Every treatment article on this site ends with a block headed who this is not for. We put it there because candidacy is the question that determines whether a treatment will disappoint you, and it is the question a commercial consultation is structurally least able to ask.
This article gathers the whole picture in one place.
The general mismatches, which cause most disappointment
These are not medical contraindications. Nobody will be harmed. They are the situations in which a person pays for something addressed to a different problem, and they account for far more unhappiness in this sector than any clinical complication does.
Your weight is currently changing
A localised treatment applied while total mass is moving cannot be assessed, because any change in the treated area is the combined result of both. Beyond assessment, an area treated during a period of change is going to change again anyway. This applies to anyone losing weight through any route, including medication, and to anyone gaining.
Your concern is total mass rather than a deposit
We set the distinction out in weight loss and fat distribution. Nothing in this category addresses total mass. Where somebody's underlying question is about how much of them there is, a device course spends significant money and leaves that question untouched, and the person very often concludes that they failed rather than that the product was mismatched.
Your abdomen is firm rather than soft
Applicator-based treatments act on tissue drawn into the applicator, which means pinchable subcutaneous fat. A firm protruding abdomen generally reflects visceral fat and abdominal contents, which sit on the far side of the muscle wall and are not reachable by anything external.
Your concern is loose skin
If you can lift skin away from the tissue beneath, that is a surplus. Devices act on tissue quality and do not remove tissue. Reducing the volume underneath frequently makes the laxity more apparent, which is a recognised cause of dissatisfaction after treatment that worked exactly as intended. See skin laxity.
You cannot or do not want to attend indefinitely
Most effects in this category are maintained rather than banked. That is a property of the mechanisms and it is not a criticism. It does mean that the relevant cost is annual and continuing, which we cover in what happens when you stop.
The medical contraindications, by mechanism
These vary by treatment and each treatment page carries its own list. In summary:
Implanted electronic devices, including pacemakers and implantable defibrillators, are an absolute exclusion for muscle stimulation and radiofrequency, and require specific clearance elsewhere.
Metal implants, plates and coils at or near a treatment site require assessment for any energy-based treatment.
Cold-related conditions including cryoglobulinaemia, cold agglutinin disease and paroxysmal cold haemoglobinuria exclude cryolipolysis.
Hernias at the treatment site exclude most mechanical and energy-based treatments.
Liver disease and disorders of lipid handling are relevant wherever the proposed mechanism mobilises stored fat.
Pregnancy and breastfeeding are a default exclusion across the category, on the basis that the sensible position is to wait rather than to establish safety in the chair.
Active infection, open wounds and significant scarring at the site exclude treatment there.
Bleeding disorders and anticoagulant treatment are relevant for anything involving injection.
The important point is not the list, it is whether anybody asked you. If you were not asked about implants, pregnancy, medicines and relevant conditions before treatment, you were not assessed.
“This treatment is suitable for everyone, with no downtime and no contraindications.”
What would have to be true
- That an intervention with a biological effect has no circumstances in which it should not be used.
- That no assessment is required before treating an individual.
What is actually established
- Every mechanism in this category has recognised contraindications, and several of them are serious rather than formal.
- Advertising rules address the trivialisation of procedures that carry clinical risk.
- A treatment with no contraindications at all would be a treatment with no biological effect.
A claim of universal suitability is self-defeating: anything capable of changing tissue is capable of being inappropriate for somebody. Where this claim appears, it usually indicates a business whose screening consists of taking a payment.
The question nobody asks
There is one more category of poor candidate and it deserves to be handled carefully.
Some people arrive at these clinics because of how they feel rather than because of a dimension. A device does not reliably change that, and the pattern of buying a course, feeling briefly better, and then finding the feeling unchanged is well recognised by anybody who has worked in this sector.
We are not going to tell anyone that their reasons for wanting a treatment are wrong. What we will say is that a clinic which asks what you are hoping will be different afterwards, and listens to the answer, is doing something valuable, and that a clinic which never asks has told you what the appointment is for. Where an appearance concern is causing significant distress, that is worth raising with a general practitioner, and it is a more useful conversation than any consultation about equipment.
The consolidated list: who this category does not suit
- Anyone whose weight is currently moving in either direction. A localised treatment applied to a changing body cannot be assessed and cannot be relied on.
- Anyone whose concern is total mass. That is a health question with health routes, and no device in this category addresses it.
- Anyone whose abdomen is firm rather than pinchable. If there is nothing to draw into an applicator, applicator-based treatment has nothing to act on.
- Anyone with a genuine surplus of skin. Devices act on tissue quality, not on quantity, and reducing volume underneath can make laxity more visible.
- Anyone who cannot return indefinitely. Most effects in this category are maintained rather than banked.
- Anyone who has not been asked about implanted electronic devices, metal implants, pregnancy, hernias, liver conditions or medicines before being treated.
- Anyone who has been given a discount to decide today.
- Anyone whose real question is about how they feel rather than about a dimension. That deserves a better answer than a course of treatment.
None of this is about who deserves a treatment. It is about whether the treatment is addressed to the question being asked, which is a different and much more answerable question.
Being told no is a good outcome
The single most valuable thing a clinic can do is decline to treat you. It costs them the sale and it saves you the money and the disappointment.
Very few do it. In a sector with no general licensing requirement and no obligation to publish outcomes, the commercial incentive runs entirely the other way, which is why the assessment has to be partly yours.
If you are told you are not a good candidate, the useful response is to treat that as information rather than as a setback, and to be sceptical of the next provider who tells you the opposite without examining you. Shopping until somebody agrees is how people end up treated by the least careful provider available.
What to do with this
Read the candidacy block on the treatment page for whatever you are considering. Work out which of the general mismatches apply to you, if any. Check the medical list against your own circumstances and medicines. Then take the questions to ask to the consultation and use them.
If you conclude that you are not a good candidate, that conclusion has just saved you a considerable sum, and it is the most useful thing this publication can do for anybody.