XERF treatment

What is XERF and how does the treatment work?

XERF is a non-invasive skin-tightening treatment that uses monopolar radiofrequency energy. Unlike laser-based procedures, XERF does not rely on light energy. Instead, radiofrequency energy encounters resistance within the tissue, where it is converted into heat.

What makes XERF unique is its combination of two radiofrequency frequencies: 6.78 MHz and 2 MHz. Depending on the selected settings, energy can be delivered to superficial, intermediate, or deeper tissue layers. This allows the treatment to be tailored to the characteristics of the treatment area and the desired aesthetic outcome.

The controlled heating process can cause existing collagen fibres to contract, creating an immediate tightening effect. At the same time, it stimulates the body’s natural regenerative response, encouraging the production of new collagen and the remodelling of existing collagen structures over the following weeks and months. This process is known as collagen remodelling.

XERF also features advanced energy delivery technology, integrated cooling, and continuous skin-surface temperature monitoring. These mechanisms help protect the outer layers of the skin while allowing the heat required for collagen stimulation to develop within the deeper tissue.

It is important, however, to maintain realistic expectations. XERF is not a substitute for a surgical facelift and cannot fully correct severe skin laxity or significantly sagging tissue. The treatment is primarily intended for individuals seeking a moderate, natural-looking tightening effect and who prefer to avoid surgery.

Differences compared with other skin-tightening treatments

Unlike other skin-tightening technologies that rely on either a single radiofrequency frequency or focused ultrasound, XERF combines two monopolar radiofrequency frequencies. This dual-frequency technology allows superficial, intermediate, and deeper tissue layers to be heated in a controlled manner during the same treatment session. While all of these technologies aim to improve skin firmness through collagen stimulation, they differ in how and where energy is delivered within the tissue:

• Thermage: Also uses monopolar radiofrequency technology, but operates with a single frequency.
• Ultherapy: Utilises micro-focused ultrasound to deliver thermal energy precisely into predefined tissue layers.
• Ultraformer MPT: Uses focused ultrasound with different cartridges designed to target treatment depths ranging from 1.5 to 13 millimetres.

The most suitable treatment depends on several factors, including skin quality, the area being treated, and the desired outcome. At present, there is no conclusive evidence demonstrating a general superiority of XERF over other established skin-tightening technologies.

Who is a suitable candidate for XERF treatment?

XERF may be an appropriate option if your skin shows early to moderate signs of laxity. Common concerns that can be addressed include reduced firmness in the mid and lower face, softer facial contours, the appearance of early jowls, or a less defined jawline.

The treatment may also be suitable if you are looking to proactively support and maintain skin firmness before more pronounced ageing changes occur. Rather than age alone, the key factor is the individual condition of the skin and underlying tissue.

During a consultation, your skin quality, facial anatomy, and treatment goals are carefully assessed to determine whether XERF is the most appropriate option for achieving a natural-looking result.

Areas of application

Treatment parameters are individually tailored to each area being treated. Potential applications include:

• Forehead and brows: The treatment can help improve skin firmness in the upper face and contribute to a more open, refreshed eye appearance.
• Eye area: Fine lines and early skin laxity around the eyes may be treated, provided the individual findings are suitable.
• Cheeks: Collagen remodelling can help improve tissue firmness and create a tighter appearance in the mid-face.
• Lower face: Treatment may be considered for reduced definition and the early development of jowls.
• Jawline: The aim is to create a clearer distinction between the face and neck for improved contour definition.
• Under-chin area: Loose tissue can be tightened, helping to create a more balanced and defined facial profile.
• Neck: Radiofrequency treatment may improve skin firmness and reduce the appearance of fine lines.
• Décolletage: In suitable candidates, the skin texture can be firmed and smoothed.
• Selected body areas: Whether treatment is appropriate depends on the area, skin thickness, and the degree of tissue laxity.

Early clinical observations have also indicated potential improvements in several of these treatment areas. In a retrospective study on XERF treatment published in August 2026, 16 female patients were evaluated following a single treatment session. The authors reported improvements in skin laxity, brow and upper eyelid position, as well as overall skin quality.

However, these findings should be regarded as preliminary. Due to the small number of participants, the retrospective study design, and the absence of a controlled comparison group, larger prospective and controlled studies are required to reliably assess treatment efficacy and long-term outcomes.

Importantly, the available data do not support the conclusion that XERF is superior to other monopolar radiofrequency technologies, such as Thermage, or to alternative non-invasive skin-tightening procedures.

It is also important to understand the limitations of non-invasive treatments. In cases of more advanced skin laxity or significant excess skin, the potential for improvement may be limited. During your consultation, I will provide an honest assessment of whether XERF is likely to achieve your goals or whether an alternative treatment approach may be more appropriate for your individual situation.

Are there any side effects associated with XERF treatment?

XERF is a non-invasive procedure. Nevertheless, it is a medical aesthetic treatment that uses intensive radiofrequency energy. For this reason, careful patient selection and individually tailored treatment settings are essential. When performed by an experienced physician and with appropriate treatment parameters, serious complications are generally not expected.

Possible temporary side effects may include:

• Redness
• Mild swelling
• A sensation of warmth or tightness
• Tenderness or sensitivity to touch
• Temporary tingling or numbness
• In rare cases, minor bruising

Before treatment, I will explain all potential side effects and any individual risk factors in detail, ensuring that you are fully informed before making a decision.

XERF treatment costs

The cost of XERF treatment depends on several factors, including the areas being treated, the size of those areas, and the extent of treatment required for your individual concerns. As a general guideline, prices start at €1,500.

Following a personal consultation and assessment, I will provide you with a transparent treatment and cost plan tailored to your needs. This allows you to understand the expected costs before treatment begins.

As XERF is considered an aesthetic procedure, the costs are typically not covered by statutory or private health insurance providers.

Your personal consultation for XERF treatment

Would you like firmer skin and more defined contours without undergoing surgery? As a specialist in dermatology and aesthetic medicine with more than 30 years of experience, I offer personalised consultations on the possibilities of XERF treatment at my practice in Munich.

During your consultation, I will not only assess whether XERF is suitable for your individual situation. Together, we will also explore whether radiofrequency treatment is the most appropriate option for your skin concerns and aesthetic goals compared with other available procedures.

My priority is to provide honest, evidence-based recommendations and realistic expectations regarding the results that can be achieved.

For an initial introduction and a preliminary assessment, you are also welcome to take advantage of my video consultation service.

Disclaimer: This article is intended for general medical information only and does not replace individual medical advice, diagnosis, or treatment.