We as plastic surgeons have been searching for the holy grail of totally non-invasive body contouring modalities. Thus far, everything that I have seen has had major drawbacks that I could not whole-heartedly recommend to my patients. All of the roller-suction machines whether or not they added some heat in the form of laser or RF (radio-frequency) all worked minimally if at all and were for cellulite reduction only on a temporary basis. Similarly, the unipolar RF devices like Thermage hurt so badly no one wanted a second treatment. The high frequency ultrasound devices like LipoSonix and Ultrashape likewise hurt, have limited amounts of fat they can remove in one session and are presently still seeking FDA approval.
Two other new systems have come out in the last year or so and we looked at both. The Zerona system uses very low laser light like that from a laser pointer and aims this laser in a spinning fashion to allow the fat cells to open a hole in their cell wall allowing the fat inside to escape. Some dieting is necessary along with 6 treatments over 6 weeks and the results have not been consistent among all patients. I also looked at Zeltiq. The Zeltiq machine freezes the fat over an hour-long session and causes a programmed slow death of the fat cell. Results are seen in about 3 months. Because the applicators have a fixed size, only that amount of fat that can be squeezed into about a stick of butter can be treated. Presently, it can only treat belly, hip and bra strap fat. Also, no skin tightening is seen with Zeltiq.
The Exilis® method utilizes mono polar RF (heat from radio waves) that can be controlled for depth and intensity with different settings of how cold the delivering hand piece gets. Each 5 by 7 inch rectangular area of the body can be treated for fat or skin tightening in about 4 minutes. So a belly, from belly button to hairline would be 2, 5×7 inch areas at 9 minutes for fat reduction and 9 minutes of skin tightening. The Exilis® technique can treat all areas of the body as well as the face and neck. It requires no anesthesia, no preparation and has no downtime. The treatment is actually quite comfortable and feels like a hot stone massage. The results are best seen after 4 treatments, although some effect can be seen after just one.
I still am a firm believer that the best body contouring modalities are ones that fat cells are actually destroyed and removed from the body. This entails some form of liposuction which we do all the time. Whether under local anesthesia in the office with a laser (Liteshape), or under a general anesthetic using a power assisted cannula (PAL), liposuction will still be the gold standard against which all other non-invasive methods will have to be compared. I appreciate that there is a segment of the population that have a fear of an invasive procedure or feel that the short downtime associated with liposuction is undesirable and will, therefore, never opt for an invasive body contour procedure. Exilis® may likewise be for the patient for whom surgery is contraindicated because of health issues or bleeding problems. For all of these patients, we can now offer them a totally non-invasive body contouring procedure done in the Skin Spa by Salzman in about 30 minutes. All areas of the body and face are treatable. Fat of the area can be reduced and the overlying skin can be tightened in one session.
Exilis® body shaping and skin tightening is the newest, non-invasive plastic surgery treatment to finally offer our patients a truly no downtime alternative to improve the look of skin and reshape the contour of the face and body.