How to choose a XERF handpiece — dividing i05 · i10 · E40 · E60 by area
After “How many shots?”, the question we hear most often at XERF consultations is “Which tip will you use?” XERF has four handpieces (effectors) of different sizes, and Miso Clinic has all four. This article sets out the published specifications of each tip, how to read shot counts, and the fact that there are not yet confirmed data on differences in effect by tip size.
The short answer
Choosing a XERF handpiece means picking, from four effectors of different sizes (i05 · i10 · E40 · E60), the one that makes even contact with the width and curvature of the area being treated. The manufacturer’s published specifications 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 shot counts are the sealed allowance of each tip, not a recommended number. No human study comparing XERF tips with one another was found, so we do not present “a big tip goes deeper” or “a small tip is stronger” as an effect. Miso Clinic (4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea; +82-53-428-2700) keeps all four and uses i05 around the eyes, E40 · E60 on broad areas of the face and i10 on narrow areas (clinical judgement).
How many XERF handpieces (effectors) are there?
The manufacturer has published four effectors. All are single-use, and the number of shots each tip can deliver is sealed into it.
| Effector | Stated size | Sealed shots | Where Miso Clinic mainly uses it (clinical judgement) |
|---|---|---|---|
| i05 | 5 × 10 mm (50 mm²) | 400 shots | Around the eyes — XERF with this tip is called Eye XERF |
| i10 | 10 × 10 mm | 300 shots | Narrow, curved areas such as around the mouth · beside the nose |
| E40 | 20 × 20 mm | 600 shots | Broad areas of the face such as the cheeks · jawline |
| E60 | 20 × 30 mm | 600 shots | Broad areas of the face, lower face |
Eye XERF is not a different machine but XERF with the i05 effector. The difference is set out in How XERF and Eye XERF differ and Is Eye XERF a different machine?.
Is the stated tip size the area current actually flows through?
We could not confirm it. The electrode pattern dimensions in the 510(k) summary submitted to the US FDA (K251327) differ from the manufacturer’s figures. For example, the 60 tip is listed as 27.6 × 17.6 mm, while the manufacturer states E60 as 20 × 30 mm.
This appears to be the difference between outer dimensions and electrode pattern dimensions, but which is the true conducting area could not be confirmed from public material. So please read the sizes in this article as the manufacturer’s stated figures. Calculating areas and comparing tips as “so many times wider” calls for the same caution.
Does a big tip go deeper, and a small tip hit harder?
That the same current concentrated on a smaller area heats that spot more strongly is a basic principle of electricity. But real devices adjust the output for each tip, so it does not lead straight to “small tip = stronger treatment”.
The more important fact is this. There are no confirmed data on differences in effect between XERF tip sizes. There is no human study comparing XERF tips with one another, and data comparing tip sizes on other radiofrequency devices are mixed. The XERF frequency study (Ko 2025) also did not treat tip size as a variable.
So Miso Clinic does not use figures such as “this tip reaches so many mm” in its explanations. The principle is set out in more detail in How the four EFFECTOR tips differ.
Then what is the tip chosen by?
Contact. The face is not flat, so a wide tip on a narrow, curved area lifts off on one side, and covering a broad area with a small tip alone makes even treatment difficult and takes longer (clinical judgement).
| Nature of the area | Tip chosen first | Reason |
|---|---|---|
| Thin, narrow areas such as around the eyes | i05 | Makes even contact with a narrow surface. We often design the eye area together with the face rather than separately |
| Strongly curved areas such as around the mouth · beside the nose · the chin | i10 | Easier to keep contact along the curve |
| Broad areas such as the cheeks · jawline · lower face | E40 · E60 | Covers a broad surface evenly |
Using two or three tips in one session is more common than using a single tip. So asking “which tip on which area” is more accurate than “which tip”.
Which tips, and how many shots, were used in the studies?
| Study | Subjects · sessions | Tip combination · amount | Design |
|---|---|---|---|
| Weiss 2026 | 39 people · 2 sessions · 90 days | E60 alone, mean 568.8 shots · 56.4 kJ | Manufacturer supported, no control group |
| Erlich 2026 | 16 people · 1 session · 3 months | E60 300 + E10 200 + E5 100 shots, lower face 24–36 kJ | Retrospective, no control group |
| Hwang 2025 | 20 women · 1 session · 12 weeks | The tip combination is not carried over in this article | No control group |
Even among “XERF” studies, one used a single wide tip and another mixed three tips. So the figure “so many XERF shots” cannot be compared with another clinic’s figure unless the tip combination and number of sessions are stated with it. Shot counts are set out in How many XERF shots are right.
Do all the sealed shots have to be used?
No. The 400 · 300 · 600 shots written on a tip are the sealed allowance that tip can deliver, not a recommendation to fire that many. Miso Clinic’s end point is not filling a shot count but reaching an appropriate heat sensation in each area (clinical judgement).
Tips are single-use, so leftover shots cannot be used in the next session. That is why choosing tips to fit the area and surface from the start matters. If it feels hot during treatment, please say so rather than putting up with it. That signal is what we use to adjust the output. Blocking pain signals with heavy anaesthesia was pointed out as a risk factor for fat atrophy in data on older devices (Narins 2006).
What should I ask about handpieces at the consultation?
- Which tip on which area — “so many XERF shots” alone does not tell you whether it is the same treatment.
- Whether the eye area is included, and if so, whether i05 is used continuously with the face.
- Whether the end point is a shot count or heat sensation by area.
- Whether the design is meant to finish in this one session or was planned in parts — continued in XERF interval and number of sessions.
- Whether the concern suits XERF — if hollow cheeks · fat are the main cause, the approach changes before the tip does.
The full list of questions for a XERF consultation is in What to check at a XERF consultation, and the full map of XERF is in XERF lifting in Daegu: which skin it suits.
XERF handpieces: frequently asked questions
How many XERF handpieces are there?
The manufacturer has published four effectors: i05 (5x10 mm, 400 shots), i10 (10x10 mm, 300 shots), E40 (20x20 mm, 600 shots) and E60 (20x30 mm, 600 shots). Miso Clinic has all four.
Does a bigger tip work better?
There are no confirmed data on differences in effect by XERF tip size. There is no human study comparing XERF tips with one another, and data from other devices are mixed. So we choose by even contact with the area.
Is Eye XERF a different machine?
No. Eye XERF is XERF with the i05 effector. Miso Clinic uses i05 around the eyes and often designs the eye area together with the face rather than separately. This is clinical judgement.
With a 600-shot tip, are all 600 shots fired?
No. A tip's shot count is its sealed allowance, not a recommended number. Miso Clinic finishes each area when it reaches an appropriate heat sensation.
Is 300 XERF shots elsewhere the same amount as here?
It is the same amount when the tips and areas are the same. In the studies, too, one used E60 alone and another mixed three tips, so the tip combination and number of sessions have to be looked at together for a comparison.
Where can I have a XERF handpiece 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.
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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). In Korea it is approved in the general-purpose electrosurgical unit class; its advertising pre-screening mark is “General-purpose electrosurgical unit combination-2024-16-054”.
- Two ways of stating XERF tip dimensions — the electrode pattern dimensions in US FDA 510(k) summary K251327 differ from the manufacturer’s figures (for example, the 60 tip is 27.6 × 17.6 mm, while the manufacturer states E60 as 20 × 30 mm). This appears to be the difference between outer dimensions and conducting pattern dimensions, but we could not confirm which is the true conducting area. No human study comparing XERF tips with one another was found.
- 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 approved in the general-purpose electrosurgical unit class.
- Three XERF human studies — Hwang JK, Medical Lasers 2025;14(1):23–30 (20 people · one session · 12 weeks) · Weiss RA et al., Cureus 2026;18(3):e104546, PMID 41930066 (39 people · two sessions · 90 days, manufacturer supported) · Erlich G et al., Lasers Med Sci 2026;41(1), PMID 42611100 (retrospective, 16 people · one session · 3 months). None of the three has a control group.
- XERF heating by frequency — Ko K et al., Lasers Med Sci 2025, PMID 41315066. Computer simulation · porcine tissue. 2 MHz heated the fat layer broadly and deeply; 6.78 MHz heated locally along the fibrous septa. Most authors work for the manufacturer, and it is not a human study.
- Fat atrophy — Narins RS et al., Dermatol Surg 2006;32:115–124. Appears at 1–4 months (mean 2 months), about 4 per 10,000 treatments. Notes that heavy anaesthesia blocks pain feedback.
- Evidence for comparing radiofrequency 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.
- 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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