XERF lifting in Daegu: which skin does it suit? — A map of our 12 XERF columns
“Will XERF suit my skin?” XERF consultations usually begin with this question. But inside it sit several more: what XERF is, what it can and cannot do, and which layer your concern actually belongs to. Miso Clinic is a XERF ambassador selected by the manufacturer, so we are asked about XERF often; we have split those questions into twelve and written a detailed column for each. This article is the map that ties the twelve together.
The short answer
XERF is a monopolar radiofrequency device that uses two frequencies, 6.78 MHz and 2 MHz, to create heat inside the skin and aim for collagen contraction and renewal — a non-invasive lifting method. It suits faces where skin texture and firmness have declined and sagging is mild to moderate; for faces with hollow cheeks or temples, or with sagging deep enough that the skin folds, another approach may come first. The human studies of XERF number three (20, 39 and 16 people), none has a control group, and the longest follow-up is about 3 months. Miso Clinic (4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea; +82-53-428-2700) is a XERF ambassador selected by the manufacturer Cynosure Lutronic, and chooses among four effectors (i05, i10, E40, E60) according to the area.
Where should I start reading to understand XERF?
If you are looking into XERF for the first time, the device itself and how it works come first. Many people have heard the name but are unsure whether it is “a laser or ultrasound”. XERF is neither a laser nor ultrasound; it is a monopolar radiofrequency device.
| Detail column | The questions it answers |
|---|---|
| XERF in Daegu: what the device is and does | What kind of device XERF is and how it is classified in Korea, what the ambassador selection means, and what it can and cannot do |
| How XERF RF works: the two frequencies | How monopolar RF creates heat, where 6.78 MHz and 2 MHz each heat, and why cooling is needed |
In Korea it is classified as a general-purpose electrosurgical unit; the indication under the US FDA 510(k) (K251327) is electrocoagulation and haemostasis, and no clinical trials were submitted. So that it is not mistaken for “a device approved for lifting”, X1 covers this in detail.
How can I tell whether XERF suits my skin?
Whether XERF suits you is sorted first by which layer your concern belongs to, rather than by age. Skin texture and firmness are often a matter of the dermis, sagging of the structures beneath it, and hollowing of deep volume. The heat of radiofrequency tightens tissue; it does not fill volume.
| If this is your concern | Detail column |
|---|---|
| I want to see at a glance which skin XERF suits and which it suits less | Which skin types suit XERF? |
| My skin is thin and translucent | XERF for thin skin |
| My cheeks seem to have dropped, but I cannot tell if they are hollow or sagging | XERF for cheek sagging |
| My jawline has become blurred | Jawline sagging and XERF |
In a study that followed 25 people for 12 months, tissue mobility was the sole predictor of RF response, and age was not a significant predictor (Sasaki 2007; the sample is small). So we do not draw a line by age, as in “XERF from such-and-such an age” (clinical judgement).
How is XERF different from other devices?
Comparisons come up often in consultation. However, no study comparing RF devices directly with one another has been identified (systematic analysis of 15 studies · 1,230 people). So the three comparison columns set out differences in structure and published material, not “which one is better”.
| Comparison | At Miso Clinic | Detail column |
|---|---|---|
| XERF vs Density | We have both | XERF vs Density: what is the difference? |
| XERF vs Thermage | We do not have Thermage — explanation of the comparison alone | XERF vs Thermage: what is the difference? |
| XERF vs Eye XERF | The same device; the effector differs (i05) | XERF vs Eye XERF: what is the difference? |
Miso Clinic does not have Thermage. Nor do we have focused ultrasound (HIFU) devices such as Ulthera. When a comparison question about these devices comes up in consultation, we explain them from published material. To look more widely at lifting options beyond XERF and Density, see Lifting for facial sagging: which layer as well.
How is a XERF treatment designed?
Even under the same name, “XERF” becomes quite a different treatment depending on which effector is used on which area, with how many shots and over how many sessions. We have split this into two columns.
| What you want to know | Detail column |
|---|---|
| How to choose among the four effectors (i05, i10, E40, E60) | XERF handpieces (effectors): how to choose |
| How many sessions, and at what interval | XERF sessions and intervals |
According to the manufacturer’s published data, the XERF effectors are i05 5×10 mm 400 shots, i10 10×10 mm 300 shots, E40 20×20 mm 600 shots and E60 20×30 mm 600 shots. These counts are the number of shots sealed into each tip, not a recommended dose. Miso Clinic has all four; we use E40 and E60 on broad areas of the face, i10 on narrow areas and i05 around the eyes (clinical judgement). How to read shot counts is also covered in How many XERF shots are right.
What can I expect from XERF, and what is hard to expect?
Expectations and limits have a column of their own (XERF: what to expect and its limits). Here we carry over just the outline of the three human studies.
| Study | Subjects · sessions | Follow-up | Points to note |
|---|---|---|---|
| Hwang 2025 | 20 women (aged 28–63) · 1 session | 12 weeks | Blinded assessors identified the photographs 80% of the time, mean GAIS 2.75/4, pain without anaesthesia VAS 4–5 |
| Weiss 2026 | 39 people · 2 sessions | 90 days | E60 alone, mean 568.8 shots, improvement 84.6% at 30 days → 92.3% at 90 days, manufacturer support |
| Erlich 2026 | Retrospective, 16 people · 1 session | 3 months | E60 300 + E10 200 + E5 100 shots, lower face 24–36 kJ |
None of the three studies has a control group, and the longest follow-up is about 3 months. There are as yet no XERF data showing results maintained for a year or more. So we do not promise “how long it lasts”; we explain that we look at the result again at around 3 months (clinical judgement). The evidence on duration is covered in more detail in How long do XERF results last?.
What does it mean that Miso Clinic is a XERF ambassador?
Miso Clinic is a XERF ambassador selected by the XERF manufacturer, Cynosure Lutronic. The certificate is in the clinic.
- What it means — the fact that the manufacturer recognised this clinic’s adoption of XERF and its treatment experience, and selected it
- What it does not mean — a national qualification, a society certification, or an assurance of treatment results
- What it does not mean — that the clinic is better than other clinics
Korean medical law prohibits advertising that promises a treatment effect or compares a clinic with other clinics. Results depend on the condition of the face and on the treatment design. Photographs of the certificate and the effector kit are in XERF ambassador in Daegu: i05 for the eyes.
Can I see the full list of 12 XERF columns at once?
Here are the 12 columns introduced above, gathered in one table. Start with whichever line you are curious about.
| No. | Detail column | In one line |
|---|---|---|
| 1 | XERF in Daegu: what the device is and does | Monopolar RF · classified as a general-purpose electrosurgical unit · what the ambassador selection means |
| 2 | How XERF RF works: the two frequencies | Where 6.78 MHz and 2 MHz heat, and the role of cooling |
| 3 | Which skin types suit XERF? | Skin it suits · skin it suits less · when another approach fits better |
| 4 | XERF vs Density: what is the difference? | Two RF devices Miso Clinic has — differences in structure and data |
| 5 | XERF vs Thermage: what is the difference? | The same 6.78 MHz monopolar family; Miso Clinic has no Thermage |
| 6 | XERF vs Eye XERF: what is the difference? | Eye XERF is XERF used with the i05 effector |
| 7 | XERF for thin skin | What to watch for in thin skin, and the order of treatment |
| 8 | XERF for cheek sagging | Sorting sagging from hollowing first |
| 9 | Jawline sagging and XERF | Fat, sagging, muscle or bone — which is it? |
| 10 | XERF handpieces (effectors): how to choose | Choosing an effector by area, and the gap in data on effect by tip size |
| 11 | XERF sessions and intervals | Sessions in the studies, and how Miso Clinic decides on repeat treatment |
| 12 | XERF: what to expect and its limits | What has been confirmed and what has not |
XERF lifting in Daegu: frequently asked questions
Which skin does XERF suit?
We consider it first for faces where skin texture and firmness have declined and sagging is mild to moderate. For hollow cheeks or temples, filler may come first; for sagging deep enough that the skin folds, a surgical consultation may come first (clinical judgement).
Is XERF a laser?
No. XERF is a monopolar radiofrequency device that uses two frequencies, 6.78 MHz and 2 MHz. In Korea it is classified as a general-purpose electrosurgical unit.
How long do XERF results last?
The three XERF human studies all lack a control group, and the longest follow-up is about 3 months. There are as yet no XERF data showing results maintained for a year or more.
Can I have Thermage at Miso Clinic?
No. Miso Clinic has neither Thermage nor Ulthera (focused ultrasound). We answer comparison questions from published material.
Are results better at a XERF ambassador clinic?
There are no data that would allow us to say so. The ambassador selection is a fact of selection by the manufacturer Cynosure Lutronic; it is not a national qualification or an assurance of effect.
Where can I have a XERF consultation in Daegu?
Miso Clinic is at 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, in front of Exit 1 of Kyungpook National University Hospital Station. +82-53-428-2700. Weekdays 11:00–19:00, Saturdays 10:00–16:00 (no lunch break); closed Sundays and public holidays.
Read next
- XERF in Daegu: what the device is and does
- Which skin types suit XERF?
- XERF vs Density: what is the difference?
- XERF handpieces: how to choose a tip
- What to expect from XERF, and its limits
- Lifting for facial sagging: which layer
- XERF ambassador in Daegu: i05 for the eyes
- How long do XERF results last?
Product pages
Related: XERF product page
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- XERF specifications — Lutronic published data: monopolar, 6.78 MHz + 2 MHz, handpieces i05 (5×10 mm · 400 shots) · i10 (10×10 mm · 300 shots) · E40 (20×20 mm · 600 shots) · E60 (20×30 mm · 600 shots). Classified in Korea as a general-purpose electrosurgical unit; advertising marking “General-purpose electrosurgical unit combination-2024-16-054”.
- XERF US 510(k) — FDA K251327 (2025-08-11). The indication is electrocoagulation and haemostasis, and no clinical tests were submitted. In Korea the device is classified as a general-purpose electrosurgical unit.
- Three XERF human studies — Hwang JK, Medical Lasers 2025;14(1):23–30 (20 subjects · one session · 12 weeks) · Weiss RA et al., Cureus 2026;18(3):e104546, PMID 41930066 (39 subjects · two sessions · 90 days, manufacturer support) · Erlich G et al., Lasers Med Sci 2026;41(1), PMID 42611100 (retrospective, 16 subjects · one session · 3 months). None of the three has a control group.
- XERF ambassador — the manufacturer Cynosure Lutronic selected Miso Clinic as a XERF ambassador (certificate in the clinic). It is a selection by the manufacturer; it is not a national qualification, a society certification or an assurance of treatment results, and it does not mean the clinic is better than other clinics.
- Evidence for comparing RF devices — Aesthetic Surgery Journal Open Forum 2026, systematic analysis of the literature (15 studies · 1,230 people, one randomised controlled trial). It states that no direct device-to-device comparison was identified.
- Factors that predicted response — Sasaki G et al., Aesthetic Surg J 2007;27(4):376–387 (25 people, mean age 52.3, 12 months). Tissue mobility was the sole significant predictor; age was not a significant predictor. The sample is small.
- Thermage — Solta Medical, 6.78 MHz monopolar, a device registered with the US FDA. There is a large body of material, but it is largely uncontrolled observation and physician surveys, and a 2020 international Delphi consensus noted that device-specific guidance is lacking. No study compares it directly with Density or XERF. Miso Clinic has neither Thermage nor Ulthera.
- Medical advertising law — Medical Service Act of Korea, Article 56(2), which prohibits testimonial advertising, comparison with other clinics, superlative claims and advertising that guarantees or implies a guaranteed treatment effect.
- Miso Clinic practice guidance — indication criteria, site-by-site design, and the explanation and consent procedure. This is the source for every sentence marked as clinical judgement.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.
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