September 2013
The Effect of Exilis on Bra Fat
S Soin, A Sarkar, S Yadav, N Anand
New Delhi, India
Abstract
The aim of this study was to evaluate the effect of Exilis treatments on the overall improvement of bra
fat through the reduction of subcutaneous fat and collagen remodeling. The study was conducted on 26
female patients between 36 and 67 years of age. Two patients did not complete the study. After completion
of four sessions of treatment, subjective patient satisfaction was assessed using a written questionnaire.
Ten patients (42 %) reported excellent improvement in bra fat after treatment, six patients (25 %) reported
moderate improvement and five patients (21 %) reported mild improvement. Three patients reported no
change.
Keywords:
Exilis, fat, collagen, ultrasound, radiofrequency, bra fat
I.
Introduction
ody contouring, body sculpting and
shaping modalities are a growing trend
in the field of medical aesthetics.
Globalization and the impact of media have
contributed to growing body consciousness
among people. This is especially true for
women and teenagers and psychologists report
weight and body image to be major concerns
amongst women today. Surgical methods of
body contouring are associated with potential
risks and downtime, which has led to a
growing demand for non-surgical aesthetic
treatments. Several devices are currently
available for non-surgical contouring, each
utilizing different energies and technology,
with variable results. The Exilis device by
BTL offers a unique combination of two
modes of energy delivery with built-in safety
features and cooling. The efficacy of the
Exilis device for skin tightening and body
contouring has been investigated in several
clinical studies; however none of these have
B
specifically evaluated the effect of Exilis
treatments on bra fat.
II.
The Exilis Device
The Exilis device combines radio-frequency
(RF) and ultrasound, along with a cooling
system, in a single applicator head which can
be used for a wide range of body applications.
It also includes a separate applicator which is
specially designed for facial treatments. We
have treated a large number of patients with
the Exilis device since July 2012, for a variety
of indications including treatment of wrinkles
over the face, turkey neck, sagging jowls and
double chin and rejuvenation of skin over the
hands; contouring and skin tightening over
the abdomen, flanks, bra fat, buttocks, thighs
and calves; upper arms and décolleté for nonsurgical breast lift. In our experience, the Exilis
device by BTL is a sound, safe and effective
non-surgical technology for facial and neck
skin tightening as well as body contouring. In
this study, we specifically evaluated the effect
S Soin, A Sarkar, S Yadav, N Anand : The Effect of Exilis on Bra Fat , Page 1
September 2013
of Exilis treatments over bra fat.
III.
Materials and Methods
The study has been conducted on 26 women
from 36 to 67 years of age.
Exclusion
criteria for the study were BMI over 30 and
contraindications for Exilis treatments such
as metal implants or pacemakers. The study
consisted of 4 sessions, each twenty minutes
long. The temperature of the treated area was
allowed to reach and was then maintained at
the clinical endpoint of 42 ◦ C. The treatments
were performed 10-15 days apart. Patients
were asked to drink three liters of water the
day before and on the day of the treatment.
Post treatment patients were asked to avoid
contact of the treated area with cold water
for 24 hours and thereafter to maintain good
hydration and continue their usual routine
including light exercise and a balanced diet, to
facilitate lymphatic drainage for good results.
Two patients did not finish study. The result of
treatment was evaluated after the last session,
through a subjective questionnaire, filled in
just after the last therapy of the study. The
questionnaire was designed in the following
format:
"How do you evaluate the appearance
change after the set of therapies with Exilis
device on bra fat?
Choose one of the
options on 4-level scale". The options given
were as follows: 1- "Significant -excellent", 2"Significant- moderate", 3 - "Significant - mild",
4 - "None".
IV.
Results
From the study group of women who
completed 4 sessions of the therapy, 10
women (42 %) rated the improvement in the
appearance of bra fat as excellent. Six women
(25 %) rated their improvement as moderate
while 5 women (21 %) rated their appearance
improvement as mild. Only 3 women reported
no difference in the appearance of bra fat after
four sessions of treatment
Figure 1: Patient satisfaction ratio
S Soin, A Sarkar, S Yadav, N Anand : The Effect of Exilis on Bra Fat , Page 2
September 2013
Figure 2: Before treatmnet - After treatment
Figure 3: Before treatmnet - After treatment
S Soin, A Sarkar, S Yadav, N Anand : The Effect of Exilis on Bra Fat , Page 3
September 2013
V.
Conclusion
This study evaluated the satisfaction level of
patients with improvement in the appearance
of bra fat after four sessions of treatment with
the Exilis device by BTL. All patients tolerated
the therapy well without any side effects or
discomfort. The study shows that majority of
patients (88 %) rated the improvement of the
appearance of their bra fat as significant. We
opine that the Exilis technology is a safe and effective non-surgical modality for the aesthetic
improvement of bra fat
VI.
Discussion
The unique body applicator of the Exilis device
combines radio-frequency and ultrasound technologies which enable the treatment of skin
laxity and irregularities of contour irregularities in the same treatment session. The energy
is delivered in continuous motion in a format
termed ’Dynamic Monopolar RF’. The device
offers selectivity and specificity of treatment
of target tissues in a safe manner. Controlled
cooling through the Peltier system allows focused application of heat directed to a precise
depth of penetration. It protects the skin surface while allowing sub-dermal fat layers to
reach higher - and therefore more effective temperatures, thus yielding better results. The
Exilis device uses a safety feature called the Energy Flow Control system or EFC which detects
skin impedance (energy flow through tissue)
and shuts off energy delivery on loss of contact
of the applicator tip with the skin. The EFC virtually eliminates the risk of burns and provides
enhanced safety and comfort with reduction in
treatment time.
The goal of treatment is to reach surface
skin temperature of 40 to 43 ◦ C for 6-7 minutes
over the treated area. At this temperature, the
patient perceives a hot sensation. Energy levels
were modulated using patient feedback and
comfort along with the monitoring of skin temperatures displayed in the LCD monitor. Exilis
treatments for body contouring can postpone
or eliminate the need for elective surgery, es-
pecially for patients with mild to moderate fat
deposits and those who may not be good candidates for surgery. For additional treatment of
skin laxity, the cooling system may be turned
off to allow rapid heating of the skin surface,
with minimal impact on the subcutaneous fat.
Thus Exilis treatments may be used before and
after invasive procedures such as liposuction,
for enhancement of results, especially for the
improvement of skin laxity and bumpiness.
A word about BTL:
BTL is a leading manufacturer of medical devices with a complete range of aesthetic
products, including non-surgical aesthetic devices for body contouring, fat reduction, skin
tightening and anti-wrinkle treatments. BTL’s
devices are CE approved. The Exilis device
has been approved by the US FDA and Health
Canada.
VII.
Disclosures
The authors have no commercial interest in BTL
and received no compensation for this study.
The study was independently conducted by Dr.
Soin and her team at their clinic in New Delhi.
References
[1]
Robert A. Weiss, MD, FAAD, Margaret
A. Weiss, MD, FAAD. Dynamic Monopolar Radiofrequency for Successful NonInvasive Treatment of Skin Laxity and
Body Contouring.
[2]
Peter B. Fodor, MD; Kathryn A. Stecco,
MD, MA; Jody Johnson, BSEE The Precision of High-Intensity Focused Ultrasound (HIFU) for Non-Invasive Body
Sculpting: In Situ Thermocouple Measurement of the HIFU Treatment Zone within
Adipose Tissue.
[3]
Arnoczky SP, Aksan A. Laboratory for
Comparative Orthopedic Research, Michigan State University, East Lansing, Michigan, USA. Thermal modification of connective tissues: basic science considerations and clinical implication.
S Soin, A Sarkar, S Yadav, N Anand : The Effect of Exilis on Bra Fat , Page 4
September 2013
[4]
Roustaei N, Masoumi Lari SJ, Chalian M,
Chalian H, Bakhshandeh H. Safety of
ultrasound-assisted liposuction: a survey
of 660 operations Aesthetic Plast Surg. 2009
Mar;33(2):213-8. Epub 2008 Dec 18.
[5]
Rusciani, Antonio, et al., Nonsurgical
tightening of skin laxity: A new radiofrequency approach J Drugs Dermatol. 2007,
Vol. 6(4), pp. 377-382.
S Soin, A Sarkar, S Yadav, N Anand : The Effect of Exilis on Bra Fat , Page 5