Exion in London: what it does, what it costs, and what the evidence shows

Much of what is written about Exion repeats the same percentage without saying it was measured in pigs, promises results for "all skin types" that the US label does not support for the needle handpiece, and says little about who should not have the treatment. This guide is written by the team that runs Exion at our clinic on Devonshire Place and reviewed by our clinician. It gives you what each handpiece actually does, what the US regulator cleared and did not, the three small studies behind the claims, how we price it, and an honest answer on jowls.

What Exion is

Exion is the trade name BTL Industries gives to its BTL-785 platform, a console with several handpieces. Three are sold under the Exion name in the UK:

• Exion Face. A handheld applicator that delivers monopolar radiofrequency at 3.2 MHz together with targeted ultrasound to small areas: around the eyes, the forehead, the cheeks, the jawline, the neck and the chest. No needles. The skin is heated to between 40 and 45 degrees Celsius on the label, monitored by a thermometer in the handpiece and by what you tell the clinician.
• Exion Body. The same combination with active cooling of the skin surface and more power, for the abdomen, the arms, the thighs, the buttocks, the knees and the back. A massage attachment for the Body handpiece is the only part of the system with a cellulite wording on its US label.
• Exion Fractional RF. Radiofrequency at 1 MHz delivered through a single-use tip carrying a six-by-six grid of fine needles, set to a depth of 0.5 to 4 mm on the US summary, or through a tip of 32 or 64 surface pins. This is a microneedling treatment, in the same class as Morpheus8, and it is the one that wounds the skin on purpose to trigger its healing response.

The manufacturer's marketing speaks of "AI-controlled" energy. The regulatory documents do not mention AI; the only technical description we found is a dermatologist's note that the fractional handpiece monitors tissue resistance and temperature in real time and can be used in a single pass. Treat it as a feature name.

Clinics, including our own homepage, say Exion fosters "collagen and elastin synthesis", and many add hyaluronic acid to the list. Hyaluronic acid is the one that has been measured, and only in the ways set out below. Collagen and elastin were not measured in any Exion study we found.

What the US regulator has and has not cleared

Exion has no clearance of its own. The clearances sit under the BTL-785 model names; the ones we hold in full are dated up to March 2024, and they say less than the marketing does:

• Face and Body are cleared to provide heating "for the purpose of elevating tissue temperature for selected medical conditions such as temporary relief of pain, muscle spasms, and increase in local circulation". The cellulite wording covers the Body massage attachment only. There is no US indication for wrinkles, skin laxity, tightening, lifting, fat reduction or hyaluronic acid on either handpiece. The wrinkle indication in the same family of clearances belongs to the hands-free EMface applicator, a different treatment.
• Fractional RF is cleared for "electrocoagulation and hemostasis" and for "dermatological procedures requiring fractional treatment of the skin". Above 62 millijoules per pin its use is limited to skin types I to IV, the same limit the regulator placed on Morpheus8. Acne scars, stretch marks and wrinkles are not on the label.

These are 510(k) clearances, a finding that the device is substantially equivalent to earlier ones, based for Face and Body on bench tests that the handpiece reaches and holds its temperature. "FDA approved" is the wrong word, and US clearance says nothing about UK regulatory status. We do not yet hold the manufacturer's UK conformity paperwork, so we make no UK marking claim.

Does Exion work? What the studies show

Honestly: the published evidence is three small studies, two of them confirmed as BTL-funded, and one fat study, and it supports a modest, measurable change in the skin's hyaluronic acid and in the fat layer, not the transformation the percentages suggest.

• The "224%". In a BTL-sponsored study published in 2024, twelve pigs, six per group, had four 20-minute treatments two to three days apart on a patch of abdomen. Hyaluronic acid in the skin rose 79% at one month and 224% at two months in the animals treated with radiofrequency plus targeted ultrasound; the older Exilis handpiece produced no significant change. A second pig study in 2025, using a different assay, found about a doubling. Pigs, two months, sponsor-funded.
• The human study. In a BTL-funded study published in 2025, seven adults aged 51 to 64 were split three ways: three had Exion Face, three had radiofrequency alone, one was untreated. After four full-face sessions a week or two apart, the area of skin staining for hyaluronic acid rose 49% at one month and 68% at three months in the Exion group, against about 7% to 10% with radiofrequency alone. The three Exion patients' global aesthetic improvement scores rose to 1.88 by three months. Pain was rated 2.3 out of 10 with Exion against 5.3 with radiofrequency alone. The authors list the absence of collagen and elastin measurements as a limitation; the small numbers and the three-month horizon speak for themselves.
• The fat study. In a single-arm study of 23 people published in 2026, four treatments with a handpiece matching Exion Body (radiofrequency, targeted ultrasound and surface cooling) thinned the fat layer by 16% at one month and 22.5% at three and six months on ultrasound; 71% of the patients reported an improvement. There was no comparison group, and fat reduction is not a cleared indication for the device.
• Fractional RF. We found no published peer-reviewed study of the Exion needle handpiece. A registered BTL trial of a related fractional applicator, 31 people, three visits two to five weeks apart, finished in 2021 and has posted no results. What exists is the wider literature on radiofrequency microneedling as a technique, which supports improvement in acne scars and skin texture over three sessions or so, and a 2026 meta-analysis that found fractional CO2 laser better than radiofrequency microneedling for acne scars at the cost of more pigmentation change.

So the realistic picture is this. Face and Body are comfortable heat treatments that, on the only human data, increased the skin's hyaluronic acid content, still present at the last measurement at three months, and, in one single-arm study of a matching handpiece, thinned a fat layer modestly, still present at six. In our experience patients see a smoother, plumper, more even skin over a course, with the change building to about three months after the last session. Fractional RF is a genuine resurfacing treatment with real evidence behind the technique and none yet behind this particular handpiece. Nobody can tell you how long any of it lasts, because no study has looked beyond six months.

Can radiofrequency help with jowls?

Honestly, we do not know. Some patients tell us a mildly slack jawline looks a little firmer after a course, and that is what most people mean when they say Exion Face "tightened" them; no study has measured it. What radiofrequency heating does not do is lift: Exion has no lift indication, no study has measured a jawline or jowl change, and the regulator's wording is about heating tissue. If your jowls are established, the honest options are a focused ultrasound lifting treatment (Ultherapy is cleared in the US to lift the brow, under the chin and the neck; Sofwave carries lifting clearances of its own), a thread or surgical lift, or accepting them. We offer Ultherapy and Sofwave at the same address and we will tell you at the consultation which, if any, fits.

Who Exion suits, and who it does not

Face and Body suit adults who want to improve skin quality; in our experience patients mention dullness, texture and a soft layer over the abdomen or arms, though no Exion study measured any of those. Fractional RF suits acne scarring, deeper texture change and skin that needs resurfacing rather than warming, in skin types I to IV at the energies that do the most.

There is no public BTL manual for Exion in the UK that we have been able to obtain, so the exclusion list below is the one used in common practice and in the wider radiofrequency literature, and we check it against the manufacturer's guidance at your consultation:

• Pregnancy and breastfeeding.
• A pacemaker, a defibrillator or any implanted electronic device; metal implants in or near the treated area.
• An active skin infection, an open wound or active acne in the area.
• Recent isotretinoin (Roaccutane), a history of keloid scarring, or a bleeding disorder or blood thinners, for the needle handpiece, as for any microneedling.
• Skin types V and VI for Fractional RF at higher energies, where the US label stops and where post-inflammatory pigmentation is the main risk.
• Autoimmune skin disease, with the full list to be confirmed from the manufacturer's manual.

We do not offer Botox or dermal fillers. Exion works with your own tissue, by heat or by controlled injury. If you have had injectables elsewhere, we wait two weeks after Botox and four after filler before treating the area.

What a session is like, step by step

1. Consultation. The clinician looks at your skin, agrees which handpiece and which areas, and explains what the evidence does and does not show. You get a plan and a price in writing. Consultations and follow-up reviews are free.
2. Face or Body. A return pad is placed on your body, gel on the area, and the handpiece is moved over the skin until it reaches the target temperature, then held there. It feels like a deep hot-stone massage; the human study rated it 2.3 out of 10. In our experience a face takes up to an hour, a smaller area 20 to 30 minutes. You leave pink and warm and go about your day.
3. Fractional RF. Numbing cream for about 30 minutes, then the tip is stamped across the area, each stamp delivering the needles and the current. You feel pressure, heat and a prickling. The skin is red and tight afterwards, like sunburn, with pinpoint marks that may crust; clinics describe one to three days of redness and make-up after one to three days, and it can take longer.
4. After. Face and Body: nothing to do. Fractional RF: your clinician gives written aftercare, which in outline is a gentle cleanser, no active ingredients until the skin has settled, sun protection, and no make-up for the first day.

How many sessions, when you see the result, how long it lasts

How long does Exion Face last? The honest answer is that nobody has measured it beyond three months in humans. The pig data run to two months, the human data to three, the fat data to six. Our experience is that the skin quality holds for several months and fades gradually, which is why we review you at three months and talk about maintenance then.

What Exion costs in London

Exion is priced per handpiece, per area and per session. We price Exion from a starting price per session, per area and per course, confirmed in writing at your free consultation, and we price match any comparable written quote. Consultations and follow-up reviews are free whatever you decide.

Treat a very cheap offer as a reason to ask who treats you, what is used, and what happens if something goes wrong.

Results you can check

Exion marketing often shows the manufacturer's photographs or those of overseas doctors. At your consultation the clinician shows you our own patients' photographs where we have them, with their consent, matched to your handpiece and area, and you can compare them with your own photographs at three months. We do not publish them here.

Our reviews are collected through review.clinic, and the badge on this page links to them: 4.9 out of 5 from 84 reviews in October 2026, with 100% of reviewers saying the treatment was worth it.

Exion compared with the alternatives

The sessions and downtime rows reflect published protocols and our clinical experience; the clearance and evidence rows are from the US summaries and the papers named above.

Exion Face vs EMface. They sit on the same BTL console and are often confused. EMface uses hands-free pads that heat the skin and contract the facial muscles at the same time, and it is the applicator in this family with a wrinkle indication and a 42-person study behind it. Exion Face is handheld, adds targeted ultrasound, has no muscle component and a heating indication only. We offer both at the same address; EMface for lines and tone, Exion Face for skin quality and hydration, and some patients have both.

Exion Fractional RF vs Morpheus8. Both are radiofrequency microneedling with the same US skin type limit. Morpheus8 has far more published data and a longer track record; Exion's maker claims a single pass and less pain, which is a marketing claim with no head-to-head study. The US regulator's October 2025 safety communication on radiofrequency microneedling devices as a class, which reports burns, scarring, fat loss, disfigurement and nerve damage and calls it "a medical procedure, not a cosmetic treatment", applies to both. We offer both at the same address and choose by your skin, your scars and your tolerance for downtime.

Exion vs Ultherapy and Sofwave. Different jobs. The ultrasound lifting devices are cleared to lift; Exion is cleared to heat. For a slack neck or jowls, start with the lifting conversation. For skin quality, Exion Face is a different, heating-only tool.

Side effects, and the risks nobody writes about

Face and Body: the human study reported no adverse events and no downtime in its three treated patients, and the handpiece carries a thermometer. Expect some redness and warmth afterwards. Too much heat in one place could blister, which is why the clinician keeps the handpiece moving and asks how it feels.

Fractional RF: redness, swelling, tenderness, pinpoint bleeding and crusting for one to three days are expected; some clinics quote up to five. Less common are post-inflammatory darkening of the skin, especially in darker skin types and the reason for the label limit, grid marks that fade over weeks, cold sore reactivation, infection, and acne flares. Reported across the radiofrequency microneedling class, in the US regulator's October 2025 communication and in published analyses of its adverse event reports: burns, scarring, disfigurement, loss of fat under the skin, and nerve damage. Nobody can give you a rate; the clinician's training, conservative settings and honest patient selection are what reduce it.

Be wary of three phrases: "safe for all skin types" for the needle handpiece, which the label contradicts; "no downtime" for a treatment that puts a grid of needles into your skin; and "clinically proven" without a sentence saying proven on whom, in what, and for how long.

How to choose an Exion clinic in London

• Ask which handpiece and why. Face, Body and Fractional RF are three different treatments. A clinic that sells "Exion" without saying which has not examined you.
• Ask who holds the handpiece and who supervises. Ours is a doctor-led team, and this guide is reviewed by Dr Marie Duggan, GMC 7488383; the clinic is CQC registered.
• Ask whether the tip is single-use. The Fractional RF needle tips are, by label.
• Ask for the plan in sessions, areas and pounds, in writing.
• Ask for the exclusions before you sign, and if you have darker skin and want the needle handpiece, ask what energy they use and what the label says.
• Ask where the photographs come from. Most are the manufacturer's.
• Ask what the percentage was measured in. If the answer is not "pigs" for 224% and "three people" for 68%, keep asking.

Aftercare

Face and Body: nothing. Moisturise, use sunscreen as you would anyway, and come to the free review at three months. Fractional RF: follow the written sheet your clinician gives you; in outline, cleanse gently, no retinoids, acids or exfoliants until the redness has gone, sun protection every day, no make-up on the first day, in our experience no swimming, saunas or heavy exercise for a couple of days, and tell us about any blistering, spreading redness, a cold sore or a patch of skin that darkens rather than fades.

Frequently asked questions