Smart Microablation Technology Remodels and Improves Skin Tone and Texture

Cosmetic facial therapies come in a wide array of types and approaches, and for the aesthetic practice to be successful, it must have solid offerings. Patients want to safely achieve results they can see and feel, delivered as conveniently as possible.

The new Smart Microablation procedure available on the Exion platform from BTL Industries, Inc. (Boston, Mass.), known as Exion Clear RF™, checks those boxes. Board-certified and fellowship-trained dermatologist Joel Cohen, MD, director of AboutSkin Dermatology and AboutSkin Research (Denver, Colo.) is currently leading a study that is revealing the device’s powerful and unexpected capabilities. Preliminary data is exciting, shared Dr. Cohen. “I expected patients to come back with improvement in texture and luminosity, as well as light reflection in photos, but surprisingly we are seeing improvement in pigmentation and central cheek redness.”

How Exion Clear RF Works

Exion Clear RF delivers microablative radiofrequency (RF) energy in thermal zones reaching 200 μm deep. According to Dr. Cohen, this ablates whatever is in that path, including pigmented lesions, by breaking up pigment and stimulating cell turnover. “Given my expertise and experience with this technology in research, I believe that the coagulation and heat are leading to improvement in central cheek redness,” he remarked. “[This is] similar to what we see treating superficial telangiectasia, where the coagulation and thermal effect may induce an inflammatory response, which typically remodels and improves skin, including pigment, redness and very early fine lines. The presence of visible improvement in both pigment and redness is a definite, if unexpected, result.”

The new Exion Clear RF has a significantly simplified operational process. Setup is as quick and as easy as the procedure, and settings can be modulated with the simple touch of a button. Higher settings increase the joules per pin enabling the operator to go from mild microablation and epidermal coagulation to deep microablation with epidermal ablation and subepidermal coagulation.

Clear Results

BTL’s advanced technology ensures homogeneous microablation in each pulse without unnecessary skin damage, according to J.D. McCoy, NMD, medical director of Contour Medical (Gilbert, Ariz.). “It uses the remarkable technology of that handpiece. Impedance measurement feedback thousands of times per second ensures energy delivery during proper, even contact and pressure with skin. It is more efficient and comfortable than one would believe. You get a nice, homogeneous erythema as an endpoint, so I am confident that energy has been delivered safely, comfortably and ideally. Out of all the devices I have used for superficial facial treatments, Clear RF gives me the absolute clearest results, without a doubt.”

In fact, Exion has superseded Dr. McCoy’s previous facial go-to platform, a highly respected laser system, and at times even gets used in place of the intense pulsed light (IPL)-analog device he has relied on for years. “It is now my busiest device, and with Exion Clear RF I see vascular, pigmentary and beautiful textural improvements but it is a far easier treatment to perform. I do not have the ancillary concerns that come with a laser such as cooling, smoke evacuation and the need for eye protection. The patient experience is also better because the laser device I relied on was loud and certainly not relaxing. Exion Clear RF is a wonderfully comfortable, quiet treatment,” Dr. McCoy continued.

After a session with Exion Clear RF, facial skin is a bit dry and flaky with minimal swelling that resolves rapidly, according to dermatologist Lesley Clark-Loeser, MD, at Precision Skin Institute in Davie, Fla. “Patients can counter this with basic moisturizers and can wear sunscreen. Before you know it, the face looks refreshed and clean, and you will see improvement in mottled hyperpigmentation and similar issues, as well as texture. Outcomes manifest over time, but patients can see a difference rapidly, which drives compliance and engagement.”

Maximum Capabilities, Minimal Overhead

Multimodality platforms are an ideal pathway to maximizing capabilities while minimizing overhead – if they work and suit the needs of your patient base. Exion is just such a platform. Four of its technologies are geared toward the face and neck, including the vaunted Emface® and Emface Submentum therapies with HIFES™-brand technology and Synchronized RF; the Exion Face RF plus ultrasound (US) applicator, which has been shown to increase hyaluronic acid up to 224%¹; and the technology-packed RF microneedling applicator for patient comfort. Dr. Clark-Loeser co-authored a study highlighting the RF microneedling applicator’s powerful capabilities to improve acne scars and skin texture.² “RF is colorblind by nature, and settings can be adjusted for all skin types,” she explained. “It is AI (artificial intelligence) controlled, meaning you have precision reproducibility pulse to pulse. The fractional treatment leaves behind untreated areas by default to aid in the healing process.”

Multi-Modality Treatment

Cosmetic dermatologist Mariano Busso, MD, (Miami, Fla.) likes to add Emface and Exion’s other modalities to the Clear RF mix for a superior global outcome. “Adding Emface produces synergistic results,” he commented. “You can easily do Emface and Clear RF the same day without needing to adjust the parameters of either differently than you normally would.” If adding the RF plus the US of Exion Face, you would want to modulate settings accordingly, he added, but the treatments are complementary. “Exion Face goes deeper, and Clear RF is more superficial, so they work well together. Combination treatments like this make platforms like Exion so valuable in the armamentarium,” Dr. Busso noted.

Compared with “resurfacing” treatments, which recall more aggressive long-downtime procedures, less invasive, more convenient treatments with a dramatically better downtime profile are available with Exion and growing in popularity. “Many patients have enjoyed the benefits of Exion’s diverse capabilities,” Dr. Cohen remarked. “And while they are on the table having that procedure, I can treat their face and neck with Clear RF in 15 to 20 minutes. Patients can expect smoother, more luminous skin with improvement in pigment and, surprisingly, superficial redness as well. This is highly desirable to patients.”

References:

1. Duncan D, Bernardy J, Hodkovicova N, Masek J. Increased Levels of Hyaluronic Acid in Skin After Monopolar Radiofrequency and TUS Treatment: Porcine Animal Study. Presented at: American Society for Laser Medicine and Surgery (ASLMS) annual meeting; April 27, 2022; San Diego, California.

2. Clark-Loeser LR, Halaas Y. Efficacy and Safety of Novel AI-Controlled Fractional Radiofrequency for Acne Scars Treatment and Skin Texture Improvement. Presented at: American Society for Laser Medicine and Surgery (ASLMS) annual meeting; April 27, 2022; San Diego, California.