XERF or Shurink? Two different technologies
People increasingly search for the price of both in one line, as if choosing between them. They are not the same kind of treatment. Here is what differs, from how the heat is made to how the dose is counted.
The short answer
XERF is radiofrequency and Shurink is focused ultrasound. Radiofrequency passes current through tissue and heats a broad volume; focused ultrasound converges sound waves on a point and makes discrete coagulation points at a set depth. One heats a volume, the other places points. So there is no answer to which is better, and some faces need both. The units differ too, which means a XERF shot and a Shurink line cannot be lined up and compared. Miso Clinic has Density, XERF and Oligio Kiss, and does not have a Shurink device. This column therefore goes as far as what each technology heats and counts, and no further. Miso Clinic is at 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, in front of Exit 1 of Kyungpook National University Hospital station. Phone 053-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00 with no lunch break, closed Sunday and public holidays.
The heat is made in different ways
| XERF (RF) | Shurink (HIFU) | |
|---|---|---|
| Energy | Electromagnetic energy, that is current | Sound waves |
| How heat arises | Tissue resistance makes the tissue heat from within | A lens focuses the wave and heat arises at the focal point |
| Distribution of heat | A broad volume, relatively evenly | Discrete coagulation points |
| What sets the depth | The shape and arrangement of the electrodes | The focal depth of the transducer |
| Protecting the epidermis | Cooling | Heat is made below the focus so the surface is passed over |
| Unit | Shot (sealed into the tip) | Line |
The row people misread most often is the one about depth. In radiofrequency, depth is set by electrode geometry rather than by power. In focused ultrasound the transducer focal depth sets it, which is why the cartridge is changed to change depth.
The numbers cannot be compared because the units differ
Put 600 XERF shots next to 300 Shurink lines and they look comparable. They count different things.
| Unit | What it counts | Devices |
|---|---|---|
| Shot | One delivery of energy through a tip held against the skin, sealed into that tip | XERF, Density, Thermage and other radiofrequency |
| Line | One row of roughly 1 mm³ coagulation points | Shurink, Ultherapy and other focused ultrasound |
No formula converts between them, in manufacturer documents or in the literature. It is like holding a length against a weight and asking which is larger.
For scale: in the trial of Ultherapy, a device in the same focused ultrasound class, the planned dose for face and neck was 820 lines. That is worth knowing when a clinic sells 300 or 600 lines. Also, in the ultrasound market one line is often called a shot, so “Shurink 300 shots” usually means lines, not radiofrequency shots.
Which one works better
We found no study that put the two technologies against each other under the same conditions. What exists are studies that used both together. The radiofrequency evidence deserves stating plainly too: the 2026 systematic review gathered 15 studies and 1,230 people but only one randomised trial, did not perform a meta-analysis because of heterogeneity, and stated that no direct device-to-device comparison was identified.
So the sentence “XERF is better than Shurink”, or the reverse, is not supported by data at present. That both technologies now appear inside single combined devices reflects the same point: some faces need both.
How the choice is actually made
Not by ranking, but by what is being treated. The following is clinical judgement at Miso Clinic rather than a criterion drawn from a comparative trial.
- To raise elasticity and texture evenly over a broad surface the radiofrequency side, which heats a volume, is easier to plan.
- To tighten one defined depth with discrete points the focused ultrasound side, whose focus can be set to that depth, fits better.
- If the sagging is really lost volume neither device is the answer, and volume treatment should be considered.
- If you are sensitive to pain the two feel different; say so before treatment.
People often ask about having both on the same day. Combination studies exist, but the evidence on which combination in which order is better is thin. We do not stack strong heat-based treatments on the same area as a default; we separate them and plan around recovery.
Comparing the prices side by side
Searching for both prices together is common, and comparing the two numbers directly goes wrong for three reasons.
- The units differ, and shots do not convert into lines.
- The same number covers a different area with a different tip or cartridge.
- Market numbers are generally multiples of a consumable specification, not a clinically defined dose.
So rather than the number, ask which part of my face, to what depth, and over how many sessions. Fees depend on the area and the extent of treatment and are explained by phone or at the clinic.
Summary: what is established and what is not
Established
- XERF is radiofrequency and Shurink is focused ultrasound, which are different classes
- Radiofrequency heats a broad volume and focused ultrasound makes discrete coagulation points
- There is no conversion formula between shots and lines
Not established
- Any study comparing the two technologies under the same conditions
- Which combination and which order works better
- Any data on either beyond six months
XERF and Shurink: common questions
What is the difference between XERF and Shurink?
XERF is radiofrequency and heats a broad volume. Shurink is focused ultrasound and makes discrete coagulation points at a set depth. They belong to different classes.
Which is more, 600 XERF shots or 600 Shurink lines?
They cannot be compared. The two units count different things and no conversion formula exists.
A clinic listed Shurink 300 shots. Is that the same as a radiofrequency shot?
No. In focused ultrasound one line is often called a shot.
Which one gives a better result?
We found no study comparing the two under the same conditions. The 2026 systematic review also stated that no direct device-to-device comparison was identified.
Can I have XERF and Shurink together?
Combination studies exist, but the evidence on which combination is better is thin, so Miso Clinic separates strong heat-based treatments on the same area rather than stacking them.
Does Miso Clinic have Shurink?
No. Miso Clinic has Density, XERF and Oligio Kiss. This column is not a ranking of devices but an account of what each technology heats and counts.
Where can I discuss lifting treatment 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, 053-428-2700. Weekdays 11:00-19:00, Saturday 10:00-16:00, closed Sunday and public holidays.
Read next
Product pages
Product pages: XERF · Density · Oligio Kiss
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 plus 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). The shot count is sealed into the tip; it is not a recommendation for how many shots a face needs.
- The unit used by focused ultrasound (Shurink class) — Ulthera System Instructions for Use and trial documents. One line is a row of roughly 1 mm³ coagulation points, and the device displays a recommended line count per transducer. The planned dose in a five-centre Chinese trial (NCT03351335) was 820 lines for face and neck. Clinics often call one line a shot. Miso Clinic does not have a Shurink device.
- The units do not convert — a shot (sealed tip count), a line (one ultrasound pass) and a joule (total energy) count different things. No formula converting 600 shots into joules, or 30,000 J into shots, exists in manufacturer documents or in the literature. The tables here reproduce published manufacturer values and must not be read as a ranking.
- Evidence for comparing devices — Aesthetic Surgery Journal Open Forum 2026 systematic review (15 studies · 1,230 people, one randomised trial). Heterogeneity prevented meta-analysis and the review states that no direct device-to-device comparison was identified.
- The same shot count is a different dose with a different tip — nominal area is tip area × shot count, and real coverage is smaller because passes overlap by 15-30%. Yang YS et al., J Clin Aesthet Dermatol 2024;17(2):20–22 (3 versus 4 cm², 300 shots per side) · Suh DH et al., Lasers Med Sci 2025;40:530 (0.25 cm² eye tip, 225 shots per lid). Nominal area is our own calculation and appears in no paper.
- 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. That is why this column reports mechanisms and data without ranking devices.
- Fees and patient inducement — Medical Service Act Articles 45 (posting of non-covered fees), 27(3) (prohibition of inducement for profit) and 56(2) (prohibited advertising). That is why no price or discount appears in this column.
- 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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