The Future of Body Contouring: Insights from David Goldberg, MD, JD

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At the South Beach Symposium 2025, David Goldberg, MD, JD, provided a comprehensive overview of body contouring technologies, emphasizing the evolving landscape of aesthetic medicine and the role of various devices in clinical practice. His discussion centered on selecting the appropriate technology, market trends, and the impact of non-invasive procedures.

Technology Selection and Market Considerations

Goldberg began by addressing the selection of devices for body contouring, emphasizing the importance of understanding market trends. He highlighted the significance of GLP-1 agonists in weight management and how body contouring technologies will complement these pharmaceutical advancements. He advised that February is not the optimal time for purchasing new devices, stating, "This is not necessarily the best time to negotiate for any of these machines," as pricing structures fluctuate throughout the year. “If you’re thinking about purchasing a new device, understanding the price cycles in the industry is crucial.”

Liposuction and Non-Invasive Alternatives

He discussed the long-standing use of traditional liposuction and its evolution into laser-assisted and radiofrequency liposuction techniques. While these modalities provide effective fat removal, they are more invasive compared to newer non-invasive alternatives such as cryolipolysis (CoolSculpting) and ultrasound-based technologies. Goldberg noted cryolipolysis remains prevalent despite its limitations compared to surgical liposuction.

Ultrasound-based body contouring has gained traction due to ease of use and cost-effectiveness. Goldberg emphasized that focused ultrasound technology allows for efficient fat reduction without requiring multiple transducers, thus improving the accessibility and efficiency of treatments.

Radiofrequency and Ultrasound for Skin Tightening

Radiofrequency technologies have become widely adopted for non-invasive skin tightening. Goldberg noted that these devices are significantly less expensive to manufacture than laser-based counterparts. Additionally, ultrasound-based skin tightening methods, such as Ultherapy, have demonstrated efficacy in improving skin laxity. Studies show that these devices stimulate collagen production, resulting in firmer skin over time.

Injectables in Body Contouring

Goldberg discussed the increasing role of injectables, including poly-L-lactic acid (Sculptra), in body contouring. This biostimulatory filler enhances collagen production and has shown effectiveness in treating skin laxity. He also referenced studies on novel injectables that are expected to emerge in the near future.

Electromagnetic Stimulation for Muscle Toning

The integration of high-intensity focused electromagnetic (HIFEM) stimulation in body contouring has gained popularity. Devices such as Emsculpt target muscle hypertrophy and fat reduction simultaneously. Goldberg explained that these technologies induce supramaximal muscle contractions, leading to enhanced muscle tone and fat metabolism.

MRI studies support the efficacy of HIFEM devices in increasing muscle thickness and reducing adipose tissue.

Combination Treatments and Future Directions

Goldberg emphasized the trend toward combination therapies, wherein technologies such as radiofrequency and electromagnetic stimulation are used concurrently. By synchronizing these modalities, clinicians can achieve improved patient outcomes, targeting both fat reduction and muscle enhancement simultaneously.

He concluded by reiterating that body contouring remains a growing industry, driven by technological advancements and evolving consumer demand. With the increasing adoption of non-invasive and combination treatments, aesthetic practitioners must stay informed about the latest developments to optimize patient outcomes.

Conclusion

The talk underscored the importance of selecting the right body contouring technology based on clinical efficacy, cost considerations, and market trends. “We have a lot of young doctors joining the practice, and we want them to learn things that are safe and easy to use,” he said. Goldberg's insights reaffirmed the growing role of non-invasive treatments in aesthetic medicine and highlighted the continued expansion of innovative techniques in the field.

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