Which is More Effective, Exilis or the New Thermage?

Question

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!

Rebecca Fitzgerald, MD · Answer

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.

Gregory Mesna, MD, FACS · Answer

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.

Peterson Pierre, MD · Answer

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!

William LoVerme, MD · Answer

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.

Which is More Effective, Exilis or the New Thermage?

Answers (4)

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