As collagen and other underlying structures age, skin becomes progressively loose. You might be able to see a flatter cheek line, slight sagging skin around the face or loose skin around the neck and face.
If you are seeking to improve mild skin laxity without surgery or needles, then XERF treatment could be an option. It applies controlled radiofrequency energy to the surface to heat the tissue under the skin, without causing damage to the surface. Before recommending a procedure, at MedLinks, the skin, degree of laxity and treatment area are assessed. This will help to establish if XERF is appropriate for the concern.
XERF is a non-invasive monopolar radiofrequency treatment which gently targets heat beneath the skin surface. Two frequencies of radiofrequency energy are combined, 6.78 MHz and 2 MHz, which permits different depths of tissue.
XERF does not involve needles, as opposed to RF microneedling. The treatment handpiece remains on the skin surface, and radiofrequency energy penetrates the skin below. This is a great needle-free and non-surgical skin tightening treatment, since it is called XERF RF.
XERF is a radiofrequency device that selectively targets radiofrequency energy to collagen-rich tissues under the skin. Collagen is a protein which helps to support and maintain the firmness of skin. As skin ages, it may become lax or loose, due in part to changes in the collagen.
In the XERF skin treatment, radiofrequency energy is applied to increase the temperature in the areas being treated. This controlled heating has a beneficial effect on the existing collagen fibres and contributes to slow collagen remodelling.
Two different RF frequencies to treat at different depths in tissues. Cooling at the skin surface is also incorporated into the system to aid in heat control during treatment. XERF treatment can be used to treat a wide variety of conditions, such as:
For mild to moderate skin looseness, a skin tightening treatment called XERF might be an option. It can be used to relieve:
Some slight skin sagging in the face
Early jowling
Reduced jawline definition
The skin around the lower face that hangs down.
Mild cheek laxity
Mild neck laxity
Loss of firmness in the skin is related to age.
Skin firmness is age-dependent.
Unlike a dermal filler, XERF doesn't provide facial volume. It also will not tighten the skin in the face as a facelift would. Therefore, the level of laxity should be evaluated and the type of laxity before deciding on the treatment.

Heat is applied to the skin to impact collagen in several treatments, which are deemed non-invasive skin tightening treatments. The difference with XERF is the manner of delivery of the radiofrequency energy.
Dual-Frequency RF
XERF is a radiofrequency energy that is comprised of 6.78 MHz and 2 MHz monopolar radiofrequency energy and operates at various tissue levels.
No Needles
There are no microneedles required as the treatment is done on the skin’s surface.
Surface Cooling
The system allows for cooling to assist control of heat at the outer skin surface with the delivery of RF energy below.
Non-Surgical Treatment
No need for incision/surgical wound. This makes XERF one of the non-surgical skin tightening treatments for individuals who want a less invasive treatment.
Adults who have started to notice mild skin looseness but aren't interested in surgical treatment may want to consider XERF. It might be appropriate if you:
Have mild looseness in the face or neck
May not provide strong jawline definition
Mild jowls (slight sagging along the jawline)
Prefers a treatment without needles
Wants firmer, tighter skin over time
Prefers little to no downtime after treatment
The suitability will depend on the thickness and structure of the skin, laxity of the skin, medical history, previous treatments and treatment objectives.
The treatment starts with an evaluation of the skin and areas to be treated. The skin is treated prior to the XERF handpiece covering the area. Controlled radiofrequency energy is then transmitted through the skin surface.
The heating of the tissue may cause the subject to feel warmth. The ability to control surface cooling is crucial for temperature and treatment comfort. Based on the area, tissue depth and individual tolerance, the doctor can adjust the settings for the treatment.
The outcome of a skin tightening treatment can take time to show. A tingle/tightening sensation may be felt in some individuals. Additional changes may occur over time as collagen-rich tissue remodels.
The results may vary and are subject to the following factors:
The amount of skin that is loose
Skin quality
Age
Treatment area
Treatment settings
Individual response
Number of sessions
XERF is a non-invasive method; no surgical wounds or needles are involved. Typically, people can resume normal activities following treatment. Temporary side effects might include:
Mild redness
Warmth
Slight swelling
Tenderness
Temporary sensitivity
The effects of these may differ for different individuals. Your dermatologist will tell you what to expect after your treatment depending upon your skin type.
Some people should not receive XERF treatments for these reasons: Not all people will be able to use XERF. If you want to, then a medical assessment is very important to you. Discuss your medical history with your dermatologist and let him/her know about previous cosmetic treatments or implanted devices prior to treatment.
The first step of skin tightening treatment at MedLinks is to determine the concern, not the device. The dermatologist takes into account the quality of the skin, how lax it is, facial structure and desired outcomes before planning the procedure. MedLinks offers laser, energy-based, and nonsurgical cosmetic dermatology treatments.
Dr Pankaj Chaturvedi is an MBBS and MD in Dermatology from AIIMS New Delhi who also practises clinical and cosmetic dermatology and is a co-founder of MedLinks. Consultation can be used to identify if XERF treatment for skin tightening is appropriate or if another treatment will be more effective in meeting the concern.
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