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Radiofrequency (RF) skin tightening has been a common, non-invasive procedure for improving sagging, “crepey” skin and wrinkles for the past decade.

Patient experience with older RF technology had been marred by the intense pain associated with the procedure and the often subtle improvement despite the excruciating ordeal. Now, a tweaking of the existing know-how and its combination with ultrasound hope to put a new shine on the old technology. Exilis is a device that delivers monopolar radiofrequency. The older method of RF therapy involves “stamping” the skin to deliver RF energy to the skin one square at a time.

of improving sagging,
"crepey" skin
& wrinkles?

With the Exilis, the handpiece that delivers the energy is constantly moved over the skin allowing the heat to build up gently over 4 to 6 minutes in the treatment area. The constant motion of the handpiece allows the areas of greatest skin laxity to be specifically targeted. This is known as dynamic monopolar RF. Devices that deliver monopolar RF achieve the greatest penetration of energy in the skin as compared to bipolar, tri-polar, multi-polar or unipolar devices.

In addition, the use of ultrasound in the device enhances the accessibility of target sites in the skin and augment new collagen formation.

The treatment tip of the device which is in contact with the skin can be cooled to protect the upper layers of the skin from injury. This allows more heat to penetrate to the deeper reaches of the skin and fat. Alternatively, the cooling can be turned off to optimise the heating of the skin for maximal improvement of skin laxity.

What to Expect

There is very little preparation needed before undergoing Exilis therapy. The treatment area should be free from any active inflammatory skin disease. You will need to drink 6 to 8 glasses of water starting on the day before the therapy to ensure adequate skin hydration to optimise the results of therapy.

There is no need for anaesthesia as the procedure is usually well-tolerated. For facial treatment, the skin is first cleansed with a mild soap-free cleanser. A gel is applied on the skin and then, the treatment tip of the device glides gently over a specified treatment area for 4-6 minutes. As the desired skin temperature is reached, the patient feels a comfortably warm sensation. One of my patients described it as “soothing warmth” in the skin. He fell asleep during the procedure.

For the body, mineral oil is applied on the treatment area.

In the first part of the treatment, the treatment tip is moved constantly over the area for about 6 minutes to target the fat. To complete the contouring therapy, the skin over the fatty area is treated again to tighten it. This aims to produce a reduction in the circumferential measurement of the girth and an improvement in the wrinkly/dimpling appearance of the lax skin.

During the treatment, if the patient reports that an area is becoming too warm, the treatment tip is moved away from the area. Depending on the areas to be treated, the procedure may take between 20 – 40 minutes.

After the treatment, the skin appears mildly pink for about 5 to 10 minutes. The patient will be asked to cleanse the treated area. A sunscreen is applied after treatment of the face before leaving the skin clinic as advised by your dermatologist.

The Effect & Results

On the face, therapy with Exilis can result in tightening of the skin around the eyes and the cheeks and reduces the appearance of sagging skin at the sides of the jaw. The thinned-out, “crepe-like” appearance of the skin on the cheeks may be reduced as skin density and dermal thickening improves.

Another area where beneficial effects are often seen is the sagging skin under the jaw. The neck can be treated quite comfortably to improve the fine lines and laxity as well.

Therapy in these areas can result in a measureable reduction in the fat and an improvement in the contour of the body.

In addition, signs of skin laxity in these areas such as wrinkles and folds of excess skin can be improved by the skin-tightening effect of the procedure.


In several American studies, there were no significant complications reported. No skin burns were documented although this is a potential problem given the fact that heat has to be generated to produce results. About 5% of patients reported soreness lasting less than 24 hours after the procedure.

The Reality Check

Like other non-surgical procedures, the beneficial effects of Exilis therapy appear gradually and incrementally after repeated sessions. The results are neither immediate nor dramatic and cannot be compared to those obtained with plastic surgery.

While Exilis therapy aims to improve body contour, it is not meant solely for weight reduction. People who are over-weight are unlikely to benefit from the treatment alone. A holistic approach to weight management which includes attention to diet and exercise go a long way to optimise results of Exilis therapy.


Exilis therapy is a safe, non-surgical means of skin tightening, wrinkle and fat reduction and enhancement of body contour. Its advent provides patients with a non-invasive option for improvement with a minimum of discomfort and virtually no downtime.

The effect of radiofrequency on the skin is largely due to the heat it generates at the level targeted. It is believed to stimulate the formation of new collagen and elastic tissue resulting in an improvement in the structure of the skin. It may result in the breakdown of fat and fat cells as well. Since it is the water in the skin that is heated, radiofrequency therapy is not constrained by skin colour or skin type, unlike other technologies.