EXION Face and Thermage FLX both use monopolar radiofrequency, but they aim at different problems. EXION Face pairs radiofrequency with targeted ultrasound over about 4 sessions to help skin make more of its own hyaluronic acid, collagen and elastin, so it leans toward hydration and fine lines. Thermage FLX heats deeper collagen-rich layers, usually in one session, for laxity and firmness. A physician assessment decides which fits.
Below is a side-by-side comparison, then the questions people ask most when choosing between them. Prices are not covered here; plans are quoted after assessment.
How do EXION Face and Thermage FLX compare at a glance?
EXION Face is a gentle course aimed at skin quality, while Thermage FLX is a single, deeper heating treatment aimed at tightening, so they differ in goal, depth, feel and timeline.
| EXION Face | Thermage FLX | |
|---|---|---|
| Mechanism | Monopolar radiofrequency plus targeted ultrasound, with AI reading skin temperature and impedance in real time | Monopolar radiofrequency through a treatment tip; AccuREP measures skin impedance before each pulse |
| What it targets | Dryness, dullness, loss of bounce and fine lines; skin quality on the face and neck | Mild to moderate laxity, texture and pores; eyes, face, neck and body |
| Depth / layer | The dermis, where fibroblasts make hyaluronic acid, collagen and elastin | The dermis and deeper collagen-rich layers; according to the manufacturer the body tip reaches up to about 4.3 mm |
| Typical session feel | Gentle warmth; numbing cream usually not needed; about 10 to 30 minutes | Brief pulses of heat eased by built-in cooling and vibration |
| How results develop | Smoother, more hydrated-looking skin during the course, continuing for up to about 3 months | Some tightening may be felt right away, with collagen remodelling over the following months |
| Common reactions | Mild redness or warmth that usually fades within hours | Brief redness or swelling that settles quickly |
| Who it may not suit | Pregnancy or breastfeeding, pacemaker or metal implants in the area, active infection or recent sunburn, recent fillers, threads or energy treatment in the same area | Pregnancy or breastfeeding, pacemaker or metal implants in the area, active infection or inflammation, recent thread lift or high-energy laser in the same area |
How does EXION Face work?
EXION Face delivers radiofrequency and targeted ultrasound together: the radiofrequency warms the dermis, and the ultrasound acts on fibroblasts, the cells that make hyaluronic acid, collagen and elastin.
Hyaluronic acid holds water in the skin, and the skin's own supply falls with age, which shows as dryness, fine lines and a loss of bounce. EXION does not add a filler; it aims to prompt the skin to make more of its own. Throughout the session an AI system reads how the skin responds and adjusts energy to keep it in its target range. In BTL's manufacturer-reported data (a study reported by Duncan), skin measured after four treatments showed increases in hyaluronic acid, collagen and elastin; individual results vary.
How does Thermage FLX work?
Thermage FLX sends monopolar radiofrequency through a tip to heat the dermis and deeper collagen-containing tissue, so collagen fibres contract and then remodel over the following months.
FLX is the fifth generation of the system. AccuREP adjusts each pulse to your skin's impedance, and cooling and vibration in the handpiece ease the heat. Different tips are used for the eyes, face and body. Thermage works on the skin's own collagen and firmness; it does not replace lost volume or reposition marked sagging.
Which concerns lean toward EXION, and which toward Thermage?
Dry, dull, crepey-looking skin and fine lines lean toward EXION Face, while early loosening along the jaw, mild eyelid hooding and a general loss of firmness lean toward Thermage FLX.
Many people have both: skin that looks tired and a jawline that is starting to soften. In that case the question is which matters more to you now, and whether a combined plan makes sense. EXION is also used to maintain results from other skin treatments. If the main concern is volume loss, neither is the primary tool.
What does each treatment feel like?
EXION Face feels like gentle warmth as the applicator glides, while Thermage FLX feels like short, deeper heat pulses that are eased by cooling and vibration.
EXION usually needs no numbing cream. With Thermage, comfort options can be discussed at consultation, and energy can be adjusted during treatment. Neither uses needles.
How soon do results show, and how many sessions are typical?
EXION Face is usually a course of 4 sessions about 1 to 2 weeks apart, while Thermage FLX is typically one session, with some people repeating about once a year.
EXION changes often show during the course and continue for up to about 3 months after the last session. Thermage change develops gradually over months, and our Thermage page notes that with good skincare and sun protection results often last one to two years. Results vary with age, skin and habits.
What are the common reactions and recovery?
Most people resume normal activities the same day after either treatment; temporary redness, warmth or mild swelling are possible.
After EXION, use a gentle cleanser, moisturizer and daily SPF, and avoid saunas, hot yoga and intense heat for 24 hours. After Thermage, avoid saunas, hot baths and intense workouts for 2 to 3 days and skip harsh scrubs or peels. Contact the clinic if anything seems unusual.
Who should not have either treatment?
Pregnancy, a pacemaker or metal implants in the area, and active infection rule out both, and recent treatments in the same area need timing.
- EXION Face is not used with a recent sunburn, or soon after fillers, threads or another energy treatment in the same area; conditions that affect healing need review.
- Thermage FLX is not used soon after a thread lift or high-energy laser in the same area, or with extremely sensitive skin or neuropathic pain conditions.
Can they be combined?
Yes, EXION can be planned together with Thermage when appropriate, because one focuses on skin quality and the other on firmness, with spacing set by your physician.
A plan might use Thermage FLX for tightening and an EXION course for hydration and fine lines, or EXION to maintain skin quality between yearly Thermage sessions. Either can also sit alongside Ultherapy when deeper lifting is needed.
How is the choice made at RAAC?
At RAAC in Richmond, BC, the choice is made at a physician assessment led by Dr. Charles Jiang, who separates skin-quality concerns from laxity concerns before recommending one or both.
Settings and session plans are adjusted to your skin, including skin prone to pigmentation. RAAC uses genuine BTL equipment and genuine Solta FLX tips, unboxed in front of you. Consultations are available in English, Mandarin and Cantonese at Unit 110, 5580 No. 3 Rd, about a 3-minute walk from Lansdowne Station on the Canada Line, open every day from 9:00 to 18:00. Pricing is quoted after the assessment.
Frequently asked questions
Is EXION Face the same as Thermage?
No. Both use radiofrequency, but EXION adds targeted ultrasound and aims at hydration and skin quality over a course, while Thermage aims at tightening, usually in one session.
Is EXION a filler?
No. A filler adds volume by injection. EXION adds nothing to the skin; it aims to help the skin make more of its own hyaluronic acid, collagen and elastin.
Which one is gentler?
Most people describe EXION as gentle warmth without numbing. Thermage pulses are more noticeable, which is why cooling and vibration are built in.
Can either treat the eye area?
Yes. EXION is used for fine lines and crepey skin around the eyes, and Thermage has a dedicated eye tip for mild hooding and fine lines.
How long do results last?
EXION changes keep developing for up to about 3 months after the course, and maintenance may be suggested. Thermage results often last one to two years with good skincare.
Can I go straight back to work?
Most people do. Any pinkness after EXION usually settles within hours, and redness after Thermage settles quickly.
For how Thermage compares with ultrasound lifting, see Thermage vs Ultherapy.
This article is for educational purposes only and does not constitute medical advice. Please consult with a qualified healthcare professional before undergoing any treatment.
