Which is More Effective, Exilis or the New Thermage?

I have read a lot of doctor's opinions here on Ulthera being better than Thermage, but what about Exilis vs Thermage for tightening of the face (not discussing fat reduction). They both use RF, but I read that Exilis goes deeper. I am not discussing pain or cost, or that Exilis requires more treatments, just the bottom line results. Thanks!

Doctor Answers 4

Which is more effective for skin tightening on the face, Exilis or Thermage

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Hi 4ever Young,

I want to respond to your question asked a few weeks ago about the difference in these treatments. Ulthera, which you mentioned, is ultrasound technology, and is an effective technology for many things, including skin tightening and fat reduction. The reason our practice has not selected Ulthera or Liposonix is primarily patient comfort. We haven't selected Thermage technology becasue it's been of mixed reviews from peers and patients for years. As we began to look at current technology for non-surgical body contouring, we were overwhelmingly pleased with CoolSculpting and began to look for a complementing treatment to further improve skin laxity without surgery. Fortunately, we had an option to use Exilis for a few months so as to see results after the recommended treatment series. We ultimately chose Exilis after seeing many terrific consistent responses when treating for skin tightening. We find the diverse and versatile Exilis system a gem in the office with endless uses. My recommendation to yo u is to visite practices near you who offer this treatment. It sounds as though you're doing all the right things a patient should do prior to selecting a treatment and the next steps are to have consultations to confirm that the treatments you're pursuing are ideal for you. Thank you again for asking your honest question. I wish you the very best of luck.

Exilis potential over Thermage for tightening

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Probably the biggest advantage of Exilis over Thermage for tightening is the ability of the system to measure temperature increases in the skin from a technical perspective instead of patient feedback. The technician can see on the device screen the heat levels reached and be sure effective levels are achieved during the treatment process.

Any heat-based procedure that is designed to tighten the skin must create enough heat to spur collagen changes (referred to as remodeling).

Exilis has a built in temperature measurement system which Thermage has not had. This makes the process of achieving the clinically significant heat levels objective instead of subjective. 

The Exilis Elite system has another fail-safe in that it automatically adjusts energy levels as it senses tissue density and depth changes, so more energy would automatically be employed in the cheek area where there is more tissue, and less around any bony structure so as to prevent any over heating.


Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Exilis vs Thermage

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Exilis Ultra is an outstanding treatment for skin tightening that combines two of the best technologies available for this purpose: radiofrequency (as found in Thermage) and ultrasound (as featured in Ultherapy). That means you get the best of both worlds!

Those two forms of energy heat up the collagen in the skin causing it to contract leading to skin tightening in the treated area. They also stimulate collagen production which will lead to further tightening visible within 4-6 months so you get an immediate and long-term benefit. The most common areas I treat are the eyelids, lower face (for the jowls), neck, and abdomen but any body part can be treated, including private areas.

Thermage was the very first radiofrequency treatment offered for skin tightening over ten years ago so there is a long history and quite a bit of experience with the device. Results have been a mixed bag and inconsistent with pain being one of the most frequent patient complaints. I have spoken to many colleagues, friends and patients over the years and have received mixed reviews. Although results can never be guaranteed with any treatment, it is very important to me to have a high level of confidence that a treatment will deliver the goods before I offer it to my patients. However, that was the case with Exilis Ultra. Feedback and results have been excellent and consistent and it is one of the most popular cosmetic treatments that we offer.

Another big advantage of Exilis Ultra over Thermage for tightening is the ability to measure temperature increases in the skin objectively instead of through patient feedback. This built in feature is very important because it allows us to achieve the optimal levels of heat to maximize effectiveness and minimize side effects. There is another fail-safe that automatically adjusts energy levels based on the area being treated to prevent over heating.

The treatment feels like a hot stone massage and is usually performed every other week for a total of four treatments. There is zero downtime and you can return to your regular activities immediately. There are no short term side effects other than the sensation of heat and there are no long term side effects other than tightening of the skin! No aftercare is necessary though I do recommend a combination of skin care products to further boost and support collagen production. There results aren't permanent; we are simply turning back the clock but the clock will keep ticking. After your series of four, I recommend maintenance treatments once or twice a year depending on your age, genetics, starting point, and lifestyle considerations.

With all the amazing treatment options at our disposal, there has never been a better time in history to grow old gracefully!

Peterson Pierre, MD
Thousand Oaks Dermatologist
4.3 out of 5 stars 6 reviews

Exilis, Ulthera and Thermage

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I find that Exilis works very well. I have been doing radiofrequency for over ten years starting with the first Thermage machine and progressing with a newer Thermage machine. I now have the Exilis machine. The radiofrequency  is the same monopolar type as Thermage which is important in differentiating each of them from other types of radiofrequency machines on the market. However, we have finally found a way to deliver the power in a safe, affordable, comfortable and effective manner. Although it takes more treatments than the Thermage, each Exilis treatment is far more comfortable (different than Ulthera which is high frequency ultrasound, not radiofrequency) and no pretreatment medication is required. For tightening the facial skin we use Exilis at a depth no deeper than Thermage. It is for fat reduction and cellulite treatment that Exilis goes deeper and is able to target fat cells. Exilis results tend to be more consistently good in my hands than what the Thermage results were. There are still a few patients who get less results than others but the more experience the office has with the machinery, the bmore consistent our results tend to be.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.