The verdict is in, the people want more cosmetic procedures and less surgical procedures, As Americans (and Europeans and Latin Americans and eventually Asians) age, they will seek more ways to turn back the hands of time without necessarily going "under the knife". We have seen an incredible rise in injectables (Botulism toxin and a myriad of fillers) over the last three years while seeing a decline in invasive forms of resculpting the body and rejuvenating the face and skin.
A recent entry into the field is a Radio frequency generator that will not only tighten skin (like its predecessor Thermage) but can shrink the underwanted fat under the skin. This device is called Exilis and I had the opportunity to try nit out on several of my patients and had it tried out on myself. Although this device takes 4 treatments over 4 to 6 weeks and a period of up to three months for the collagen recruitment and final results, I was impressed by the comfort and expedient nature of the treatments.
A principal difference between Exilis and Thermage is that the energy in Exilis was being delivered in a moving fashion allowing greater energy deliverance over a shorter period of time in a more comfortable treatment session. The energy delivered by this way can also affect the deeper fatty layers in a way Thermage could not.
Here is how it works. Radiofrequency passes through skin virtually un-impeded and has to get into the fat layer to actually start heating up the tissues. When the heat builds up in the fat it 'bounces back' and heats up and affects the deep dermis. This alters the skin collagen and is responsible for the tightening of the skin. Now, if you cool the skin using the cooling head, the Radio frequency energy can reach the 2-3 centimeter depth before reaching the appropriate temperature required to affect the fat cells in the desired manner. While the fat cells are not killed by the Exilis device, the fat cell's contents leak out and are evacuated by the body. The energy also appears to tighten the tissues around the now emptied shrunken fat cells thus giving the long term reduction of the fatty areas. I am very excited about the possibility of being able to offer a non-invasive solution to tough areas such as laxity of arms, knees, and even those tough back rolls. Post liposuction 'touch ups' will no longer require taking the patients back to the oprating room.