When it comes to skin tightening in Singapore, the spotlight falls on two contenders – Thermage and BTL Exilis Elite. There has been much debate on which among the two is most efficient in terms of function and results. So, if you want to get the most out of your money when going in for a skin tightening treatment, let’s dissect the matter further to see which one is worth investing in.
When we age, most of the collagen in our skin breaks down faster than our bodies can rebuild it. Thermage targets the collagen found in the skin with Capacitive Radiofrequency technology which stimulates the growth of new collagen, skin tightening, and improvement of the skin’s contour.
What is it?
Thermage is a non-invasive non-ablative device that uses monopolar radiofrequency energy to heat the underlying skin in bulk while protecting the epidermis (the outermost layer of the skin) to produce skin tightening. It became a popular treatment for skin laxity by promoting skin rejuvenation.
The device has been around for years now, but it is now improved with the newest version out in the market called Thermage CPT (Comfort Pulse Technology). It is said to provide improved results with less pain.
The new Thermage CPT has shown results that are consistently better than those produced by the older machines. The handpieces and tip sizes have changed, and vibration mechanisms have been added. This provides better patient comfort while delivering more energy with each pulse.
How does it work?
The goal for this treatment is to induce thermal damage to stimulate collagen conformation and promote neocollagenesis in the deep layers of the skin and subcutaneous tissue. It utilizes radiofrequency, which is heat. So, through a process of deep heating and simultaneous cooling of the skin, you will actually produce new collagen over several months after the treatment.
According to studies, Thermage can create a mild tightening of periorbital mid and lower facial laxity. It can also treat sagging skin, loose jowls, a lack of definition at the jaw line, turkey neck, wrinkles and fine lines. It can also be used on the eyelids, the backs of the hands, the neck and the chest.
Topical anaesthesia is usually used as Thermage is a painful procedure. Some doctors may even prescribe stronger painkillers to make the procedure more tolerable. During the procedure, a handpiece is applied on the skin’s surface. This delivers varying degrees of heat with the top layer of the skin being cooled while heat is delivered to the deeper layers. The pulses are delivered in a grid-like pattern until the entire area is treated. The treatment can take about 20 minutes to 2 hours, depending on the treated areas. Fortunately, there is no downtime with Thermage and you can resume your usual activities immediately after treatment.
Thermage does not improve deep lines and wrinkles. It is not the best treatment on very thin and sun-damaged skin, wrinkles and sagging on the neck (unless it is mild), and severe sagging under the chin. This is not a facelift and it is not for anyone who has a true jowl.
Like any medical procedure, Thermage has a few risks involved. Some of the complications include, temporary skin damage, mild redness or swelling. Patients may also experience mild pain beneath the jaw.
The results provided by Thermage vary for each patient. Some have subtle but noticeable results, while others report minimal to no results. It takes about six months before the full outcome becomes evident. Having realistic expectations is important when you choose to go for Thermage. It does not give you a facelift, but it can give you the extra glow due to the extra collagen, with subtle texture improvement and a minimal lifting effect.
BTL Exilis Elite
Another skin tightening option that is climbing up the ranks is BTL Exilis EliteTM, one of the two available Exilis models.
What is it?
The Exilis Elite is a treatment for collagen stimulation and skin tightening. It is also an FDA-approved, non-invasive treatment for wrinkles and rhytids. It uses radiofrequency energy to tighten skin in any area of the body or face. Compared to Thermage, the Exilis Elite uses ultrasound which allows the energy to go deeper. It works on three layers and serves a dual purpose because it can kill both fat cells and tighten the skin.
During the consultation, we will advise you on the number or frequency of treatments that is recommended for your case. This may vary according to the amount of loose skin and fat that you want to improve. The Exilis Elite combines radiofrequency energy with cooling so that all areas of the body can be treated even up to the deeper layers.
You will need 4-6 treatments spaced 1-2 weeks apart to achieve optimal results. Cognizant of the difference in anatomy as the skin varies in thickness in different areas of the body, the treatment is also customizable depending on the needs and wants of the patient. This is why both the energy and cooling strength should be adjusted accordingly to achieve optimal results. To illustrate the necessary adjustment, the Exilis Elite treatment for the thighs requires a stronger radiofrequency in order to reach the fat deposits, while the face needs stronger cooling and weaker radiofrequencies.
Exilis Elite stimulates collagen production in the skin. The radiofrequency energy activates the fibroblasts to produce more of these proteins. This builds up the skin’s fiber network which leads to the tightening of the skin after the required treatment sessions.
Fat reduction is possible by delivering radiofrequency deeper into the tissues. This energy destroys the fat cells by melting them away. Once the fat is broken down, it is then eliminated naturally by the body.
Compared to Thermage, which is a one-time treatment, Exilis Elite will need 4 sessions. However, there have been a lot of positive responses both from practitioners and patients alike.
The Exilis Elite procedure uses safe radiowaves in heating the skin and targeted fat cells. It is not painful, rather, it is a tolerable heat sensation which is similar to a hot stone massage during the procedure. The treatment area may have some mild, transient redness.
There is no downtime associated with Exilis Elite, and you can resume your usual activities immediately after treatment. The treatment can produce significant results after a few sessions. It is also a reliable way to address excess fat in certain areas of the body. However, one must understand that it is not as effective as liposuction since it can’t get rid of a lot of fat in a single session.
At The Aesthetics Centre, we choose the BTL Exilis EliteTM over Thermage for skin tightening because of the ability of the system to measure temperature increases in the skin from a technical perspective instead of a patient’s feedback. This built-in feature is important because it allows us to achieve optimal levels of heat to maximize effectiveness and minimize side effects. Thermage, on the other hand, heats the skin up to very high temperatures which risks destroying the fat cells that sit below our skin. Fat loss, particularly in the face, may be desirable for some individuals but may make others look older. This defeats the purpose of doing skin tightening – something you can avoid with the Exilis Elite.
BTL Exilis EliteTM delivers results that tend to be consistently good. In the right hands, it doesn’t have any short-term side effects other than the sensation of heat, and there are no long-term side effects other than the tightening of the skin.
We recommend that our patients do a skin tightening treatment every year to stimulate collagen in the skin because we lose 1% of it every year after the age of 25. Our patients are happy to repeat the Exilis Elite treatment, whereas most patients who have had Thermage are unwilling to do so for fear of the pain.