Looking for more info on which device you would recommend using for facial skin tightening, especially under the eyes.

We used to treat those with Thermage. But then we stopped it because patient satisfaction is low. Patients rate pain as 8-10 on on a pain scale of 10. We are using Exilis now. This can be used anywhere on the face, as well as the body.

We've been using Thermage for the last four years with topical to mitigate the pain. It's not feasible without it and the results are highly dependent upon how much energy is delivered. Patient satisfaction is variable from fair to very good (very, very rarely could be classified as excellent and could fairly often be poor.) Patient selection is key and you should photograph everything without 'cheating', meaning same lighting etc. since they'll be looking at everything through a loupe.

We are using the Smartxide DOT fractional CO2. It dramatically removed fine lines and tightened the skin around the eye area of my patients.

have you tried zeltiq (coolsculpting)?

We are also using the DEKA DOT. We are seeing significant improvements in our patients. I also use it on myself. Happy patients = more referrals = more happy patients. It's wonderful and I am so glad I added it to my practice.

Our clinic purchased Reaction from Viora months ago and we could not be happier with the overall results--not just on the face but also on the body. Unlike some other monopolar RF devices, we can tailor the desired results according to patient's needs because there are various frequencies to choose from. We have demoed Exilis but found that Viora is far superior. Amazingly, we still get the best outcome with RF--short downtime and minimal discomfort.

PU.Reinhardt, I suggest you look into Ellman Radiofrequency Device. We've been using it for periorbital skin tightening, as well as for the neck. Hand pieces are very ideal for facial contouring. Very practical as you can switch it up, and you can perform additional procedures with this device.

I also swear by the Viora's Reaction device as being the most versatile and effective device on the market today. It is by far the wisest decision I made.

We have tried using Thermage for the face and under the eyes but had some issues with patient discomfort. Currently, we are trying Alma (laser) and Ellman (RF) but I noticed limited results for facial tightening and usage under eyes. Any suggestions?

@ Van: I'd like to hear more about the Ellman treatment options, specifically what additional pieces are you using, etc...

mntp, I haven't tried using zeltiq for the under eyes as there is little fat in that specific area. zeltiq is indicated for fat layer reduction on resistant lumps on parts of the body such as the stomach, thighs and love handles.

We had great results with the Smartxide DOT fractional CO2. It got rid of most of the lines and smoothened the skin under the eyes beautifully.

Let's take a poll. Which machine is better for skin tightening under the eyes, face and neck? Exilis or Viora ? Why did you choose this over the other?

for under eye tightening we use the ellman pelleve and have seen very good results. Not large enough for the body.

I am very impressed with the eTwo and sublative rejuvenation. If you have not tried it yet, you should check this out. Guaranteed satisfaction for facial skin tightening.

We tried the Viora, Exilis, Pelleve, Thermage, Venus Freeze and a few others and decided on the Exilis. We've seen outstanding results in the 11 months we've owned the system which can be used anywhere on the face or body. Nothing agaist the other systems but the Exilis offered the best results and is painless.

We have used RF in our practice for more than a decade with Thermage and over a year ago decided to add Exilis. We currently offer both technologies. The key is that the amount of pulses (Thermage) or the amount of time doing Exilis equals results. We have done hundreds of cases and the more treatments you do (and/or the time per treatment) the better the results in my experience. Our clients have been very pleased with the Exilis treatment as long as you prep them for what to expect for a realistic result and that you choose the right treatment in the first place. We have coolsculpting as well and direct abdominal/flank fat in that direction if appropriate

We use the Ellman device for skin tightening. we use it for the face and neck only-I don't think that it would really work for the body. I like it because the handpieces are smaller so you can really contour on the face, also you can switch out the handpieces so you can do other procedures-cut, coagulation etc.

I say go with those with the clinical data. Since 2002 that would be Thermage, and Cutera's Titan (2004). RF and IR options. Both work and have the clnical data to support the claims. hardest part for the practitioner is patient selection. that, and over selling the technologies - if you advertise as "lunch time face lift" you'll get customers that are likely not satisfied.

For those of you who are using Skin Tightening Systems, how many treatments are needed before your clients see the results and how frequent do you perform the treatments? What is the cost of the Exilis? I was never impressed with the results of the Skin Tightening Systems in the past.

I am a rep for Syneron-Candela. Having come from the Candela side of the merger I wasn't convinced that bipolar RF could do anything really substantial. It turns out it is more controllable than monopolar RF (Thermage) and produces a substantial impact in one 15 minute treatment. I was very impressed with the eTwo and sublative rejuvenation. If you have not tried it please do. I don't say this to schill the device; I say this as someone who also has a reputation for making customers and their patients happy. You don't have to buy it, but please learn about it - patient satisfaction with this device for the ENTIRE face is extremely high.

We have tried a few modalaties in my clinic as well as my prior one. My prior one used Thermage for face and under eyes but we had some issues with patient discomfort. Currently,we are trying Alma (laser) and Ellman (RF) with limited results for facial tightening and usage under eyes. We recently acquired a Reaction system from Viora and have to tell you we love the results. Not only can we use it for facial skin tightening but also under eyes, for body contouring, , cellulite reduction and body skin tightening following bariatric surgery. Seems to do it all with little patient discomfort.