injectable for cellulite — was pulled from the market in December 2022 [13]. Honest 2026 body contouring requires acknowledging what the evidence actually shows, not what device reps promise.

Mechanism

How non-invasive fat reduction works

Every non-invasive fat device kills adipocytes while sparing skin, muscle, and nerve. Four thermal mechanisms dominate.

Cold (cryolipolysis) crystallizes lipid-rich adipocytes at a target temperature around -11 °C, triggering apoptosis and macrophage clearance over 2–4 months. This is the CoolSculpting mechanism [1][2].

Hyperthermic laser (1060 nm diode) raises subcutaneous fat to 42–47 °C, producing adipocyte apoptosis while contact cooling protects the dermis — the SculpSure approach [3][18].

Radiofrequency heats deeper tissue via monopolar (truSculpt iD) or bipolar (BodyTite, Morpheus8) current, causing thermally mediated adipocyte death and a secondary dermal tightening effect [4][5][23].

High-Intensity Focused Electromagnetic (HIFEM) energy induces approximately 20,000 supramaximal muscle contractions per 30-minute session; Emsculpt Neo adds synchronized RF to attack fat and build muscle simultaneously [20][21].

Imaging-measured fat reduction in properly selected candidates runs 8–25% per treated area, with cryolipolysis most reliably at the upper end. Results develop over 8–12 weeks as the lymphatic system clears damaged adipocytes. None of these devices produce weight loss. Patients with BMI >30 are generally poor candidates — Emsculpt Neo is the notable exception with clearance to BMI 35.

Fat Devices

Fat reduction devices compared

CoolSculpting Elite — cryolipolysis

The strongest evidence base in the category. FDA 510(k)-cleared for abdomen, flanks, thighs, upper arms, back, bra fat, banana roll, and submental area — submental up to BMI 46.2, all other areas ≤BMI 30 [1][2]. Peer-reviewed literature reports consistent 20–25% fat-layer reduction per treated area. Standard protocol: 1–2 cycles per area spaced 4–6 weeks apart. Ideal candidate: BMI ≤30, discrete pinchable fat, good skin elasticity.

The single most important fact prospective patients are not being told consistently: paradoxical adipose hyperplasia rates. The original Jalian 2014 JAMA Dermatology paper estimated PAH at 0.0051% (1 in 20,000) from Zeltiq-reported cases [14]. Every independent study since has found higher rates:

• Singh et al. 2015 Lasers Surg Med: 0.47% in a single practice — approximately 100× higher [15]
• Nikolis & Enright multicenter review of 8,658 cycles (Aesthet Surg J 2021): 0.05–0.39% [16]
• 2025 systematic review and meta-analysis (Aesthet Surg J Open Forum): pooled incidence 0.22% — roughly 6.67× Allergan’s current 0.033% figure [17]
• Some case series: up to 0.72%

PAH disproportionately affects men despite their comprising only ~15% of cryolipolysis patients; testosterone-driven adipocyte biology is the leading hypothesis. The treated area develops a firm, well-demarcated enlargement 3–9 months post-treatment. It does not self-resolve. Only liposuction or surgical excision corrects it, and even then it can recur. Linda Evangelista’s 2021 disclosure and 2024 settlement with Zeltiq made this widely known to consumers.

Houston pricing: $600–$1,500 per cycle. DermaTouch RN starts at $850/cycle [30]; Glamour Plastic Surgery 8-cycle abdominal packages around $4,000 [32]; Ovation Med Spa $1,600 per area [31].

SculpSure — 1060 nm diode laser

Cleared 2015 for flanks, 2015 for abdomen, expanded through 2017 to back, thighs, and submental (submental up to BMI 43 — broader than CoolSculpting’s submental indication) [3]. A 25-minute treatment per area; typical protocol 2 sessions 6 weeks apart.

Efficacy varies by study: Katz & Doherty (Dermatol Surg 2018) reported ~24% MRI-measured fat reduction in flanks [18]; Kislevitz & Kenkel independent replication (Aesthet Surg J 2021) found only ~8.55% ultrasound-measured reduction at 12 weeks in abdomen [19]. The discrepancy is real and likely reflects imaging-modality and funding-source differences. No PAH-equivalent has been reported.

Houston pricing: $350 per applicator at Houston Liposuction Center [33]; typical abdomen treatment runs ~$1,400 (4 applicators).

truSculpt iD — monopolar RF

Cleared 2018 for non-invasive lipolysis of the abdomen [4]. A 15-minute hands-free RF session targets 45 °C in adipose tissue. Manufacturer materials cite ~24% fat reduction from a single session, but independent multicenter replication is limited and most pivotal data is Cutera-sponsored. Small secondary benefit of modest skin tightening from collagen heating.

Houston pricing: starts at $750 per session at Utopia Plastic Surgery [34]; tiered packages drop to ~$250 per handpiece at volume.

Kybella — deoxycholic acid

FDA-approved April 29, 2015 for moderate-to-severe submental fat in adults [7]. Mechanism: injected deoxycholic acid disrupts adipocyte membranes, triggering local fat lysis. Protocol: 2–4 sessions spaced ~4 weeks apart, 20–50 small injections per session. Evidence is strong for submental use (Phase III REFINE-1 and REFINE-2, ~2,600 patients).

Off-label body use — bra rolls, inner thighs, jowls, axillary fat — happens in Houston and nationally, but the FDA label is explicit: the safe and effective use of Kybella outside the submental region has not been established and is not recommended. A 2019 systematic review identified only 10 articles across all non-submental indications, predominantly case reports. Any Houston provider offering Kybella outside the chin should disclose the use is off-label.

The adverse event to understand is marginal mandibular nerve paresis (asymmetric smile) in approximately 4% of clinical-trial participants, median duration 31 days, resolving without permanent sequelae. More dangerous are tissue necrosis or dysphagia from wrong injection depth — which is why Kybella should be performed by a provider trained specifically in submental anatomy.

Houston pricing: ~$650/vial at MD Aesthetica; ~$1,250/session (2 vials) at Face Forward Houston.

Muscle

Muscle toning: Emsculpt Neo and the HIFEM category

Emsculpt Neo deserves its own section because it does something other modalities cannot: it measurably increases muscle mass. BTL-reported clinical trials show average 25% muscle-mass increase and 30% subcutaneous-fat reduction at the treated area after 4 weekly sessions. The foundational Kinney & Lozanova MRI study (Lasers Surg Med 2019) showed 18.6% fat reduction, 15.4% rectus abdominis thickness increase, and 10.4% diastasis recti reduction with the HIFEM-only Emsculpt [20].

The honest calibration: a 2023 systematic review of 14 HIFEM studies (Clayton et al., PRS Global Open) confirmed the directional effect but measured smaller mean changes than marketing averages — roughly 5.5 mm fat thickness reduction and 2.2 mm muscle thickness gain. All included studies involved BTL-affiliated investigators [21].

Original Emsculpt received FDA 510(k) clearance in 2019 for abdominal lipolysis; Emsculpt Neo is cleared for BMI up to 35 for abdomen and thighs — broader than nearly every other non-invasive fat device. October 2024 expansion added clearance for rehabilitative neuromuscular stimulation in arms and legs. Contraindications: pacemakers, defibrillators, metal implants in the field, pregnancy.

Houston 4-session packages: $3,000–$3,600. Glamour Plastic Surgery $750/session in 4-pack ($3,000) [32]; Ovation Med Spa $3,600 [31]; Clear Lake Dermatology $750/session.

This is the modality with the strongest case for post-GLP-1 patients — it’s the only device that rebuilds the lean mass that GLP-1 medications cause patients to lose alongside fat [25].

Skin

Skin tightening and minimally invasive body contouring

Three devices dominate, and they sit on a spectrum of invasiveness. The honest frame: non-invasive and minimally invasive devices can improve mild to moderate skin laxity. They cannot eliminate significant skin redundancy. When the pinch test reveals more than 2–3 cm of skin that does not recoil, surgery is the honest answer.

Morpheus8 Body — InMode fractional bipolar RF microneedling

Insulated gold-coated needles up to 8 mm deep. 510(k) clearances K200947, K221571, K251632; July 2024 expanded clearance (K240017) for soft-tissue contraction [5]. Typical protocol: 3 sessions spaced 4–6 weeks apart, with 1–3 days of erythema and microcrusting.

Body-specific RCT evidence is thinner than face evidence — most Morpheus8 data are from face/neck studies or industry-sponsored registries. Claims of “non-surgical tummy tuck”-level tightening are not supported by level-1 evidence. The foundational body paper is Alexiades & Munavalli (Lasers Surg Med 2021) showing laxity and subdermal adipose improvement after a single treatment [22].

In October 2025 the FDA issued a safety communication on RF microneedling as a category, warning of burns, scarring, fat loss, and nerve damage — most reports tied to aggressive settings, improper technique, or unsupervised use [12].

Houston pricing: Galleria Aesthetics $1,200/body area [35]; Basu Aesthetics $600–$3,000; most providers are consultation-only.

BodyTite — RF-assisted lipolysis (RFAL)

Minimally invasive RFAL procedure. An internal cannula electrode and external skin electrode pass bipolar RF through subcutaneous tissue, simultaneously coagulating fat for aspiration and contracting the fibroseptal network — producing skin tightening that traditional liposuction cannot deliver. Real-time thermistor cutoff at 38–42 °C [23].

Industry-reported skin-contraction figures of 25–40% derive from InMode-sponsored and early case-series data; independent quantitative work places real effects lower. The pivotal Theodorou series in Aesthetic Plastic Surgery (2012) covered 97 patients under local anesthesia [23]; a 2023 arm-contouring series reported 3.75 cm mean circumferential reduction with satisfaction rising from 35% to 87%.

In Texas this is a surgical procedure requiring a physician — not delegable to nursing staff. 3–7 days of visible swelling, 3–6 months to final contraction.

Houston pricing: Dr. Roth Plastic Surgery $2,000–$5,000/area; SGK Plastic Surgery $11,000+ for comprehensive cases (The Woodlands).

Renuvion / J-Plasma — helium plasma with RF

Apyx Medical device. Helium gas ionized by monopolar RF into a cold plasma stream delivered subdermally via cannula or externally via dermal handpiece. The regulatory history is essential informed-consent content.

On March 14, 2022, the FDA issued a safety communication warning against Renuvion for dermal resurfacing and subcutaneous skin contraction after reports of second- and third-degree burns, subcutaneous emphysema, pneumothorax, gas/air emboli, and serious events requiring ICU admission — “serious and potentially life-threatening adverse events.” The communication was updated May 10, 2023 [8].

Subsequent narrow clearances followed: Dermal Handpiece (K211652, May 2022) for moderate-to-severe wrinkles Fitzpatrick I–III [9]; APR Handpiece (K220970, July 2022) for lax skin in neck/submental [10]; K230272 (April 2023) for coagulation of subcutaneous soft tissues following liposuction for body contouring [11]. There is no general FDA clearance for whole-body skin tightening with Renuvion. Any Houston provider offering Renuvion outside these cleared indications is practicing off-label.

The pivotal 2023 Aesthet Surg J IDE study on neck/submental reported 82.5% effectiveness and 96.9% safety [24]. Operator training and helium-flow technique are the dominant safety variables.

Houston pricing: Memorial Plastic Surgery $3,500–$7,500 [36]; Texas Liposuction Specialty Clinic $2,000–$3,500; Morales Plastic Surgery $3,000–$8,000.

Cellulite

Cellulite: what actually works

Cellulite is caused by fibrous septae tethering the skin downward through herniating fat lobules. No topical, suction device, or acoustic wave has ever reliably eliminated it.

Avéli (Revelle Aesthetics) — the current first-line option. 510(k)-cleared October 2021; extended to 12-month durability in September 2022 [6]. A sterile handheld instrument with integrated light is advanced subdermally through a 3-mm incision under local anesthesia; a distal hook captures and mechanically releases individual fibrous septa. The CONFFIRM pivotal trial documented durable 1.48-point Cellulite Severity Scale improvement at 12 months with 69% patient satisfaction. Published primary evidence supports 12-month durability; longer “1–3 year” claims in marketing exceed what has been published. Single session, 48-hour downtime.

Houston pricing: $3,000–$7,000 per session. Nuveau Plastic Surgery publishes this range [37]; Dr. Stan Plastic Surgery and Body by Ravi are consult-based.

QWO (collagenase clostridium histolyticum-aaes) — FDA-approved July 2020 as the first injectable cellulite treatment; discontinued by Endo Aesthetics on December 6, 2022 due to persistent bruising and skin hyperpigmentation that the APHRODITE mitigation study failed to resolve [13]. Commercially unavailable; cautionary historical note only.

Emtone (BTL) — combines monopolar RF with targeted pressure energy. Evidence limited to small industry-sponsored open-label studies showing modest improvement after 4 sessions. Typical rates $400–$600/session ($1,600–$2,400 for a 4-pack). Reasonable for very mild cellulite; not a substitute for Avéli in moderate-to-severe cases.

GLP-1

Body contouring after GLP-1 weight loss

The semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) wave has fundamentally reshaped Houston aesthetic demand. ASPS 2024: over 800,000 aesthetic patients used GLP-1s in 2024, 20% have already had plastic surgery, 39% are considering surgery, 41% are considering non-surgical procedures [27]. The 40% YoY decline in non-invasive fat reduction volume almost certainly reflects this shift — these patients have lost the fat and are now looking at skin and volume problems that cryolipolysis cannot fix.

Peer-reviewed body composition data quantify the problem. The SURMOUNT-1 DXA substudy (Look et al., Diabetes Obes Metab 2025) of 160 tirzepatide-treated participants showed −21.3% body weight at 72 weeks, comprised of 75% fat loss and 25% lean-mass loss (5.6 kg absolute) [25]. The STEP 1 semaglutide substudy showed similar proportional dynamics at −15% total body weight. Facial-volume deflation (“Ozempic face”) is now a recognized clinical entity in peer review (Mansour et al., J Plast Reconstr Aesthet Surg 2024) [26].

The physiologic consequence is threefold: fat loss outpaces dermal retraction; muscle loss removes the scaffolding that filled out the new silhouette; facial fat-pad loss ages the face.

The intelligent treatment menu looks different from the pre-GLP-1 era:

• Emsculpt Neo becomes genuinely therapeutic — not just cosmetic. It directly addresses the documented sarcopenic component. BMI ceiling of 35 makes it one of the few non-invasive options for patients still in the overweight range post-weight-loss.
• Morpheus8 Body and Renuvion APR handle mild-to-moderate skin laxity.
• BodyTite paired with liposuction works for patients with residual fat pockets plus moderate laxity.
• Biostimulators (Sculptra PLLA, Radiesse CaHA) combined with hyaluronic acid fillers address facial deflation.

What does not work: CoolSculpting on a post-GLP-1 patient whose primary issue is skin redundancy addresses the wrong tissue compartment. Non-invasive skin tightening alone is inadequate for significant skin redundancy. Significant skin redundancy requires excisional surgery. Full stop.

Weight should be stable 6–12 months before surgical contouring, and nutrition should be screened — GLP-1 patients are often protein- and micronutrient-deficient at consult. Perioperative GLP-1 management has shifted from ASA’s 2023 one-week hold recommendation toward 2024–2025 case-by-case guidance based on GI symptoms and procedure type.

Surgical Decision

When to consider surgical options

A decision framework, not a surgical how-to. If two or more columns on the right side apply, a plastic surgery consult is the better next step.

Liposuction remains the #1 US cosmetic surgery — 349,728 procedures in 2024 per ASPS, +1% YoY [27]. Variants: traditional tumescent (SAL) is gold standard; PAL (power-assisted) uses oscillating cannula; VASER uses ultrasound and is preferred for fibrous areas and fat grafting; SmartLipo (LAL) adds modest laser-induced skin tightening; BodyTite/RFAL adds measurable skin retraction.

Abdominoplasty was #3 cosmetic surgery in 2024 (171,064 procedures, +1%) [27]. Full tummy tuck addresses supra- and infra-umbilical skin excess and diastasis recti with fascial plication and umbilical translocation; mini-tuck addresses infraumbilical excess only without rectus plication; panniculectomy removes a pannus for functional reasons and is occasionally insurance-covered in massive-weight-loss patients.

Brachioplasty (arm lift), thighplasty, and lower body lift are the procedures for significant post-massive-weight-loss skin redundancy. ASPS 2024 showed arm lifts +2%, thigh lifts +3% YoY — directly attributed to GLP-1 patients [27].

ASPS 2023 average surgeon fees (most current published): liposuction $4,711; abdominoplasty $8,174; brachioplasty $6,192; thigh lift $7,641; lower body lift $11,397 [28]. Add 50–80% for facility, anesthesia, garments, labs. True Houston totals: $8,000–15,000 for liposuction, $12,000–22,000 for full tummy tuck with liposuction.

Board certification matters. The only ABMS-recognized board for plastic and reconstructive surgery is the American Board of Plastic Surgery (ABPS). Verify via the ABMS Certification Matters portal before booking.

What to Expect

Consultation, treatment, recovery

Consultation. A good Houston consult runs 45–60 minutes and starts with goals and history, not a device pitch. Expect medical history (including all GLP-1 medications, pregnancy/breastfeeding status, pacemakers/metal implants, hernias, cryoglobulinemia for cryolipolysis, active malignancy in treated area), a pinch test (how much tissue lifts, how quickly it recoils), and honest documentation of skin quality, striae, and any diastasis.

Treatment. Non-invasive: 25 minutes (SculpSure, Emsculpt Neo, truSculpt iD) to 45–60 minutes (CoolSculpting Elite per cycle). Minimally invasive (BodyTite, Renuvion): 2–3 hours under local tumescent anesthesia, sometimes with oral sedation. Surgical lipo and tummy tucks: 2–5 hours under IV sedation or general anesthesia at an accredited facility.

The recovery timeline below reflects non-invasive cryolipolysis — the most common Houston fat-reduction path. Device-specific variations for HIFEM, RF microneedling, RFAL, and surgical procedures are noted at each phase.

1. Day of treatment

   Cryolipolysis: 45–60 min per cycle, firm vacuum pull then numbing cold, closing with a 2-minute massage that's often the most uncomfortable moment. HIFEM (Emsculpt Neo): 30 min per session, feels like an intense workout. RFAL (BodyTite) and Renuvion: 2–3 hours under tumescent local with oral sedation, compression garment placed at the end.

2. Days 1–3

   Cryolipolysis: temporary numbness, redness, tingling, and mild bruising in the treated area — most patients return to work the next day. HIFEM: 24–48 hours of workout-like soreness. RFAL/Renuvion: visible swelling, mild bruising, compression garment worn continuously.

3. Weeks 1–3

   Cryolipolysis: residual tenderness and itch as adipocytes clear; rarely, persistent numbness can extend longer. RF microneedling (Morpheus8 Body): bronzing and shedding 3–5 days, fully resolved. RFAL/Renuvion: compression garments continue 3–6 weeks; measurable swelling persists.

4. Weeks 4–8

   Cryolipolysis: initial contour change becomes visible as the lymphatic system clears damaged fat cells. HIFEM: measurable muscle-thickness and fat-reduction changes on imaging after the 4-session series. Surgical lipo: most patients socially presentable; garments transition from continuous to daytime only.

5. Weeks 8–12

   Cryolipolysis: final fat reduction fully visible — do not judge outcomes before this point. Second cycle may be scheduled if additional reduction is desired. HIFEM maintenance typically every 3–6 months.

6. Months 3–6

   RFAL and Renuvion final skin contraction completes at 6 months. Surgical liposuction final contour and scar maturation. Avéli cellulite results at 12-month durability milestone. Stable weight is essential — weight regain can diminish or reverse any contouring result.

Houston Pricing

Houston pricing: what to expect

All prices below accessed 2026 on named Houston provider websites. “Consult required” dominates the BodyTite, Renuvion, and Avéli markets — expect quotes to vary 25–50% between similar-tier providers; comparison-shopping by phone is the norm.

Surgical benchmarks (ASPS 2023 surgeon fees, add 50–80% for total): liposuction $4,711; tummy tuck $8,174; brachioplasty $6,192; thigh lift $7,641; body lift $11,397 [28].

Combinations

How body contouring combines with other treatments

Houston combination protocols reflect that fat, muscle, skin, and volume are separate problems:

• CoolSculpting Elite + Emsculpt Neo — fat reduction then muscle building; the most common “body recomposition” bundle in Houston med spas.
• Morpheus8 Body + Emsculpt Neo — skin tightening plus muscle toning for post-weight-loss abdomen, arms, thighs without surgery.
• BodyTite or Renuvion + adjunct RF microneedling — surgeon-performed tightening in zones with significant laxity, Morpheus8 Body for adjacent lesser-laxity areas.
• Avéli + RF microneedling — cellulite subcision on buttocks/posterior thighs plus collagen remodeling for texture.
• Kybella + CoolSculpting submental — for double chin, either alone or sequenced.
• Biostimulators (Sculptra, Radiesse) for “Ozempic” volume loss — often stacked with Morpheus8 Body; see dermal fillers and wellness and HRT.

Texas Law

How to choose a provider in Houston

Credentials first. Texas restructured its medical cosmetic procedure rules in early 2025: the Texas Medical Board repealed 22 TAC §193.17 and redistributed its substance into 22 TAC Chapter 169, Subchapter E (§§169.25–169.28), effective January 9, 2025 [29]. The substantive requirements:

• Non-surgical medical cosmetic procedures (injectables, RF, lasers, HIFEM, IV therapy) are the practice of medicine.
• A physician must delegate to qualified clinicians via signed written protocol.
• Before any treatment, a Good Faith Exam must be performed in person by an MD, DO, PA, or APRN — RNs alone cannot perform the initial evaluation.
• A physician, PA, or APRN must be on-site or immediately available during procedures.
• Facilities must post the delegating physician’s name and Texas Medical License Number in public areas and treatment rooms.
• Minimally invasive procedures with incisions — BodyTite, Renuvion subdermal, Avéli — must be performed by a licensed MD/DO, not delegated.
• Medical practices performing medical acts must be structured as a physician-owned PLLC or PA. A non-physician-owned med spa relying on a remote medical director is a textbook corporate practice of medicine risk in Texas.

Device authenticity. Counterfeit cryolipolysis devices are a documented global problem; Allergan/Zeltiq has pursued trademark and IP actions. Ask your provider to confirm current-generation genuine CoolSculpting Elite and to see the device panel. Discounted “cryolipolysis” at unusually low prices is a red flag for unbranded or counterfeit hardware.

Red flags — walk away:

• Before/after photos without device attribution
• Quoted fat-reduction percentages above published literature (over 25% per cycle for cryolipolysis is suspect)
• Same-day pressure for 4-cycle packages
• No mention of PAH in CoolSculpting informed consent
• RN-performed Morpheus8 with no physician on-site
• BodyTite or Renuvion offered at a non-physician-owned facility
• No delegating physician license posted

Credential verification:

• Texas Medical Board license: tmb.state.tx.us
• Plastic surgery board certification (ABPS): certificationmatters.org
• Registered nurse license: bon.texas.gov

Areas

Areas treated

• Abdomen and flanks — highest-volume area; CoolSculpting, SculpSure, truSculpt iD, Emsculpt Neo, RFAL.
• Inner and outer thighs, banana roll — CoolSculpting, SculpSure, Emsculpt Neo, Morpheus8 Body, Avéli (posterior thighs).
• Upper arms — CoolSculpting, Morpheus8 Body, BodyTite RFAL (strong evidence), brachioplasty for significant laxity.
• Bra fat and back rolls — CoolSculpting, off-label Kybella, Morpheus8 Body.
• Submental (double chin) — Kybella (on-label), CoolSculpting submental, SculpSure submental, Renuvion APR.
• Buttocks — Emsculpt Neo (muscle), Avéli (cellulite), Morpheus8 Body (texture/laxity), biostimulators (volume).
• Knees, axillary fat, jowls — off-label Kybella in selected cases.