Your Questions

Q: Dr. Eppley,  even though I am fairly young (35 years old), I have some bags over my cheeks. These are not lower eyelid bags but cheek bags/puffiness. I tried injectable fillers in the tear trough but that just made me look puffy and did not solve my problem. I have heard about using some external devices to help shrink them and tighten the skin. In talking to several doctors and reading, I am looking at the Exilis device for the treatments. But one doctor is saying the Exilis is the first generation radiofrequency device (RF) and they now use this Ultherapy instead. There is also an  Apollo device whichi is powered by TriPollar technology which is the 3rd generation of RF, allegedly the most advanced RF technology currently in the market. Many clinical studies published on the TriPollar technology demonstrated that it is very effective for wrinkle reduction, skin tightening and body contouring I don’t understand why or what to do. I have set up some consultations with some docs but I am worried. Can you tell me what I should do? 

A:  The world of non-surgical fat reduction and skin tightening devices is very confusing. It is filled with much inaccurate and sometimes deceiving information. Between manufacturer promotions of the devices that they make and doctor’s pushing the devices that they own, it is impossible for any patient to weave their way through this maze of voluminoos and often contradictory information.

What I can tell you with great certainty is that there is no single device out there that has been proven to be superior to any other…no matter what you are told or have read. Many devices may have comparative results but none can claim to be more effective at fat reduction or skin tightening than another one. We know this because no comparative studies have ever been done between the devices that exist nor it is likley any will be done.

I mentioned Exilis only because I am familiar with it and use it in my practice so I know its effects. This is what I would try if you were coming to my practice. This does not mean it is the best device available or that there may be others that worko just as well and perhaps even better. Exilis is not a first generation RF device nor is it similar to ultherapy which uses a different enegy to creates its tissue effects.

I think the conclusion is that some effort using any of the available energy-based devices is what you should try. I would not get hung up on which one. Availability and reasonable costs are the parameters to use on what device to try. The point is that if it does not have any effect, it is not likely any other device will be any better.

Dr. Barry Eppley

Indianapolis, Indiana