The skin-tightening device known as Xerf, which has long been favored in South Korea, is now generating significant buzz in the United States. Even celebrity Kim Kardashian recently called it her "new fave" tightening tool earlier this month.

Expert Endorsements and Early Adoption

A Long-Time Favorite Abroad

Dr. David Kim, a board-certified dermatologist practicing in New York City, first learned about Xerf approximately two years ago during his annual visits to dermatology colleagues in Korea. He noted they were all highly enthusiastic about the technology.

After Xerf, a non-invasive radiofrequency device, launched in the U.S. market last summer, Dr. Kim met with the company. He personally tested the treatment on the "most aggressive" setting and was highly impressed by both the noticeable results and the lack of associated pain.

Rapid Adoption by US Practitioners

Upon opening his New York City practice last month, Dr. Kim immediately decided to incorporate Xerf into his service offerings. Similarly, Dr. Nina Desai, a board-certified dermatologist in Los Angeles, began offering the treatment in December.

Dr. Desai reported that after experiencing the treatment herself without anesthesia, all practitioners in her office subsequently tried Xerf. Experts confirm that initial results are visible right away, requiring no downtime or anesthetic.

Understanding the Xerf Technology

How Radiofrequency Creates Tightening

Dr. Evan Rieder, a New York City dermatologist, explains that Xerf functions as a non-invasive radiofrequency device. It converts delivered heat into energy, effectively stimulating the skin to revitalize itself and generate new collagen.

Dr. Rieder likens the process to "tricking your body into building new collagen." Xerf utilizes a monopolar mechanism, requiring a grounding pad on the patient to complete the circuit, allowing energy to reach deeper skin layers.

Unique Dual-Wavelength Targeting

Dr. Kim highlights that Xerf is unique because it employs two distinct radiofrequency wavelengths, each targeting a different facial layer. The 6.78 MHz frequency addresses more superficial skin layers.

Conversely, the 2 MHz frequency penetrates down to the superficial musculoaponeurotic system (SMAS), the connective tissue layer beneath the skin and fat used in surgical facelifts. Dr. Rieder suggests this depth capability may offer more profound tightening than other available technologies, resulting in lifted skin, particularly around the jawline, according to Dr. Kim.

Addressing Concerns: Fat Loss and Pain Levels

Concerns Over Unwanted Fat Reduction

Dr. Rieder notes that deep penetration with radiofrequency carries a theoretical risk of unwanted facial fat loss, potentially leading to sagging. However, Dr. Kim counters that this risk is more associated with radiofrequency microneedling due to its focused heating via needles.

Dr. Kim asserts that Xerf's heat is more dispersed, mitigating the fat loss concern. Dr. Desai concurs, stating, "These different depths do not target fat, so the energy actually doesn't get to the fat."

Pain Profile and Recovery

A major advantage cited by practitioners is Xerf's comparatively low pain level. Dr. Kim rates the discomfort around a 1 out of 10, noting that avoiding topical numbing speeds up appointments. Dr. Desai ranks it slightly higher at a 2 or 3 out of 10.

Both doctors acknowledge that certain areas, such as near the jawbone or ear, can have temporary "hot spots" of sensitivity, though still manageable. Patients typically experience only temporary pinkness from the heat for about 30 minutes, with no required downtime, allowing an immediate return to normal activities.

Timeline for Results and Treatment Scheduling

Immediate vs. Long-Term Effects

Patients see some immediate lifting after the procedure, which Dr. Kim sometimes demonstrates by treating only half a patient's face. Dr. Desai explains that while initial lifting occurs, the primary benefit—deep collagen building—takes four to six weeks to fully manifest.

She advises patients not to judge the treatment solely on immediate visual changes. Experts generally recommend a second session for optimal outcomes, with schedules varying between practitioners.

Treatment Frequency and Longevity

In Korea, a second session might be recommended after just one month. Dr. Desai schedules follow-ups between four and six weeks, while Dr. Kim prefers a three-month interval. The resulting skin tightening effects are generally reported to last for about one year, with the most significant improvements seen along the jawline.

Cost and Ideal Candidates for Xerf

Investment in Non-Invasive Lifting

The expected cost for a single Xerf session ranges generally between $1,500 and $3,000, depending on the practice. Dr. Desai's office charges $2,500 for the full face and neck, though costs can be lower for treating only specific areas. Both experts stress that two sessions are usually necessary to achieve the best results.

Who Benefits Most from Xerf?

Dr. Desai defines the ideal candidate as someone seeking lifting and tightening but who is not yet ready for or in need of surgery. Dr. Kim suggests this often applies to individuals in their mid-30s or 40s beginning to notice early signs of skin laxity.

It is described as an excellent entry point into non-invasive anti-aging for those developing mild jowls. Furthermore, Dr. Desai confirms Xerf is safe for skin of color, unlike some other energy-based treatments.

Cautious Optimism Regarding Long-Term Data

While Dr. Kim and Dr. Desai are pleased with early patient feedback, Dr. Rieder remains reserved about immediate widespread adoption in the U.S. Since the device only launched domestically in August, he notes that no U.S. practitioner has sufficient long-term clinical experience yet.

Dr. Rieder mentioned that initial studies using Xerf on pig skin showed "pretty compelling" initial tightening. However, he states that more clarity on patient selection and long-term outcomes will emerge over the next six to twelve months.

Despite this, Dr. Desai remains positive, emphasizing, "The beauty of this device is it’s very safe, and in the right patient, you can really do a beautiful job with it."