How Exilis works

Exilis is BTL's radiofrequency treatment: monopolar radiofrequency heats the tissue under the skin. A handpiece is moved over the area, the energy passes through the skin to a return pad and warms the deeper layers, and the temperature of the skin surface is monitored as it goes. Heat makes existing collagen fibres contract at once, and over the following weeks the skin lays down new collagen, which is the gradual firming people see. On the body the aim is a smaller measurement around the treated area as well as firmer skin. BTL's Ultra 360 model adds ultrasound to the radiofrequency. Every treatment is given by Dr Marie Duggan, GMC 7488383, at Exilis London, 130 Harley Street, London, W1G 7JU, after a free consultation.

What the clearances say

In the United States the Exilis is cleared by the FDA through the 510(k) route, a finding of equivalence to devices already on the market; it is cleared, not approved. The Exilis clearance is for the "non-invasive treatment of wrinkles and rhytids", granted in 2009 without a clinical test, and BTL's monopolar devices of the same design are cleared for periorbital wrinkles. The Exilis XP and XP II are cleared for heating "for selected medical conditions such as temporary relief of pain, muscle spasms, and increase in local circulation". Their massage head is cleared for "a temporary reduction in the appearance of cellulite". BTL's circumference clearances for the abdomen and thighs are for its XP1000 RF and XP1100 RF, a hands-free bipolar device the summaries never call Exilis, so we do not quote them as Exilis results. No FDA wording says skin tightening or fat reduction; "tightening" is the maker's marketing word, and the studies are where it is measured. The clinic is CQC registered, and we make no claim about any other registration.

The session

1. Free consultation. In our practice Dr Marie Duggan examines and measures the area, agrees the areas and the course, goes through your history, and gives you the price in writing.
2. Preparation. In our practice the skin is cleaned and a thin layer of gel or oil is applied so the handpiece glides, and a return pad is placed on your skin.
3. Treatment. The handpiece is moved over the area while the energy builds the heat beneath the skin. You feel warmth that builds, and we adjust the level with you; most patients find it comfortable. About 30 minutes per area.
4. Straight after. The skin is pink and warm, and you go straight back to your day. The pinkness settles over hours and any tenderness within a day.
5. The course. Usually four weekly sessions per area, as the published series ran them, set at the consultation.
6. Results. The skin firms and the measurement falls gradually over the course, and the studies read the result one to three months after the last session.

Which areas

Every area the device is used on, we treat. The abdomen, the thighs and the upper arms have small published series with a combined radiofrequency and ultrasound device, and the face has two small studies, one naming Exilis; there is no sham-controlled Exilis trial. The neck, the décolletage, the flanks, the buttocks, the knees and the hands have no Exilis study and no FDA area wording, so no result figure, and the doctor advises at the consultation what to expect. The intimate area has one small series of 17 women, on the labia. The abdomen page, the thighs page, the arms page and the face page explain each, and every other area has its own page, from the forehead to the intimate area.

Who it suits

In our practice, an adult with mild to moderate loose skin, or a stubborn area of the abdomen, thighs or arms close to the shape they want, who prefers a course of comfortable half-hour sessions with no downtime. Not with a pacemaker or other internal electronic device, metal implants in the area, pregnancy or breastfeeding, or an active skin infection, and the longer list on a US consent form is screened at the consultation. The full guide covers the rest.