EXION

HOW WOULD YOU DESCRIBE YOUR EXPERIENCE USING EXION DEVICES?

It really has been a very positive experience. None of our patients have had any adverse reactions, and this has proven to be a very effective treatment for a variety of conditions. I can use it on almost any patient I see in practice, which is important because I see patients with all different skin types. When you are using energy-based devices on darker skin types, you need to be mindful of not making the problem worse by affecting their pigment adversely. I can treat all skin colors effectively for acne scarring, photorejuvenation, texture remodeling, and more.

IS THERE A SPECIFIC TREATMENT FOR WHICH YOU HAVE SEEN SIGNIFICANT IMPACT WITH VERY FEW TREATMENTS?

We usually advise patients to prepare for a series of three or four treatments, approximately a month apart, and we tell them that we will evaluate the results after that. What has surprised me is that I am often seeing meaningful improvement after the first or second treatment with EXION Fractional RF. Patients—and practitioners, too—have a hard time waiting to see how well something works. When you can see benefits sooner, your buy-in to this investment in a procedure has just elevated and given way to more patient satisfaction. One particular area that is pesky is the laxity under the chin, the submentum, and the neck area. I just finished treating a patient who had lost a significant amount of weight with Emface for her face, and she said, “What about my neck?” After a single treatment of the RF microneedling, she really had meaningful improvement. People around her have noticed it, too. That really makes it a win for the practice.

WHAT ELSE DO YOU LIKE ABOUT THE PLATFORM?

EXION Fractional RF is designed to be a single-pass treatment. Other devices on the market can do a single pass, but they are designed to treat at different depths during that same treatment, so you end up doing multiple passes. That can lead to more patient discomfort, more downtime following the procedure, and sometimes unanticipated, undesirable outcomes like too much heating of tissue in certain areas. Having a technology that allows for single-pass treatment is great. It also has real-time impedance and thermal monitoring to give you the confidence to know you’re doing exactly what you intended to do during the treatment.

WHAT OTHER COMPONENTS OF THE EXION PLATFORM DO YOU USE?

EXION Face and EXION Body utilize a combination of monopolar radiofrequency and targeted ultrasound. The goal with those treatments is to really drive ideal energy into the tissue to allow for increased production of hyaluronic acid; you are stimulating the tissue, to achieve tissue contraction, remodeling, and improvement in the quality of skin without the microneedling. You can also layer on a single pass of RF microneedling; that combination works synergistically and really creates incredible results.

WHAT ARE THE ADVANTAGES OF THE EXION HANDPIECE?

You can control the temperature on the handpiece. When you turn on the cooling, you are cooling the epidermis, therefore protecting it while delivering higher energies deeper into soft tissue. We use that for fat reduction in areas that are difficult to treat with other devices—above and below the bra, above the elbows, above the knees, on the medial aspect of the knees, etc.

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WHY IS IT PARTICULARLY USEFUL FOR ACNE SCARRING?

The ability to treat acne scarring in a very effective way with very little downtime is significant. RF microneedling is not a new procedure; we have been doing it for years. The technology has improved, and you can do things now in a single pass and be effective. I use fractional ablative lasers for acne scarring, but there is downtime. We now can send a patient home and tell them, with fairly strong confidence, that they can go to work the next day with very little or no evidence that we have done a treatment, and that they can safely cover the area with a tinted sunscreen. Not only are they not having downtime, but they are seeing improvement.

WHAT ELSE MAKES THE EXION PLATFORM UNIQUE?

Consumables costs are one of the key areas we evaluate with any new piece of technology. I do not know of a single RF microneedling device that does not have a consumable on it, because needles need to be disposable. These really are competitively priced, and the grounding pad, which is necessary because it uses monopolar radiofrequency, costs less than $20. Additionally, the lack of pain for the patient is important. The clinical studies were performed without a topical anesthetic, but we use a topical anesthetic for most of our energy-based devices, and it is very well tolerated. Lastly, it is delegable; depending on the type of practice you have and what you enjoy doing, that can be important. Medical aestheticians and physician extenders can very safely perform this procedure.

HOW DO YOU INCORPORATE IT INTO YOUR OVERALL TREATMENT APPROACH AND PATIENT CARE PROTOCOLS?

Most of us really appreciate the importance of treating the envelope along any aesthetic journey that is geared toward skin rejuvenation, regenerative capacity, looking natural, etc. This is a version of an energy-based device that is allowing us to do that, and it meets the need for many who cannot have the downtime. The expense is palatable for most patients. When I do a consultation with a patient, we talk about the benefits of a multi-modal or multipronged approach to their aging journey. Using energy is part of the equation to aging well, so I present this to almost all as an option. Other types of laser treatments are good options also. Doing this does not preclude doing something else later, or vice versa.