If you’ve been searching for a way to restore firmer, more youthful skin without surgery, injections, or extended recovery, XERF may be exactly what you’ve been looking for. At Dr. Dana MD, we are proud to offer XERF Structural Skin Tightening — the world’s first multifrequency monopolar radiofrequency (RF) system, cleared by the FDA in August 2025.
XERF is an energy-based treatment by Cynosure Lutronic that uses advanced radiofrequency energy to gently and precisely heat the deeper layers of the skin where collagen and elastin are produced. The result is visibly tighter, smoother, more lifted skin — without a single needle or drop of numbing cream.
What Technology Does XERF Use?
XERF is the world’s first multifrequency monopolar RF device, combining two frequencies in a single treatment to target different depths of tissue simultaneously:
6.78 MHz — Upper Dermis
- Targets the upper dermal layer to remodel collagen and elastin for improved skin texture and firmness.
- Penetrates the deep structural layer (SMAS) — the same layer addressed in surgical facelifts — for true lifting and tightening.
This dual-frequency approach achieves meaningful tightening across multiple tissue depths in a single session — something no previous monopolar RF device has been able to accomplish. XERF also features Wave Fit™ pulse technology that automatically adjusts to your skin’s unique thickness, and Integrated Cryogen Delivery (ICD) to keep the skin surface comfortably cool throughout your treatment.
How Does XERF Work?
During a XERF treatment, the device’s handpiece is guided over the treatment area, delivering controlled RF energy that penetrates the skin without disrupting the surface. The energy gently heats the dermis and deeper structural layers, triggering the body’s natural collagen remodeling response.
Clinical research using histological analysis has confirmed that XERF causes a measurable increase in collagen density and thickness beginning within days of treatment, with ongoing remodeling continuing for weeks to months. Unlike ablative lasers or needling treatments, XERF requires no wound healing because the epidermis (the outer skin surface) is actively cooled and protected throughout.
What Areas Can Be Treated?
XERF is FDA-cleared for skin tightening on multiple areas of the face and body, including:
- Face and jawline (skin laxity, jowling)
- Neck and décolletage (crepey or loose skin)
- Arms (loose or crepey skin)
- Abdomen (skin laxity from weight changes or aging)
- Thighs and other body areas with loose skin
What Should Patients Expect?
The XERF experience is unlike most energy-based treatments. There is no numbing cream, no anesthesia, and no needles required. Most patients describe the sensation as a pleasant gentle warmth that is comfortable throughout the session. You can even wear makeup the same day.
- No numbing, no needles, and no downtime
- Comfortable warmth sensation — tolerable without anesthesia
- Makeup can be worn immediately following treatment
- Some patients notice early firmness immediately after treatment
- Most significant results develop over 4–12 weeks as collagen remodels
View real patient results from XERF treatments performed at Dr. Dana MD. Individual results may vary.
What Are the Results Like?
XERF delivers both immediate and lasting results. Many patients notice some degree of tightening right after their first session. Over the following weeks and months, collagen continues to build and reorganize, producing progressive improvement in skin firmness, tone, and texture. Results are enhanced with a series of treatments tailored to your individual goals.
XERF is safe for all skin types and integrates seamlessly into any skincare routine — making it a perfect complement to other treatments available at Dr. Dana MD, such as our CO2 Resurfacing Laser, RF Microneedling, or injectable treatments.
Who Is a Good Candidate for XERF?
You may be an ideal candidate for XERF if you:
- Have mild to moderate skin laxity on the face, neck, or body
- Want to delay or complement surgical options
- Are looking for a comfortable, no-downtime treatment
- Have enlarged pores, uneven texture, or early jowling
- Are looking for progressive, natural-looking improvement
XERF is suitable for all skin types and tones. Our providers will assess your unique skin profile and recommend the appropriate depth settings and number of sessions.
What Is the Social Downtime?
One of the most compelling advantages of XERF is that there is no required downtime. Unlike surgery, laser resurfacing, or injectable treatments that may leave temporary swelling or bruising, XERF requires no recovery period. You can return to your normal activities, including work and social engagements, immediately following your session.
How Much Does XERF Cost?
The cost of XERF treatment varies based on the areas being treated, the number of sessions recommended, and the depth and intensity settings customized to your skin profile. A personalized cost estimate will be provided at your consultation.
We accept plastic surgery financing through CareCredit® and Alphaeon for qualified patients, ensuring that advanced skin tightening treatments are accessible and affordable. Learn more about financing options.
Backed by Clinical Evidence
Journal of Cosmetic Dermatology, 2024A peer-reviewed preclinical study found that the XERF system’s noninvasive monopolar RF technology delivers controlled dermal heating — reaching therapeutic temperatures of 50–70°C in the dermis while keeping skin surface temperatures safely below 43°C. Histological analysis confirmed increased collagen density 30 days post-treatment with no thermal damage to the epidermis.
Skin Research & Technology, 2024A separate histological study demonstrated that XERF’s dual-frequency (6.78 + 2 MHz) approach produces significant thickening and shortening of collagen bundles, as well as measurable thickening of both superficial and deep fascial layers — evidence of structural remodeling at depths previously unattainable with traditional single-frequency monopolar RF devices.