Exilis & Ultherapy New Generation Confusion?

I'm confused about what Exilis is used for. My concern is nasolabial folds, marionette lines, some fat under chin, and lowering eyebrows. Does Exilis address this or is it just for fat reduction? Is it really painless? I also heard Ulthera has a new generation machine that causes less pain - any comments? Are any pre-treatment physicals needed for either of these procedures?

Doctor Answers 4

Ulthera (Ultherapy), in the right hand, is simply the better choice

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Dear Patient,

I have experience with both the original Ulthera and new generation Ulthera with DeepSea -hand piece. The second generation Ulthera is a lot more comfortable and can be performed with no sedation. We deliver more pulses at a lower setting to get the same cumulative energy.

I have performed about 150 Ultheras in the past year and half. Over 90% of my patients are very happy and would recommend the procedure.

Wall street journal compared all the non-surgical modalities to lift up the eyebrows, tighten the neck and face and determined that Ulthera is The Best out there. Here is the link.

I hope this was helpful

A. David Rahimi,MD,FAAd,FAACS.

Los Angeles Dermatologist
4.7 out of 5 stars 50 reviews

Exilis skin tightening

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Dear amom, thank you for your question. Exilis has won numerous awards and is considered one of the best skin tightening devices on the market. It is very popular at our San Diego medical spa. Ideal candidates have mild to moderate skin laxity, and no implantable metal devices in the treatment area or a pacemaker. Consult with an Exilis physician to see if you are a good candidate. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon

Exilis vs Ultherapy

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We have the newest models of both machines so I can tell you our feedback on both.  Ultherapy with the Deep-See handpiece and new software protocol is the only FDA device approved to lift the skin on the face and neck.  It utilizes both deep and superficial ultrasound focused waves to achieve this.  However, it can be uncomfortable since it goes fairly deep.  Exilis Elite is using radiofrequency to tighten the skin similar to Thermage but more affordable and comfortable.  In the long run, Ultherapy results last longer but both technologies can be used together but just not on the same day.  Exilis Elite is very comfortable on the body for skin tightening but Ulthera does not have FDA approval for off face/neck areas yet.


Dr. Liu

Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 52 reviews

Exilis and Ultherapy - Differences

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Exilis has two different functions - tightening skin and fat reduction. Ultherapy is used to "lift" deeper structural tissue and uses focal points of energy instead of bulk heating like Exilis does.

No truly effective tissue heating device is going to be completely painless. Expect some discomfort and recognize that this is a medical treatment and if you want it to work, some level of pain is to be expected...but it can always be managed with appropriate pain medication if necessary.

There are a variety of ways to address your multiple issues and it's very unlikely that a single procedure type will get you the results you want.

What folds, wrinkles and creases actually mean:

Marionette lines and nasolabial folds represent tissue loss (usually a combination of fat and loss of bone that is typical with aging). The same goes for brows dropping and sometimes what works quickly and rather inexpensively is Botox or similar plus some Restylane under the brow to replace lost tissue. 

Even with facelifts, if there is a volume loss, that needs to be addressed to achieve a more youthful appearance.

Fat under the chin would most likely be best addressed with Exilis.


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

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.