Cosmetic Dermatology
XERF: tightening skin without surgery or downtime.
XERF uses radiofrequency energy delivered at two tissue depths to heat the deeper layers of skin, stimulating collagen remodeling and gradual tightening — with no incisions and essentially no downtime.
Candidacy
What it’s good for
- Early or mild laxity along the jawline, cheeks and neck
- Softening of facial contour that has changed gradually with age
- Patients who want improvement without surgery or recovery time
- Skin quality and firmness as part of a longer-term maintenance plan
- All skin types, because radiofrequency does not target pigment
How it works
The mechanism, plainly
Radiofrequency energy heats tissue in a controlled way below the skin surface. That thermal signal contracts existing collagen and prompts fibroblasts to build new collagen and elastin over the following months.
XERF delivers energy at two depths in the same treatment, which allows deeper structural heating along with more superficial work on skin quality.
Because the effect is biological rather than mechanical, results develop over weeks to months rather than appearing immediately.
The visit
What to expect in the room
- Skin is cleansed and a coupling gel is applied.
- The handpiece is moved over the treatment area in passes; most patients describe a warm, deep massage-like sensation.
- Treatment usually takes 30 to 60 minutes depending on the areas treated.
- A series of sessions is typical, with about eight weeks between subsequent treatments of the same area, followed by periodic maintenance.
Patient instructions
Treatment care
XERF™ RF Patient Pre-Treatment Care Instructions
Preparing for your appointment
- Avoid exposure to the sun and tanning, including tanning beds and self-tanners, for at least 2–4 weeks prior to treatment.
- Use a broad-spectrum SPF 30+ daily on areas to be treated.
- Discontinue retinoids (Retin-A, tretinoin), glycolic/salicylic acids and other exfoliants at least 5–7 days before treatment.
- Avoid chemical peels, microdermabrasion or waxing in the treatment area for 1–2 weeks before the session.
- To maximize the effectiveness of your treatment, drink plenty of water in the 24–48 hours leading up to your appointment.
- Inform your provider of any metal implants, pacemakers or defibrillators.
- Antiviral medication may be prescribed if you have a history of cold sores.
- Hair-bearing areas within the treatment area should be shaved about 1–2 days prior to treatment.
- No makeup, lotions, deodorant or oil is allowed on the area to be treated on the day of treatment.
XERF™ RF Patient Post-Treatment Care Instructions
After your treatment
- Mild erythema (redness) and edema (swelling) may appear immediately following treatment and can persist for up to 1–3 days.
- Do not use a cooling or ice pack in the treatment area after treatment.
- A non-occlusive topical product, such as a gentle moisturizer, can be applied to soothe the treated area. Moisturize daily.
- Increased redness may result from any activity that increases blood flow or body temperature.
- Avoid cosmetics containing alcohol for at least 1 week after treatment.
- To minimize the risk of hyperpigmentation, avoid sun exposure. Apply a broad-spectrum sunscreen with SPF 50 or higher at all times throughout the treatment series.
- Contact your treatment provider with any questions or concerns.
Recovery
Downtime and aftercare
- Mild redness or warmth for a short period afterward
- Occasional temporary swelling or tenderness
- No incisions, sutures or activity restrictions in most cases
- Makeup and normal activity the same day for most patients
Honest expectations
What this treatment will not do
XERF improves firmness and contour in skin with mild to moderate laxity. It is not a facelift, and it will not produce a surgical result. If your goals require surgery to achieve, Dr. Gaul will tell you that rather than sell you a series of treatments that cannot get you there.
Cosmetic treatments are not covered by insurance. Payment is due at the time of booking, and a cosmetic consultation is $150. Pricing is subject to change, and a consultation may be required before treatment.
This page is general education and is not medical advice, diagnosis or treatment, and it does not create a physician–patient relationship. Individual circumstances differ; please discuss your own skin with a qualified clinician. If you are having a medical emergency, call 911.
Questions
Frequently asked
Some patients notice tightening within a few weeks, but collagen remodeling continues for roughly three to six months after a treatment series. Results vary between individuals.
Most treatment plans involve a short series of sessions. The number is determined at your consultation based on your skin, your anatomy and your goals.
Dr. Gaul generally recommends about eight weeks between subsequent treatments of the same area. Collagen remodeling takes time, and treating the same tissue again before it has finished that response adds cost without adding benefit.
Radiofrequency energy does not target melanin, which makes it suitable across skin types. Your suitability is confirmed at consultation.
Start with a consultation.
Whether something has changed, something has been bothering you for years, or you simply want expert guidance on keeping your skin healthy, we’re here to help.