Standing Appointment is our review series that investigates the best new and notable cosmetic treatments in the aesthetics space and determines whether or not they are worth trying for yourself. This week, one writer tries Exion to help sculpt and refine her cheeks and jawline.
I’m no stranger to trying out non-invasive treatments for better skin — in the past, I’ve gotten both Fraxel and VBeam to treat my hyperpigmentation and lingering redness. But while those lasers target what you see on the surface, if you want to tackle issues like volume and laxity, then you’ll need to seek out other solutions. Injectables are a quick fix, but for those seeking to either supplement or minimize their use, another promising option that has emerged is Exion.
Exion is a skin tightening treatment that uses radiofrequency and ultrasound to stimulate collagen production, as well as restore natural hyaluronic acid. The result is a more lifted appearance as well as less visible fine lines. “Injectables are not going anywhere, but they’ve been around long enough that we’ve seen overuse that can create a problem at any age, particularly in the younger crowd that may not need as much correction,” says Dr. Paul Jarrod Frank, celebrity cosmetic dermatologist and founder of PFRANKMD. “EXION restores the face in a way that sets the stage for more work if they need it.”
As someone who has dabbled with tiny amounts of Botox and filler, I knew from prior experience that I didn’t require a ton of injectables. The thought of prolonging the time between those appointments was appealing, so I decided to give Exion a try.
What Is Exion?
Developed by BTL Aesthetics, the makers of EmFace (another face-firming treatment), Exion relies on a combination of monopolar radiofrequency and targeted ultrasound to tighten and lift your appearance. During your treatment you’ll be asked to slip into a robe and a small pad will be affixed to your back — this is the transducer that serves to ground the high-frequency electric current that will travel through your body as the wand is applied across your face. Monopolar radiofrequency devices work by creating heat through that electric current, and this, along with the ultrasound serves to create stress in your skin. In response to this stress, your body will increase blood circulation in addition to stimulating fibroblasts, the cells that secrete collagen.
The device itself has four applicators, all of which use the same technology. One targets the face while another is for the body. A third, known as EmFemme, is used for vaginal rejuvenation while the fourth is a microneedling attachment, which can be used in tandem with the radiofrequency and ultrasound. The last is interesting to note — unlike Morpheus8 and other comparable treatments, the Exion version only requires one pass across the face.
Another thing that sets Exion apart is that the machine has selective targeting technology, so it can adapt to the patient. There’s an artificial intelligence system that continuously monitors and adjusts the energy output so you can get the best results on the targeted areas with minimal damage to the surrounding skin.
Benefits of Exion
In the long term, Exion can help boost collagen and hyaluronic acid production, keeping your face looking full and lifted. “While this is not going to replace injectables, it definitely is an injectable sparing agent,” says Dr. Frank. What that means is that while neuromodulators and fillers can help with volume and muscle relaxation, this treatment can work in tandem with them, making them a potent combination to keep your face looking fresh and rested. “It’s also great as a quick boost of elasticity for any upcoming events,” he adds.
Who’s a Good Candidate?
“Exion tends to be best for younger age groups, anywhere from 20s to 40s,” says Dr. Frank. “Older patients may use it in combination with other treatments because they have [more lax] skin.”
Like all treatments, the price varies based on location and practitioner but expect to spend couple hundred dollars and upwards for each session. Dr. Frank recommends a series of four, at one-week intervals, so factor that into your budget as well; his office offers a package of four for $1,800 total. To maintain your results, he suggests incorporating quarterly maintenance sessions.
What to Expect During Your Treatment
Regardless of whether you opt for microneedling or simply just the radiofrequency and ultrasound option, it’s best to avoid retinoids and other potentially irritating topicals like Vitamin C for a few days prior to your session. Come with a clean face and be prepared to change into a robe. For those who receive microneedling, you’ll get numbing cream, but for those who are getting just radiofrequency and ultrasound, you can dive right into the treatment. Your clinician will attach the transducer pad on your back and then you lay back to begin the treatment. A conducting gel is spread over your skin and the wand will work on each section, beeping when it’s time to move on.
Since Dr. Frank recommended just radiofrequency and ultrasound for my skin, the process was mostly pain-free. You’ll definitely notice some discomfort in certain areas, particularly bony bits like your forehead and right under your chin. And if you have any popped pimples that are healing, you’ll note that those spots will also feel a bit spicy. For the most part, however, it feels like a hot stone massage, especially on your cheeks and jawline, which have more fat cushion. Expect to stay 30 to 45 minutes for the entire process.
Unlike other ultrasound and radiofrequency treatments, the downtime is minimal. I experienced some redness immediately following, as if I was slightly flushed from the cold. The heat also made my skin feel slightly drier than normal. After wiping the conduction gel from my face, I applied some sunscreen and headed out. If you had plans, you could easily wear makeup, since there’s no recovery time. By the next morning, my face was back to normal.
For those who opt to add on the microneedling, you’ll need more downtime, as it’ll take several days for your face to heal. Dr. Frank’s team recommended at least five days, depending on how your skin reacts. In that case you’ll want to avoid retinoids or other active topical treatments that might irritate your skin in favor of a gentle moisturizer.
Dr. Frank notes that this treatment won’t result in starkly different before and after images, so if you’re looking for an immediate dramatic difference, this treatment isn’t for you. Instead, think of it as an investment for the future version of yourself. “The effects are going to be subtle with long-term significance,” he says. In my case, because my facial elasticity was already pretty firm, I didn’t require much in the way of lifting or fine line reduction. Instead, the treatment ensures that my collagen and hyaluronic acid levels remain close to where they are currently, creating a stable underlying architecture for my face.
That said, when you check out the before and after photos on BTL’s site, you’ll notice many patients do see a noticeable reduction in fine lines, scarring, as well as tightening effects. This is even more pronounced when you add in microneedling. For my course of treatment, Dr. Frank noted that microneedling wouldn’t markedly change the outcome in my skin, so always check with your provider to see which option works best for your desired results.