BackgroundA growing demand for aesthetic treatments for localized abdominal unwanted fat has developed as a healthy lifestyle is not always able to improve abdomen appearance.AimsThe purpose of this retrospective nonrandomized observational study was to evaluate the efficacy and safety of a new device delivering microwaves energy for unwanted fat reduction, using three‐dimensional (3D) imaging analysis.MethodsTwenty patients (both female and male) were treated in the abdominal area. Subjects received 4 treatments with the study device. Follow‐up evaluations were conducted to estimate safety and efficacy. A Numerical Rating Scale (NRS) was used for pain assessment. Patient's 3D imaging analysis was performed at baseline and at 3 months follow‐up. Finally, a satisfaction questionnaire was filled in by all the patients.ResultsAll subjects completed the whole cycle of treatments and presented for the follow‐up visits. Analysis of 3D imaging yielded a significantly reduction in circumference (cm) and volume (cm3), passing, respectively, from 85.2 ± 8.1 cm and 1950.6 ± 471.0 cm3 at baseline to 80.8 ± 8.2 cm and 1728.9 ± 490.9 cm3 (p < 0.001) at 3‐months follow‐up after the last treatment. According to the NRS results, the treatment was well tolerated. From the analysis of the satisfaction questionnaire the 90% of patients are interested in carrying out the same treatment in other body areas.ConclusionWith the use of three‐dimensional imaging techniques, the efficacy of a new system delivering microwaves energy for the reduction of abdominal volume correlated to a subdermal fat reduction while preserving/improving skin tightening, was quantitatively and objectively demonstrated.