XERF Lifting: How Dual-Frequency RF Works on Sagging Skin

What kind of treatment is XERF lifting?

XERF delivers monopolar radiofrequency energy into the skin to generate heat. The heat acts on collagen-rich structures, inducing firmness, and over time tissue remodelling is expected to improve elasticity.

One distinguishing feature is that energy delivery can be adjusted to skin condition and treatment area: three depth settings, ten energy levels, and real-time impedance feedback that reads the skin as the handpiece moves.

Read alsoThe basic principle behind XERF is covered in “XERF lifting if you want firm, tight skin” (Korean).

Why use two frequencies?

Most monopolar RF devices use a single frequency. XERF uses two so that heat can be delivered at more than one depth. Sagging is not a change in one layer: the skin and the supporting structures beneath it change together, which is why the cheek and jawline descend as a unit.

Treating the whole face at one depth and one intensity is therefore a blunt approach. Skin thickness, fat volume and the degree of descent differ by region, and the depth and energy level should follow those differences. Multiple depth and energy settings exist precisely so a plan can be built region by region rather than applied uniformly.

A systematic review of monopolar and bipolar radiofrequency devices found measurable improvement in skin laxity on both face and body, with complications mostly mild and transient.^[1]

What concerns can XERF address?

Facial ageing is not simply a matter of one more wrinkle. Skin around the cheek loses tone and descends, the jawline blurs, and the face as a whole feels less firm — often at the same time. In these cases XERF can be considered as a way of managing the facial line through firmness and tightening.

It may be worth assessing when you notice:

• Cheeks and mid-face sitting lower than before
• A blurred jawline and a face that looks collapsed at the edges
• Reduced firmness of the skin itself
• Overall laxity together with fine wrinkles
• Wanting a non-invasive option rather than injections or incisions

Not all descent is the same, however. Whether the cause is skin laxity, fat position and volume, or facial structure changes what treatment is needed — which is why the whole face, not one region, should be examined.

In a retrospective study of 16 patients treated with a single XERF session, 3D imaging measured progressive elevation of the brow and upper eyelid — a small series, so the finding is suggestive rather than definitive.^[2]

What should be checked before treatment?

The point is not to apply one intensity to the whole face but to choose settings that fit the individual. A cheek with more fat and a thin face with little fat should not receive the same depth and energy.

After treatment, temporary redness or a feeling of heat can occur, and the degree varies between individuals. Skin condition and any previous treatments should therefore be reviewed beforehand so that energy and range can be set appropriately.

What matters in the end is not raising the shot count or the energy level but planning which area is treated at which depth.

XERF lifting: common myths and facts