Dr. Darm Exilis (Rothaus zdinak090810)


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Dr. Darm Aesthetic Medicine
Exilis Therapy

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Dr. Darm Exilis (Rothaus zdinak090810)

  1. 1. Exilis from BTL Offers Unique RF Platform for Both Face and Body By Bob Kronemyer, Associate Editor Aesthetic practices seeking the next significant advancement in radiofre- Kenneth Rothaus, M.D. quency (RF) technology for body shap- Assistant Clinical Professor of Surgery ing and skin tightening need look no New York Presbyterian Hospital Weill-Cornell Medical Center further than Exilis from BTL Aesthetics, New York, NY Inc. (Columbia, S.C.). Exilis’s evolution- ary Energy Flow Control (EFC) system aims at redefining RF by delivering the maximum thermal effect to tissue in the shortest period of time, while ensuring “Exilis allows us to easily unsurpassed safety, comfort and en- ergy control. treat the patient. It is also relatively painless, Exilis, which received FDA clearance for treating wrinkles in 2009, also fea- thus no local anesthesia tures one of the most sophisticated RF handpieces on the market. Real-time is required, and there monitoring of skin temperature allows is no downtime.” the operator complete visual control. Additionally, power and cooling are easily monitored and adjusted directly Dr. Rothaus, who is also an assis- on the touchscreen of the applicator. tant clinical professor of surgery at Face and submental region before Tx Focused around eliminating risk and New York Presbyterian Hospital - Weill discomfort, the applicator possesses Cornell Medical Center (New York, two major visible safety meters that re- N.Y.), believes Exilis represents an im- spectively indicate good ground elec- provement over existing RF medical trode contact and the quality of the products. “This is a monopolar device applicator tip to skin contact. as opposed to bi-polar, which I think is noteworthy if you are going to achieve In addition, Exilis uses the same ap- more extensive bulk heating of the sub- plicator for both body contouring and cutaneous tissues,” he said. “Overall, I skin laxity. This is accomplished by first believe monopolar is better for aesthet- deep heating with concomitant cool- ics than bi-polar, unless you are treating ing for body shaping, then decreasing a really superficial area. Since bi-polar the cooling to heat the skin more su- RF contains both a transmitter and re- perficially for laxity. The economics of ceiver in the same handpiece, you can- the device are also appealing, as there not penetrate very deep nor treat larger are no consumables. areas.” Data indicates that bi-polar is limited to a depth of 8 or 9 mm, com- “I’m excited that Exilis allows us to eas- pared to over 2.5 cm for monopolar, ily treat the patient. It is also relatively which is more than twice as deep. painless, thus no local anesthesia is re- quired, and there is no downtime,” said Furthermore, the Exilis system avoids Face and submental region after four Exilis treatments Kenneth Rothaus, M.D., a plastic sur- “problems with peak power levels and Photos courtesy of Peter Hajduk, M.D. geon in private practice in Manhattan, the resultant pain and potential com- N.Y. “Perhaps most importantly, results plications that have troubled us with appear to be impressive.” other devices,” Dr. Rothaus pointed2 THE Aesthetic Guide September/October 2010 www.miinews.com
  2. 2. out. “If you have a traditional unipolar telling patients that it will be three to six or bi-polar system and lose proper con- months before optimal results, but at one tact with the skin while the machine is month, with four treatments, the nurse still emitting power the energy can jump achieved an incredible result,” he said. off from the handpiece to the skin. This “Her submental region has gone from creates a condition similar to an arc, being convexed to being concaved, which is painful for the patient and can and her mandible, which was sort of ob- cause a blister or a burn.” Conversely, scured, is now well defined.” Exilis immediately senses when the handpiece leaves the skin, and turns the Abdomen, obliques, thighs and up- power down. By providing this constant per arms are four popular off-face in- Abdomen before Tx monitoring, Exilis virtually eliminates dications that Dr. Rothaus has treated problems with arcing, pain, blistering with Exilis. “A 5” x 7” area usually and potential burns. “Basically, the pa- takes about four to five minutes to tients and my staff are much more re- treat,” he said. laxed now,” Dr. Rothaus said. Dr. Rothaus chose Exilis for his prac- Lisa Zdinak, M.D. Cosmetic Laser Surgeon tice because patients found treatments New York City, NY comfortable. “Other RF devices we tried were painful,” he related. “I also appreciate the continuous readout of Abdomen after four Exilis treatments temperature on the body handpiece.” Photos courtesy of Lisa Zdinak, M.D. For facial and neck tightening, pa- “It is not a procedure tients schedule a treatment once every that the physician has to seven to ten days, for a total of three to four sessions. “The whole neck takes perform. It is very easy between 10 and 20 minutes, whereas the face ranges from 15 to 30 min- to use and it is very easy utes. The average patient is here for to learn how to use.” about a half hour,” Dr. Rothaus said. “My patients describe the comfort lev- el as a hot stone massage. Many peo- Lisa Zdinak, M.D., a cosmetic laser ple find treatment soothing. However, surgeon in private practice in New York Arm before Tx there are occasions when the temper- City, N.Y., likes that she can completely ature becomes too hot or warm for a delegate Exilis treatment to her staff. “It particular patient, so we reduce the is not a procedure that the physician energy level accordingly. However, has to perform,” she said. “It is very not a single patient has requested an- easy to use and it is very easy to learn esthesia and no patient has failed to how to use.” Dr. Rothaus reinforced that return for additional sessions. In fact, the procedure can easily be performed patients come back enthusiastic and by a nurse. “Furthermore, a good nurse ask for other areas to be treated and or a skilled laser practitioner can learn they are recommending friends.” this in a very short time,” he said. Arm after four Exilis treatments Photos courtesy of Peter Hajduk, M.D. Dr. Rothaus first treated one of his nurs- With a digital thermometer in the es with Exilis, beginning in June. “We’re handpiece, Exilis provides continuous4 THE Aesthetic Guide September/October 2010 www.miinews.com
  3. 3. feedback as to the temperature of the the noticeable results in as little as two skin’s surface at all times, thus increas- weeks with Exilis.” ing safety. “Exilis is also one of the few RF devices where if you lose full contact Although Dr. Zdinak has been very with the skin, the machine will shut off, pleased with the results, “it really “With Exilis we are so there is no risk of any uneven contact doesn’t matter what I say, it’s what the with the skin,” Dr. Zdinak reiterated. patients say. The first person I treated not constricted by the with Exilis was a woman who conveyed structure of the device Treatment is quick, too. “Patients love to me that she knew she wasn’t going to the fact that it takes only 10 to 15 min- lose any weight soon, even though her so we can treat virtually utes to treat an area, without having to sister was getting married in London. experience the discomfort of some oth- The woman said she would be happy if anywhere on the body.” er competing technologies,” Dr. Zdinak she could just get the sleeves of her tops stated. Furthermore, Exilis is exception- to fit slightly better. Two days after hav- ally versatile in treating different areas ing her arms treated, the woman called of the body, in part because of the size back and asked if her stomach and of the handpiece. “It was very well con- thighs could be treated as well. Almost figured to be ergonomically adaptable everyone who starts treatment in one to the contours of the body, compared area with Exilis invariably wants to add to other technologies that primarily on other areas.” have flat surfaces,” she said. “This al- lows you to maintain a rigid control of Men as well as women like treat- the delivery of RF energy.” ment, according to Dr. Zdinak. The favorite sites to treat in males are the Heating of the deeper tissues is ac- obliques or “love handles.” Women complished by leaving the cooling on. typically have their arms, legs and “You can then turn off the cooling to abdomen treated. “Many upper arms treat laxity,” Dr. Zdinak explained. have excessive fat and skin laxity,” said “With RF alone, you can achieve both Dr. Zdinak. “I believe Exilis is the best body contouring and skin tightening, device on the market for treating these Before Tx which is something that is unique to two indications since it addresses both Exilis. Normally, you would need to issues during the same treatment. The use two different systems.” same holds true for other body areas, such as knees, abdomen and bra fat.” Patients schedule four sessions, two weeks apart. “However, I’m see- A few of Dr. Zdinak’s patients had ing noticeable results after one ses- previously undergone cryolipolysis sion versus other technologies where (freezing fat). “That technology is limit- you have to wait,” said Dr. Zdinak, ing in that you cannot treat all areas of who has been using Exilis over the the body because you need to be able past nine months. Major changes in to fit the handpiece into the treatment body contouring and skin tightening area. However, with Exilis we are not occur after the first and second treat- constricted by the structure of the de- ment session “and are maintainable, vice so we can treat virtually anywhere After four treatments whereas with other technologies you on the body,” she noted. “With cryo- Photos courtesy of Peter Hajduk, M.D. have to wait anywhere from six weeks lipolysis, this particular woman could to three months before you see notice- only be treated at the belly button and able results. Patients really appreciate below. She could not be treated from6 THE Aesthetic Guide September/October 2010 www.miinews.com
  4. 4. the belly button up to her rib cage. With Exilis, no pain medication is When she came to me, the patient still needed. There is no discomfort with had some fatty tissue in this upper re- the gradual warming. You feel a deep gion that she wanted improved.” After heating sensation toward the very end, three sessions of Exilis, the patient lost but by the time you feel that sensation, about 1.5” to 2” off her upper abdo- treatment is over.” men, “and she was still waiting for her results from cryolipolysis.” As long as patients maintain their current lifestyle (activity and diet), “results should be permanent because we’ve seen the changes – compres- “Exilis is a good device sion of the fatty layer – in imaging because there is no studies,” Dr. Zdinak reported. disposable stream. It also Dr. Rothaus acknowledged that in the current challenging economic en- requires little in the way of vironment, “no practitioner necessar- maintenance. Furthermore, ily wants to invest in a new device. However, Exilis is a good device be- the cost and the downtime cause there is no disposable stream. It also requires little in the way of main- to the patient is minimal.” tenance.” Furthermore, “the cost and Before Tx the downtime to the patient is minimal, relative to other procedures; there- Exilis also enables Dr. Rothaus to fore, it is a type of procedure patients treat certain areas that might not be are willing to undertake. Additionally, amenable to laser-assisted lypolysis, it is an easy enough procedure with such as skin over the sternum between a reasonable cost to the patient, so a the breasts. “It can also potentially follow-up treatment every year to two, tighten areas on the face following a it is very doable.” surgical face-lift, for example,” he said. “If I tried to tighten the patient’s face Dr. Zdinak further noted, “In these with surgery, I would end up with an economic trying times Exilis is such a unnatural look. Exilis is another tool to great investment because you don’t achieve a natural look in facial tight- have a huge capital outlay. Most aes- ening and treatment of areas I simply thetic systems can cost tens of thou- cannot treat with other devices.” sands of dollars, plus the add-on of After four treatments disposables which can run thousands Photos courtesy of Peter Hajduk, M.D. Compared to competing body shap- of dollars a month.” ing and skin tightening devices, Exilis “is quicker,” Dr. Zdinak said. A 20 min- Dr. Zdinak predicts Exilis will be very ute session with Exilis is equivalent to a well accepted by all physicians who session lasting 40 minutes to 2 hours are looking to incorporate a valuable with other technologies. “Treatment is technology to address the expanding also less painful with Exilis. Some other body shaping and skin tightening op- technologies are working at the sacri- portunity of their practice. fice of patient comfort, so patients need to take pain medication beforehand.8 THE Aesthetic Guide September/October 2010 www.miinews.com