Exilis or HIFU? How to Choose the Right Skin Tightening Treatment

If you are looking at non-surgical skin tightening in Newcastle, two names come up again and again: HIFU and BTL Exilis Ultra 360. They are often described as alternatives to each other, which is only half true. They work in different ways, they suit different skin, and at RT Aesthetics we recommend them for different reasons. The treatment pages for HIFU in Newcastle and Exilis Ultra Face have the prices; this page is about choosing between them.

Here is an honest comparison, written by the team who use both machines every week.

The short answer

• Choose HIFU if you want the strongest possible lift from a single treatment, you have some skin laxity to correct, and you are happy to wait around three months to see the full result.
• Choose Exilis Ultra 360 if you want gradual, comfortable tightening with no real recovery, you are treating a larger or more delicate area, or you want to reduce a small pocket of fat at the same time.
• Choose both if your main concern is significant laxity along the jaw and neck. They stimulate collagen through different mechanisms, so they stack well.

What each treatment actually does

HIFU (UltraCel Q+)

HIFU stands for High Intensity Focused Ultrasound. It delivers ultrasound energy to a fixed depth beneath the skin, creating tiny, precise points of coagulation in the SMAS layer, the same fibrous layer a surgeon tightens in a facelift. Your body repairs those points by laying down new collagen, and the tissue contracts as it heals.

Because the energy is focused rather than spread, HIFU reaches deeper than most non-surgical devices. That is what gives it a genuine lifting effect rather than just a surface glow.

BTL Exilis Ultra 360

Exilis Ultra 360 combines two energies in one handpiece: monopolar radiofrequency and ultrasound, delivered at the same time with controlled cooling on the skin surface. The radiofrequency heats collagen in the dermis so it contracts and remodels. The ultrasound component disrupts fat cells when the applicator is set for body work.

The cooling plate is the reason it is comfortable. The tissue underneath reaches a therapeutic temperature while the surface stays protected, so treatment feels like a warm massage rather than anything sharp.

Exilis versus HIFU at a glance

• Energy: HIFU uses focused ultrasound. Exilis uses radiofrequency plus ultrasound together.
• Depth: HIFU targets fixed depths including the deep SMAS layer. Exilis works through the dermis and subcutaneous layer with adjustable depth.
• Sessions: HIFU is usually one session, repeated annually. Exilis is a course of four sessions, roughly a week apart.
• Sensation: HIFU produces brief heat and deep prickling. Exilis feels like a hot stone massage.
• Downtime: Neither has real downtime. HIFU can leave mild tenderness or slight swelling for a few days.
• Results appear: HIFU builds over 8 to 12 weeks. Exilis shows changes from around the third session and continues for about three months after the course.
• Best for: HIFU for lifting a sagging jawline, brow or neck. Exilis for firming, texture, fine lines, delicate areas and small fat pockets.

How each one feels in the chair

This is the difference most people notice first. HIFU is felt. As each line of ultrasound is delivered you feel heat and a deep prickling sensation, sometimes described as a small electric pulse against the bone. It is entirely manageable and it stops the moment the applicator lifts, but nobody falls asleep during HIFU.

Exilis is the opposite. The handpiece is moved continuously over the area and the heat builds slowly to a plateau that is warm and even. Most of our clients find it genuinely relaxing, which matters when you are committing to four appointments.

If you are nervous about discomfort, or you are treating the neck or around the eyes where tissue is thinner, Exilis is the easier starting point.

How many sessions you need

HIFU is designed to be a single event. One full treatment, then you let your collagen do the work over the following three months. Most people repeat it once a year.

Exilis is a course. Four sessions spaced about a week apart is standard for the face, and four to six for the body depending on the area. The effect is cumulative, so skipping sessions or spacing them too far apart undercuts the result.

Neither is a one-off fix that lasts forever. Both slow and partially reverse the loss of collagen that keeps happening as you age, and both need topping up.

What they cost at our Newcastle clinic

Current prices for the face:

• HIFU UltraCel Q+ face, one session £1,095. Face and neck £1,295. Face, lips, neck and décolletage £1,495. Neck alone £995. Eyes and brow lift £895.
• Exilis Ultra Face, four sessions £1,075. Face and neck £1,275. Face, lips, neck and décolletage £1,500. Neck alone £975. Eyes and brow lift £775. Lips £475.

For the body, Exilis Ultra 360 is priced by area: one area £785 for four sessions or £1,199 for six, two areas £1,285 or £1,999, three areas £1,785 or £2,699.

Note what that comparison shows. A course of four Exilis face sessions costs roughly the same as one HIFU session. You are paying for a different delivery, not a cheaper or more expensive treatment.

Prices change, so check the current price list before you budget.

Which should you choose?

Rather than a general recommendation, here is how we actually decide in consultation.

• Jawline and jowls that have started to drop: HIFU first. The lifting effect is what you need, and Exilis alone will firm the skin without repositioning it.
• Crepey neck or décolletage: Exilis. The tissue is thin, the area is broad, and gentle even heating suits it better.
• Fine lines, dullness and loss of firmness in your thirties or forties: Exilis. You are maintaining collagen rather than correcting laxity.
• Around the eyes and brow: Either works. HIFU gives a sharper brow lift. Exilis is more comfortable and more forgiving.
• A small pocket of fat under the chin or on the body: Exilis, because the ultrasound component addresses fat as well as skin.
• Significant laxity and you want the best possible outcome: Both, sequenced. See below.

Can you have both?

Yes, and for the right person it is the best plan we can offer without surgery. The usual sequence is HIFU first to lift the deeper layer, then a course of Exilis starting around six to eight weeks later to refine the skin surface and support collagen production while the HIFU result is still building.

What we do not recommend is booking both on the same day or in the same week. The tissue needs time to respond to one before you add the other.

If you want the technical background on how each machine heats the skin, our older Exilis vs HIFU article goes into the properties of each, and the science behind Exilis Ultra 360 covers the radiofrequency side in more depth.

Frequently asked questions

Is Exilis or HIFU better for skin tightening?

For lifting loose skin, HIFU is stronger because it reaches the deep SMAS layer that gives skin its structural support. For overall firmness, texture and fine lines, Exilis produces a more even result across the whole treated area. They tighten in different ways rather than one being better than the other, which is why we ask what specifically is bothering you before recommending either.

Does Exilis Ultra 360 hurt?

No. Exilis is one of the most comfortable treatments we offer. The handpiece cools the skin surface while heating the tissue underneath, so the sensation is a steady warmth similar to a hot stone massage. There is no numbing cream and no recovery period. You can drive home and go back to work straight away.

How long do the results last?

HIFU results typically last around 12 to 18 months before most people want a top-up. A course of Exilis holds for roughly 12 months with maintenance sessions every few months keeping it going longer. In both cases the honest answer is that collagen loss continues with age, so these treatments slow the clock rather than stop it.

Which one works faster?

Exilis shows visible change sooner. You will often notice firmer, smoother skin by the third session, around three weeks in. HIFU takes longer because the collagen remodelling happens over 8 to 12 weeks, but the eventual lift is greater.

Can I have HIFU or Exilis if I have fillers?

Tell us at consultation. Both treatments generate heat that can affect hyaluronic acid filler, so we usually leave at least two weeks after filler before treating, and we plan around your filler schedule. This is one of several reasons an in-person assessment matters more than booking online from a list.

Am I too young or too old for either?

Most of our Exilis clients are between 30 and 55 and are maintaining what they have. HIFU tends to suit people from around 40 upwards who have visible laxity to correct. If skin has lost a lot of elasticity, neither will match a surgical result, and we will tell you that honestly at consultation rather than sell you a course that cannot deliver.

Book a free assessment in Newcastle

The only reliable way to choose between them is to have someone look at your skin. We offer a free, no-obligation assessment at our Newcastle upon Tyne clinic where we will tell you which treatment suits your skin, what result is realistic, and whether neither is right for you.

Book your free assessment, or read more about HIFU in Newcastle and BTL Exilis Ultra Face. You can also see real Exilis before and after results.

Many people end up having both. Our skin tightening Newcastle page explains how we combine them and what each one costs.

If Ultherapy is on your list as well, our Ultherapy vs HIFU comparison explains why they are the same technology and what each one costs in Newcastle.

Related guides

• Radio frequency skin tightening in Newcastle
• Exilis before and after photos