Dr. Darm Exilis (Btl abg weiss_vasily+1-11)

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Dr. Darm Aesthetic Medicine:
Exilis Platform Offers Array of Options
for Aesthetic Practices

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Dr. Darm Exilis (Btl abg weiss_vasily+1-11)

  1. 1. Exilis Platform Offers Array of Options for Aesthetic Practices By Bob Kronemyer, Associate Editor Radiofrequency for body contouring, experiencing some sagging of the skin Robert Weiss, M.D. skin laxity and skin tightening has tak- around the jowls, or wrinkles around Associate Professor of Dermatology en a major leap forward with Exilis the eyes. The system has also shown Johns Hopkins University School of from BTL Aesthetics, Inc. (Columbia, S.C.). “very nice results” for the abdomen in Medicine Hunt Valley, MD This radiofrequency (RF) device has the patients with lax skin (e.g., post-lipo- unique ability to safely deliver controlled suction, post-pregnancy),” Dr. Weiss thermal energy to many different targets noted. Thighs have also responded fa- in the skin and body for effective and vorably, “with improvement in saggy David B. Vasily, M.D. safe treatment with minimal patient dis- skin.” A third area with noticeable re- Dermatologist comfort and no downtime. sults is the upper arm and shoulder – Director Aesthetica Cosmetic and Laser Surgery particularly women in their 40s and Center Treatment time is also reduced be- 50s. “These women start to notice that Bethlehem, PA cause the Energy Flow Control (EFC) they don’t like the way their arms look component delivers the maximum ther- in short sleeves because of some sag- mal effect to tissue while allowing the ging skin,” Dr. Weiss said. operator unparalleled visual control and Patricia Wexler, M.D. flexibility due to real-time monitoring of For full-face treatment, most patients Associate Clinical Professor of Dermatology skin temperature. Moreover, the ad- require three to four sessions of about Mount Sinai School of Medicine vanced cooling system allows the der- 15 to 30 minutes each, spaced two to New York, NY mis, deep dermis, subdermis and deep three weeks apart. Following a series tissue to all be targeted. Skin burns are of treatments, patients should “see a no- also prevented by a unique feature ticeable improvement in skin tone, tex- that immediately turns the power off if ture and laxity,” Dr. Weiss conveyed. the handpiece loses contact with skin. The number of sessions for off-the-face When you consider its versatility and areas is basically the same, depending lack of costly consumables, Exilis be- on the patient’s needs. “Again, there is comes an affordable treatment option a noticeable improvement in contour, appealing to a wide-range of patients. skin texture and folds.” “For those practices that have used Dr. Weiss, who is director of the RF, Exilis is different,” said Robert Weiss, Maryland Laser, Skin and Vein Institute M.D., an associate professor of derma- in Hunt Valley, Md., appreciates that tology at Johns Hopkins School of “Exilis is unique in delivering monopo- Medicine (Hunt Valley, Md.). “The treat- lar RF with a grounding pad, so we Submental region before Tx ment tip is constantly moving and the know it is penetrating deeply.” The built- treatment itself is actually pleasant and in temperature sensor also allows for relatively quick. Patient satisfaction is the skin temperature to be maintained also high and you can offer treatments between 40° and 42° C. “This permits to patients that are unable to afford delivery of enough energy to cause skin some of the pricier devices with expen- tightening and contour changes, with- sive consumables. Exilis is an excellent out causing pain,” Dr. Weiss explained. alternative. You have more control. “People feel a heat sensation – similar You’re not confined to a fixed pattern.” to a very warm massage.” No local or topical anesthesia is needed. Patients achieve skin smoothing and Submental region after four Exilis treatments skin tightening, according to Dr. Weiss. Exilis is extremely user-friendly and Photos courtesy of Robert Weiss, M.D. Candidates for facial treatment are has preset parameters according to the typically those in their 40s through 60s area being treated. “Besides suggested2 THE Aesthetic Guide January/February 2011 www.miinews.com
  2. 2. starting energy, the device itself has a and they have more control over the “Within one small database program for entering treatment,” Dr. Weiss advised. “I person- patient information and keeping track ally like using it myself because I am not month after the of their energy levels and dates of limited to a predefined treatment pat- treatment,” Dr. Weiss said. A touch tern. It’s nice to have the same kind of last treatment, the screen also provides instructions on us- control as sculpting a face with dermal age and proposed energy levels for fillers. We have the ability to direct the most significant various treatments. treatment to problem areas, which is a significant advantage of Exilis. The staff improvement typically “Usually by the second treatment, also prefers Exilis because typically it we begin to notice results,” Dr. Weiss does not cause the patient any pain.” occurs. Based on our reported. “Within one month after the last treatment, the most significant im- Moreover, patient feedback is en- knowledge of similar provement typically occurs. Based on couraging. “I would say the rate of pa- our knowledge of similar technologies tient satisfaction is very high,” Dr. Weiss technologies using using RF, we anticipate results will last stated. “Often, patients will see some one to two years.” tightening and some smoothing imme- RF, we anticipate Furthermore, since the only consum- diately after treatment. They are gener- ally very pleased, especially in relation able is an inexpensive single-use, dis- results will last one posable grounding pad, coupled with to the cost and the time involved.” the rapid delivery of energy, treatment One of the first patients Dr. Weiss to two years.” prices “are very reasonable,” Dr. Weiss treated with Exilis was a thin-skinned commented. “This allows for a signifi- female in her early 50s. “I noticed af- cant cost savings compared to other ter treating one half of her face, there tightening devices.” was a real difference. The jowl was lifted,” he recalled. “With a total of Dr. Weiss has used Exilis in combi- three treatments on both sides of her nation with fractional devices to help face, the patient achieved outstanding with scarring or more superficial wrin- results, and it truly complemented the kles, along with a reduction of saggy dermal filler that I had placed in the skin. Typically, these patients will nasolabial folds and in the cheeks. schedule three fractional sessions, one She looked ten years younger.” month apart, followed by three Exilis sessions. Results are evaluated at six Exilis also has “an excellent safety 57 year old patient before Tx months. Likewise, patients who have profile,” Dr. Weiss noted. “We’ve had undergone laser lipolysis with liposuc- no skin burns, which is theoretically tion on the abdomen – but are left possible with an RF device and a with some fat or weight gain – will grounded device. However, since the benefit from two subsequent sessions patient is providing constant feedback of Exilis about three weeks apart for about what they are feeling, this great- even smoother and tighter results, ly reduces the risk of injury to the skin.” without needing to schedule a second session of liposuction. Patricia Wexler, M.D., an associate clinical professor of dermatology at Both the nurse practitioner and physi- Mount Sinai School of Medicine in cian assistant at Dr. Weiss’s practice en- New York City, N.Y., concurs with Dr. 57 year old patient one month after four Exilis treatments joy using Exilis more than other, similar Weiss about his overall impressions of Photos courtesy of David B. Vasily, M.D. devices because “it is a little less tedious Exilis. “Treatment is quick and relatively4 THE Aesthetic Guide January/February 2011 www.miinews.com
  3. 3. painless, with results seen in as early Furthermore, treatment is “extremely “Exilis may be as two sessions and improvements affordable for most patients, given the continuing throughout treatment and results,” Dr. Wexler said. Patients also used in lieu of time,” she said. “Exilis can also be appreciate the small amount of office used on virtually any area with fat or time required for treatment. Similarly, liposuction, after laxity of the skin. You do not need a Exilis “may be used in lieu of liposuc- minimum amount of skin or fat to be tion, after liposuction or even tried liposuction or treated. Exilis not only treats the deep- before liposuction as an alternative est layers, but rejuvenates the skin therapy,” she said. “Overall, my pa- even tried before when treating the upper levels of the tients and staff alike are excited about dermis, for less wrinkles and better the device’s technology and the results.” liposuction as an skin tone.” David B. Vasily, M.D., a dermatolo- alternative therapy. Dr. Wexler has used Exilis for fat gist and director of Aesthetica Cosmetic reduction and skin tightening, as well and Laser Surgery Center in Bethlehem, Overall, my patients as in patients who are not candidates Penn., was hesitant to embrace RF tech- for liposuction because of skin laxity. nology. “I’ve never really been that and staff alike are Post-liposuction patients are also can- excited about RF systems, preferring didates for treatment due to laxity or lasers instead. My experience with RF excited about the irregularity. “Patients with small areas and the feedback I had received from that would be high risk for surgery many of my colleagues who also used device’s technology and patients afraid of surgery can RF was that it had delivered some re- also benefit,” Dr. Wexler said. sults, for some people, some of the and the results.” time. Therefore, RF was not a predict- Before treatment, Dr. Wexler ar- able, consistent type of device.” ranges a patient consultation, takes photographs, measurements and weight, However, Dr. Vasily was attracted to and discusses patient expectations of Exilis because he felt the device ful- the procedure. Patients are also in- filled a missing niche in aesthetics. structed to drink three liters of water “Exilis allows us to achieve some skin the day before treatment, the day of tightening, non-invasive wrinkle reduc- treatment and the day after. Four tion and body contouring,” he said. treatment sessions are scheduled sev- Exilis offers a new approach to RF. “I en to ten days apart, with light physi- liked some of the safety controls – the cal activity in-between. “As early as advanced cooling and temperature Arm before Tx the second treatment, patients can feedback. If you lose contact with the see one inch of improvement, skin skin, the RF energy shuts off, so you do tightening and textural change,” Dr. not risk any burning,” Dr. Vasily point- Wexler related. ed out. The temperature feedback is particularly advantageous “for deeper If the patient perceives pain during applications.” treatment, the power is adjusted, “but the temperature is maintained within Dr. Vasily was also impressed by the therapeutic range at all times,” Dr. the engineering of the device, “allow- Wexler said. “Exilis is very user-friend- ing for flat-top, smooth delivery of the ly because there is one temperature thermal energy, as opposed to spiky range that is desired, and the screen heating and delivery with most other Arm after four Exilis treatments is easy to use. The variables are few RF devices. This delivery method, com- Photos courtesy of Peter Hajduk, M.D. and there are minimal disposables.” bined with the cooling and feedback,5 THE Aesthetic Guide January/February 2011 www.miinews.com
  4. 4. allows for optimized delivery of energy of four to six sessions, but more optimized and enhances safety. As a result, Exilis results often occur one to three months is able to address all compartments of after the treatments are completed.” the skin: superficial to deep.” When the peak temperature of around “I was amazed at At Aesthetica, the primary usage of Exilis to date has been facial applica- 41° C is attained, patients “feel a little transient heat,” Dr. Vasily said. “Some the reduction in some tions. “Results are amazing. In fact, Exilis is probably the most pleasant- people absolutely love the feeling and actually fall asleep during treatment. It very coarse elastotic surprise device I’ve ever had,” Dr. Vasily noted. “I started evaluating the seems to be very well tolerated and no anesthesia is used.” rhytides on the device in older individuals because traditional wisdom established that it Besides being user-friendly, the ergo- nomics and handpiece of Exilis “are face and tightening would be useful in people up to age 70. However, many women over age very nice,” Dr. Vasily pointed out. “The handpiece is not too heavy and the of neck skin.” 70 desire to look as good as they can, but we are really limited in treatment workload on the joints and body is options for this older age group. Results much less than with older endermolo- in this group – including a number of gie type units, for example. Our Exilis ladies in their mid to late 80s – have is on from morning until evening, every been just remarkable. It’s been very, day of the week. It is incredibly popu- very rewarding. Many patients had se- lar.” Dr. Vasily’s staff also enjoys Exilis. vere solar damage, also known as “It is a fairly easy treatment for them to elastotic wrinkling. Patients have been perform and the device is fun to use,” thrilled with the outcomes.” he continued. “More importantly they like the patient feedback. Standard Initially, patients scheduled a treat- feedback from patients is that skin ment session about once every seven looks very pretty, with nice texture and to ten days, for a total of four sessions. tone. Patients then want other body ar- 61 year old patient before Tx As early as one month after starting eas to be treated, and they refer treatment, “I was amazed at the reduc- friends. Exilis markets itself through tion in some very coarse elastotic rhyt- word-of-mouth.” Dr. Vasily has also ides on the face and tightening of neck successfully treated post-partum skin skin,” Dr Vasily said. One woman laxity of the belly with Exilis, as well as close to age 90 began treatment one the abdomen. month before attending her grand- daughter’s wedding. “She looked fab- Since there are no expensive dis- ulous for the wedding.” posables, “you have a lot of latitude 61 year old patient three months after four Exilis treatments in pricing,” Dr. Vasily advised. “This Photos courtesy of David B. Vasily, M.D. “Some people see results after just is very affordable treatment.” The pro- one or two sessions, while others need cedure can also be performed year to wait a few months after completing round. “During the summer, it is typi- a series. For facial wrinkling, results cally much harder to schedule photo- are noticeable after two treatment ses- facials and laser hair removal because sions and certainly within one month patients are tan, so revenues drop off,” after completion. However, tightening Dr. Vasily said. “However, Exilis can of facial laxity typically takes slightly be safely used on tanned patients.” longer. You may see results by the com- pletion of a treatment series consisting6 THE Aesthetic Guide January/February 2011 www.miinews.com

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