What Actually Happens During a Two-Hour XERF Session

The appointment is two hours, and the number surprises people who have looked up the device beforehand: about 30 minutes of topical numbing, then 90 minutes of radiofrequency. The treatment itself contracts existing collagen immediately, and new collagen keeps building for the following three months. One session, $1,500, reassessed at the three-month mark.

Before you arrive

The first fifteen minutes are not on the device at all. Alla assesses laxity along the jaw, neck and cheeks and decides whether XERF, Virtue RF, or a combination of the two fits what you are actually dealing with. This matters because XERF treats laxity — skin that has slackened — not lost volume or surface texture, and starting with the wrong problem is the most common reason anyone is disappointed with a radiofrequency result.

The first 30 minutes: numbing

XERF is a monopolar radiofrequency device made by Lutronic Corporation, FDA-cleared in August 2025 (510(k) K251327) as an electrosurgical device. According to the manufacturer, it can be used without numbing. At SkinScience NY, full topical numbing is applied for comfort before every session regardless.

The 90 minutes of treatment

The device delivers two frequencies — 6.78 MHz and 2 MHz — through a handpiece moved across the treatment area, while a return pad on your back completes the circuit. The energy heats the deeper layers of skin: existing collagen contracts on contact, and the heat also triggers new collagen and elastin to form over the following weeks. Most people describe the sensation as warm, not sharp, which is consistent with what a small published study of the device reported: a mean pain score of 4.3 out of 10 across sixteen patients, most of whom were not numbed at all.

The 24 to 48 hours after

Redness and warmth for a day or two is the extent of it — nothing that stops you going back to work, and nothing that needs to be planned around the way a surgical recovery would be.

• Redness and warmth for 24–48 hours
• SPF 30+ daily, no exceptions, for two weeks
• No retinoids or acids for five days
• Hydrate — collagen needs water to build

Weeks 4 to 12

This is where the actual change happens. The contraction from the appointment itself is real but modest; the result people notice is the new collagen laid down over the following weeks, which is why judging XERF at two weeks — the way a lot of before-and-after photography does — flatters nothing. The three-month mark is when this practice reassesses, and it is the point the published study used too.

What this session is not

It is not a facelift, and it is not marketed as one. Past a certain point of skin laxity, radiofrequency cannot do what surgery does, and the honest answer at the assessment is a referral to a surgeon rather than a treatment plan that will not hold. XERF's own published evidence is for mild-to-moderate laxity in the brow and midface — not advanced sagging.

Common questions

This guide is general information, not medical advice, and does not replace an in-person assessment. Treatments described are performed by Alla Yusim, RN, MSN, FNP at Skin in Focus, LLC, 7819 Bay Parkway, Brooklyn, NY 11214.