XERF Skin Tightening
Houston, TX
At De La Cruz Plastic Surgery in Houston, XERF offers a non-invasive way to improve early skin laxity and loss of firmness through the face and neck. Using multi-frequency radiofrequency energy, the treatment works at different tissue depths to support collagen remodeling and gradually firm areas such as the cheeks, jawline, under the chin, and neck. Dr. Emmanuel De La Cruz approaches XERF with the same attention to anatomy and proportion he brings to facial rejuvenation, looking at skin quality, facial volume, and tissue position before deciding where tightening may be useful.
XERF is a non-invasive skin tightening treatment that uses monopolar radiofrequency instead of laser energy. The device combines 6.78 MHz and 2 MHz frequencies, so it can target different layers of the skin and tissue. The controlled heat helps existing collagen contract and encourages new collagen to form over time, which can gradually make your skin feel firmer and more supported.
XERF does not use needles or break the skin. Wave Fit pulse technology controls how the energy is delivered, and built-in cooling protects the skin’s surface and keeps you comfortable as the heat works deeper. Most people do not need numbing cream, and there is usually little or no downtime after treatment.
XERF works best when loose skin is still mild. You might notice your lower face looks softer than before, your jawline is less defined, or the skin on your neck feels thinner or less firm. XERF can also help with fine texture changes and mild wrinkles that appear as collagen decreases.
XERF can’t replace lost facial volume, remove a lot of fat, or get rid of a large amount of extra skin. Skincare products can help the skin’s surface, and IPL or some laser treatments may work better for issues like pigment or redness. XERF is mainly for improving firmness, laxity, and collagen in deeper layers.
XERF uses 6.78 MHz and 2 MHz radiofrequency energy to heat tissue at different depths. The higher frequency treats the surface, while the lower frequency reaches deeper layers. This means the treatment can be adjusted for each area, rather than using the same energy everywhere.
As the tissue heats up, existing collagen tightens and the skin starts a longer remodeling process. Wave Fit pulse technology controls how the energy is delivered, and built-in cooling keeps the skin’s surface comfortable. The goal is to use the right amount of heat where it will help most, not just to use high energy.
XERF can be used on the cheeks, lower face, jawline, under the chin, and neck. The settings are adjusted based on your skin type, tissue thickness, facial volume, and the area being treated. For example, a thin cheek may need a different approach than a fuller jawline or thicker neck, so treatment depth is important.
XERF may be a good choice if your skin has started to loosen but the changes are still mild to moderate. Many people like it because they want firmer skin without needles, cuts, or the recovery time of surgery. It’s important to know that non-invasive treatments give different results than a facelift or neck lift.
The key is to figure out what is really causing the changes you notice. A softer jawline can be due to loose skin, extra fat, volume loss, facial structure, deeper tissue changes, or a mix of these. A consultation helps sort out these factors and create a treatment plan focused on your main concern.
XERF and Morpheus8 both use radiofrequency, but they work in different ways. Morpheus8 uses microneedles to deliver RF energy into the skin, which can help with texture, acne scars, or other surface issues. XERF works from the surface without needles and is mainly focused on tightening and firmness. Neither treatment is automatically better. The best choice depends on what you want to improve and how your skin should be treated.
XERF can tighten mildly loose skin, but it cannot remove a lot of extra skin or move deeper facial tissues. If you have more advanced jowling or neck laxity, a deep plane facelift or neck lift may give you a bigger improvement. Having both surgical and non-surgical options makes it easier to find the right solution for you. The goal is not to use one device for every problem, but to pick a treatment that matches the amount of aging you have.
This is a valid concern, especially for people with a lean face. XERF can send radiofrequency energy into deeper tissue, so the depth, energy level, facial volume, and treatment area all matter. Preclinical research on the dual-frequency system showed collagen and elastin remodeling without fat cell loss under the conditions studied. This means every face should not be treated the same way. A thin cheek and a fuller lower face need different approaches, and using more energy is not always better.
During a XERF treatment, you will feel repeated warmth as the radiofrequency energy is delivered, along with cooling on the skin’s surface. Most people do not need numbing cream. The treatment is not completely free of sensation, and some spots may feel briefly uncomfortable, but the cooling helps make the heat easier to handle.
Treatment starts by looking at the areas that concern you and making sure skin tightening is the right choice. A return pad is placed on your body because XERF uses monopolar RF, and the handpiece is moved over the planned areas while controlled energy is delivered under the skin.
Settings can be changed for each area based on tissue thickness, skin laxity, and how your skin responds. Since there are no needles or open skin after treatment, you do not need to worry about incision care or wound healing.
One of the main benefits of XERF is the short downtime. Since the skin’s surface is not broken, most people can get back to their normal routine soon after treatment. You might have some temporary redness, warmth, tenderness, or mild swelling, but these usually go away quickly.
Some people notice their skin feels firmer after one session, but more visible results appear as collagen remodeling continues over the next weeks and months. As new collagen forms, your skin can gradually feel firmer and look better supported, instead of changing all at once. XERF is still a new technology, so long-term clinical data are still being collected. Some people may need only one session, while others might benefit from more, depending on how much skin laxity they have, the area treated, their goals, and how they respond.
You may have temporary redness, warmth, tenderness, or swelling after XERF. Before treatment, your medical history, medications, past procedures, and other factors that could affect your treatment will be reviewed. It’s especially important to deliver energy carefully in thinner areas of the face or in people with less facial volume. The depth and settings should match the area being treated.
Dr. Emmanuel De La Cruz is a double-board-certified plastic surgeon known for an approach that combines detailed anatomical knowledge with a strong sense of proportion, balance, and restraint. His philosophy of care is centered on natural-looking results and thoughtful treatment planning rather than pushing every patient toward the same procedure.
At De La Cruz Plastic Surgery, both surgical and non-surgical options are considered within the same practice. That gives patients the benefit of a broader perspective when deciding what makes sense for their goals. Sometimes a non-invasive treatment is enough. Other times, a different approach may be more appropriate. The recommendation starts with your anatomy, your priorities, and a realistic understanding of what each option can achieve.
Care is also shaped by the practice’s emphasis on safety, physician oversight, and individualized planning. From consultation through follow-up, the goal is to help you understand your options clearly and make a decision that feels informed, measured, and right for you.
You don’t have to decide between XERF, Morpheus8, injectables, or surgery before scheduling. At your consultation at De La Cruz Plastic Surgery in Houston, your face and neck will be evaluated to see what is causing the changes you notice, whether XERF can help, and how it compares to other options. Then you can choose what works best for you.
No. XERF uses monopolar radiofrequency energy rather than laser light.
XERF has FDA 510(k) clearance as an electrosurgical unit for electrocoagulation and hemostasis. Its U.S. manufacturer describes skin tightening as an effect of soft-tissue coagulation.
Most patients feel warmth along with cooling during treatment. Sensation varies by person and treatment area, but numbing cream is generally not required.
Usually very little. Some redness, warmth, tenderness, or mild swelling can happen afterward.
Because XERF uses radiofrequency rather than targeting pigment with light, it can be considered for a broad range of skin tones. Your skin and medical history still need to be assessed first.
Results vary. Age, skin quality, treatment plan, and normal aging all affect how long improvement lasts.
It may help early or mild-to-moderate jowling when loose skin is a major part of the problem. More advanced tissue descent may need surgery.
Cost depends on the areas being treated and your treatment plan. Pricing can be discussed after an evaluation.
