XERF Skin Tightening
What is XERF?
How does XERF work?
Radiofrequency energy passes into the skin, where the natural resistance of the tissue converts it into controlled heat. That warmth produces two separate effects.
An immediate effect.
Existing collagen fibres contract in response to controlled heating. Some patients notice a subtle firmness on the same day, though the change is often too small to see in the mirror.
A gradual effect.
The warmth also prompts the skin’s natural repair response. Over the following weeks and months, new collagen forms and the existing structure is progressively remodelled. This is where the real change takes place, and it is not visible straight away.
Throughout the treatment, the device monitors the skin’s resistance and surface temperature continuously, adjusting delivery in response. If the surface temperature rises beyond a set threshold, energy output stops automatically.
Why does XERF use two frequencies?
What are the three treatment depths?
XERF offers three treatment depths, and not every patient requires all three. The combination is decided during consultation, based on facial structure, skin thickness, and the degree of laxity present.
Shallow — surface firming.
Focused on the dermal layer, where collagen gives the skin its firmness. This setting is considered for mild fine lines, texture, and early loss of elasticity.
Middle — tightening.
Reaches the deeper dermal and superficial tissue layers. Often the starting point for patients with mild to moderate looseness across the cheeks and lower face.
Deep — lifting and contour.
Reaches the deeper supportive tissue. Considered for more noticeable laxity, jowls, and reduced definition around the jawline and under the chin.
Most patients receive a combination of depths in a single session. For example, shallow across the forehead for fine lines, middle along the cheeks, and deep along the jawline.
Can skin be lifted without needles or injections?
Yes. XERF works entirely from the surface of the skin, using radiofrequency energy rather than anything that pierces or fills. For many of our patients, this is the whole point.
Nothing enters the skin.
There is no injection, no filler, and no substance introduced into the body. The treatment works with warmth alone.
Nothing is left behind.
No threads, no implants, no material that remains in the tissue afterwards.
Nothing is permanent.
The effect of XERF is temporary by design. Results typically last around twelve months, though this varies from person to person. After that, the skin returns gradually to its own course.
Nothing to explain.
There is no bruising and no visible mark. Most patients return to work the same afternoon, though some prefer a quiet evening afterwards.
What XERF encourages is your own collagen. The treatment does not add anything to the face. It warms the tissue in a controlled way so that the skin’s own repair process does the rest.
Who is XERF for?
XERF may be considered if you have:
– Early to moderate softening along the jawline
– Loss of firmness in the cheeks or lower face
– Fine lines and mild loss of elasticity
– Mild to moderate looseness of the neck or under the chin
– A preference for treatment that involves no needles and no downtime
XERF may not be the appropriate choice if:
– Your main concern is significant volume loss rather than laxity. XERF firms existing tissue; it does not restore lost volume.
– You have advanced sagging. Beyond a certain degree of laxity, no non-surgical treatment will meet the expectation, and we would rather tell you so at consultation.
– Your concern is largely excess fat beneath the chin. XERF is not a fat reduction treatment.
– You have an implanted pacemaker or defibrillator. Because this is a monopolar treatment, current passes through the body, and these are contraindications.
– You have metal plates, threads or implants in the treatment area, active skin infection, or are pregnant or breastfeeding. These require assessment before any decision.
Please tell your doctor about your medical history, current medication, and any previous facial procedures. Prior fillers, threads or implants do not necessarily prevent treatment, but they change how it is planned.
Is XERF suitable for Malaysian skin?
This is the question we are asked least often and think about most.
Malaysian patients are commonly Fitzpatrick skin types III to V, and with any heat-based treatment the concern is post-inflammatory hyperpigmentation — the darkening that can follow when skin is inflamed.
The published clinical study of this device was conducted entirely on Fitzpatrick III and IV subjects, which is a close match for much of our patient population. Across twenty patients followed for twelve weeks, no adverse events were recorded. That is a small study, and we present it as such, but it is directly relevant evidence rather than data borrowed from lighter skin.
Two things still matter more than the device itself.
Melasma requires individual assessment.
Melasma is common in Malaysia and can be sensitive to heat. If you have active melasma, please raise it at consultation. It does not automatically rule out treatment, but it changes how we approach it.
Settings are decided at assessment, not from a protocol sheet.
Energy appropriate for one patient is not appropriate for another.
Is XERF right for your situation?
This is one of the more common conversations we have.
A patient has already tried a non-surgical lifting treatment elsewhere. She spent a meaningful amount. She waited the three months she was told to wait. And very little changed — or something changed that she did not want.
It is worth saying plainly: when this happens, the device is often not the reason.
The assessment may not have matched the concern.
Sagging, volume loss, fat accumulation and muscle activity all produce a similar appearance in the mirror, and they are not the same problem. A tightening treatment applied to what is actually volume loss will disappoint, however good the machine is.
The depth may not have matched the anatomy.
Facial skin thickness varies considerably between individuals and between areas of the same face. Energy delivered at a depth that suits one patient may sit too shallow, or too deep, in another.
The settings may have been too conservative.
Treatments are sometimes delivered at low intensity, or with too few shots, to keep the session comfortable. The session passes pleasantly and achieves very little.
Or the energy may have gone somewhere unhelpful.
Some lifting treatments concentrate energy at focused points. Where that energy lands in facial fat rather than in supportive tissue, the result can be a face that looks not lifted but hollowed — particularly in patients who were already slim.
This last point matters when considering XERF. Because radiofrequency warms tissue across a broader area rather than at concentrated points, it behaves differently in this respect, and it is often considered for patients who want firmness without further loss of facial fullness.
None of which means XERF is the correct answer for everyone who has been disappointed before. It means the previous experience is worth examining before choosing anything else. At Alainn, we would rather understand what happened last time than simply offer you a different machine.
More of our patients are now arriving with the same account. They have lost twenty or thirty kilograms — through lifestyle change, or with medical support — and are pleased with their body and unsettled by their face.
XERF may help with the mild to moderate laxity that follows, by supporting collagen remodelling in the tissue that remains.
It is important to be clear about what it will not do. XERF does not replace lost facial volume, and it does not remove substantial excess skin. Where volume loss is the dominant issue, tightening alone will not produce the result you are hoping for, and a combined approach may be more appropriate.
We would rather discuss this honestly at consultation than have you spend on a treatment aimed at the wrong problem.
A growing number of our male patients ask about firmness along the jawline and under the chin, and want nothing that involves needles, bruising or recovery.
XERF suits that request. The treatment is the same; the areas of focus are usually the lower face and neck, and the emphasis tends to be on definition rather than smoothness.
There is nothing visible afterwards and nothing to explain.
Does XERF hurt?
Most patients describe the sensation as warmth that builds and then eases, followed by a cooling sensation.
No numbing cream.
XERF does not require anaesthetic cream. In the published clinical study, patients scored their discomfort as mild to moderate with no topical anaesthesia given at all.
Cooling throughout.
The treatment tip cools the skin surface continuously as energy is delivered, which is what allows the treatment to proceed comfortably without numbing.
Heat in pulses, not one burst.
The device divides each pulse into smaller micropulses. Heat accumulates gradually rather than arriving all at once, which is a large part of why the treatment is tolerable.
Thirty to sixty minutes.
Depending on the areas treated. Because no numbing time is needed beforehand, the appointment is shorter than treatments that require a wait.
Some areas are felt more than others. The skin over the cheekbones, where there is less padding, is usually the warmest part of the session. Please tell your doctor at any point if the warmth becomes uncomfortable — settings are adjusted continuously, and there is no benefit in enduring more heat than necessary.
What to expect after, and when results appear
Zero downtime.
You may return to your usual activities immediately. Makeup may be applied the same day.
Some patients experience mild warmth, redness or slight tenderness in the treated area. This usually settles within a day.
Same day. A subtle firmness may be noticeable, though it is gentle and not the main result.
Two to three months. The larger part of the change appears here, as new collagen forms. This is gradual and is often noticed first by other people.
Around twelve months. Results typically last around a year. Some patients choose a maintenance session; others prefer to wait and reassess.
We recommend daily sun protection afterwards, as we would for any treatment that works on collagen. Results vary between individuals.
Your consultation at Alainn
Every XERF treatment at Alainn begins with an assessment by an LCP-certified doctor.
We look at your facial structure, skin condition and the degree and pattern of laxity, and we discuss what you are hoping for. Only then do we decide whether XERF is the appropriate treatment — and sometimes the honest answer is that it is not.
The treatment areas, depths and intensity levels are chosen for you individually. A device with three depths and ten intensity levels is only as good as the assessment behind the settings.
Regarding cost. XERF is priced according to the area treated and the number of shots required, so a figure quoted without seeing your skin would not be meaningful. As a general guide, a session focused on the face is usually in the region of RM3,500 to RM8,000. We are happy to discuss it openly at consultation, or you are welcome to ask us beforehand.
By appointment only. Kuala Lumpur and Petaling Jaya.
Questions people ask
Is XERF safe for darker skin tones?
XERF is generally considered suitable across skin types when performed by a qualified doctor at appropriate settings. The published clinical study was conducted on Fitzpatrick III and IV skin — the range most common among Malaysian patients — and recorded no adverse events over twelve weeks. Suitability is confirmed at consultation.
Will XERF cause pigmentation?
Post-inflammatory hyperpigmentation is the main concern with any heat-based treatment on deeper skin tones. XERF cools the skin surface continuously during treatment and stops energy delivery automatically if surface temperature rises beyond a set threshold. No pigmentary changes were reported in the published study. Individual risk is assessed beforehand.
Can I have XERF if I have melasma?
Possibly, but it requires individual assessment. Melasma can be sensitive to heat, so please raise it during consultation so that treatment can be planned appropriately or an alternative considered.
Does XERF involve any injection?
No. XERF is delivered entirely from the surface of the skin using radiofrequency energy. Nothing is injected, nothing is implanted, and no substance is introduced into the body.
Are XERF results permanent?
No. Results typically last around twelve months, after which the skin gradually returns to its own course. Many patients consider this temporary nature an advantage.
Does XERF hurt? Do I need numbing cream?
Most patients describe warmth that builds and eases, followed by cooling. Numbing cream is not required — in the published study, patients rated discomfort as mild to moderate with no anaesthesia at all. Areas with less padding, such as over the cheekbones, are felt more.
How long does a XERF session take?
Usually thirty to sixty minutes depending on the areas treated. Because no numbing time is needed, the total appointment is shorter than treatments requiring a wait beforehand.
Is there any downtime after XERF?
No. You may resume normal activities and apply makeup the same day. Mild warmth, redness or tenderness may occur and usually settles within twenty-four hours.
How soon will I see results from XERF?
A subtle firmness may be noticeable on the same day. The substantial change develops over two to three months as new collagen forms.
How many XERF sessions will I need?
Many patients begin with one session and reassess. Some benefit from a second, usually spaced several weeks to a few months after the first. This is decided after seeing how your skin responds rather than sold as a package upfront.
How much does XERF cost in Malaysia?
As a general guide, a session focused on the face is usually in the region of RM3,500 to RM8,000. The figure depends on the areas treated, the number of shots required, the depths used, and whether a single session or a planned pair is appropriate. We will give you an exact figure at consultation, and you are welcome to ask us beforehand.
Will XERF make my face look hollow?
Hollowing is a recognised concern with treatments that concentrate energy at focused points, particularly in patients who are already slim. Radiofrequency warms tissue across a broader area, and XERF is often considered for patients who want firmness without further loss of facial fullness. Assessment beforehand remains the safeguard.
Can I have XERF if I already have fillers or threads?
Often, but it must be assessed first. Please tell your doctor about any previous facial procedures, including fillers, threads or implants, as these affect how treatment is planned.
Can XERF help with loose skin after weight loss?
It may help with mild to moderate laxity by supporting collagen remodelling. It does not replace lost facial volume or remove substantial excess skin. Where volume loss is the main issue, a combined approach may be more appropriate.
Is XERF the same as Thermage?
Both are non-invasive monopolar radiofrequency treatments. The principal difference is that most conventional devices work at a single frequency of 6.78 MHz, while XERF combines 6.78 MHz with a second frequency of 2 MHz, allowing energy to be placed at different depths.
Who should not have XERF?
XERF is not suitable for patients with an implanted pacemaker or defibrillator, as current passes through the body during monopolar treatment. Patients with metal implants or threads in the treatment area, active skin infection, or who are pregnant or breastfeeding require assessment beforehand.
Soalan Lazim
Apakah itu XERF?
XERF ialah rawatan pengencangan kulit tanpa pembedahan yang menggunakan tenaga radiofrekuensi dwi-frekuensi, iaitu 6.78 MHz dan 2 MHz. Rawatan ini memanaskan lapisan kulit yang lebih dalam secara terkawal bagi merangsang pembentukan kolagen semula jadi.
Adakah XERF menggunakan jarum atau suntikan?
Tidak. XERF dilakukan sepenuhnya dari permukaan kulit. Tiada suntikan, tiada benang, dan tiada bahan dimasukkan ke dalam badan.
Adakah XERF sakit?
Kebanyakan pesakit merasakan kehangatan yang meningkat kemudian reda, diikuti sensasi sejuk. Krim kebas tidak diperlukan. Dalam kajian klinikal yang diterbitkan, tahap ketidakselesaan direkodkan sebagai ringan hingga sederhana tanpa sebarang ubat bius.
Adakah XERF selamat untuk kulit sawo matang?
XERF secara amnya dianggap sesuai untuk pelbagai jenis kulit apabila dilakukan oleh doktor bertauliah pada tetapan yang bersesuaian. Kajian klinikal yang diterbitkan dijalankan ke atas kulit jenis Fitzpatrick III dan IV — julat yang paling hampir dengan kebanyakan pesakit di Malaysia — tanpa sebarang kesan buruk direkodkan.
Adakah XERF menyebabkan kulit menjadi gelap?
Hiperpigmentasi selepas keradangan merupakan kebimbangan utama bagi rawatan berasaskan haba. XERF menyejukkan permukaan kulit secara berterusan sepanjang rawatan dan akan menghentikan tenaga secara automatik apabila suhu permukaan melebihi paras tertentu. Penilaian individu tetap diperlukan.
Berapa lama masa rawatan XERF?
Kebiasaannya antara 30 hingga 60 minit bergantung kepada kawasan yang dirawat.
Adakah saya perlu berehat selepas rawatan?
Tidak. Anda boleh meneruskan aktiviti harian dan memakai solekan pada hari yang sama. Kemerahan atau kehangatan ringan mungkin berlaku dan biasanya reda dalam masa 24 jam.
Bilakah keputusan XERF dapat dilihat?
Kekencangan ringan mungkin dirasai pada hari yang sama. Perubahan yang lebih ketara berkembang dalam tempoh dua hingga tiga bulan apabila kolagen baharu terbentuk.
Berapa lama kesan XERF bertahan?
Kesannya biasanya bertahan sekitar dua belas bulan. Ia bersifat sementara dan tidak kekal.
Berapakah harga rawatan XERF di Malaysia?
Sebagai panduan umum, satu sesi rawatan untuk kawasan muka biasanya dalam lingkungan RM3,500 hingga RM8,000. Harga bergantung kepada kawasan yang dirawat dan jumlah tembakan yang diperlukan. Sila hubungi kami untuk maklumat lanjut.
Bolehkah saya buat XERF semasa berpuasa?
Boleh. Rawatan ini tidak melibatkan suntikan atau ubat oral, dan tidak menjejaskan puasa. Sesetengah pesakit lebih selesa membuat temujanji pada waktu petang.
Bolehkah XERF membantu kulit kendur selepas menurunkan berat badan?
XERF boleh membantu bagi kekenduran ringan hingga sederhana. Walau bagaimanapun, ia tidak menggantikan kehilangan isi muka dan tidak membuang kulit berlebihan yang banyak.
Siapa yang tidak sesuai menjalani XERF?
XERF tidak sesuai bagi pesakit yang mempunyai perentak jantung atau defibrilator. Pesakit yang mempunyai implan logam atau benang di kawasan rawatan, jangkitan kulit aktif, atau sedang hamil dan menyusu memerlukan penilaian awal.
