XERF Lifting: How Dual-Frequency Monopolar Radiofrequency Works

What kind of treatment is XERF?

XERF delivers radiofrequency energy into the skin to generate heat in tissue. Monopolar radiofrequency heats skin and subcutaneous tissue and induces change in collagen structure, with remodelling following. Earlier monopolar studies have observed changes in dermal collagen density and arrangement after treatment.

What distinguishes XERF is that it can use two frequencies — 6.78MHz and 2MHz — in one device. Rather than treating the whole face on one setting, thin areas such as around the eyes can be approached differently from thicker areas such as the cheeks and jawline.

How do 6.78MHz and 2MHz differ?

The main difference is how the energy is distributed and at what depth. XERF is designed with three depth settings — shallow, middle and deep. 6.78MHz is used to heat relatively superficial layers, while 2MHz is designed to reach deeper tissue.

In practice, then, it is less about delivering more energy than about judging which depth of heat a given area needs. Whether the main concern is loss of firmness in the skin itself, or sagging of the contour including the cheeks and jawline, changes how energy is allocated.

In a multicentre study of 39 patients treated with dual-frequency monopolar radiofrequency, the improvement rate rose from 84.6% at day 30 to 92.3% at day 90 — collagen regeneration appearing over time.^[1]

Which facial concerns does it address?

XERF can be considered where skin firmness has declined or the facial line looks blurrier than before. Because skin thickness and fat volume differ across the face, an area-by-area approach is needed rather than one uniform intensity — the thin, finely controlled periorbital area, laxity of the cheeks and around the mouth, and a jawline that looks less defined than it used to.

A 2026 study of XERF's dual-frequency monopolar radiofrequency applied 6.78MHz and 2MHz to 39 patients with facial laxity according to depth by area, with clinical change observed at day 30 and day 90; it was a short study without a control group, so results cannot be generalised to every patient. A smaller retrospective study of 16 patients also observed changes in the periorbital area, firmness and texture.^[2]

What is the difference between 300 and 600 shots?

600 shots do not mean exactly twice the effect or twice the duration of 300. Shot count relates primarily to how wide an area can be treated and how finely.

300 shots can be planned around specific areas of concern such as the periorbital region, cheeks or jawline, while 600 shots allow the whole face to be divided more widely or several areas of firmness and contour to be addressed together. What matters is where your sagging is concentrated and whether whole-face treatment is needed — not simply choosing the programme with more shots.

Read alsoDuration by shot count is covered in “XERF 300 versus 600 shots: why durability differs” (Korean).

What should be checked before treatment?

With XERF, energy settings matched to skin condition and a plan by area matter more than the device name or shot count. Skin thickness, fat volume, facial shape and degree of laxity differ between people, and the periorbital area, cheeks and jawline differ in structure.

Before treatment, confirm which areas you want improved, how shots will be allocated, and at what depth and energy the treatment will run. Redness, warmth, swelling or tenderness can occur temporarily; burns or tissue damage from excessive heat are possible though uncommon, so simply raising intensity is not the answer. Recent studies report mostly transient adverse events, but large long-term data are still limited.

XERF lifting: common myths and facts