XERF Dual-Frequency Monopolar RF System

Multi-Depth RF Skin Tightening with 6.78 MHz and 2 MHz

XERF is a non-invasive monopolar radiofrequency system designed to deliver controlled thermal energy across multiple tissue depths.

Door te combineren 6.78 MHz and 2 MHz RF frequencies, XERF provides three selectable thermal diffusion modes—Shallow, Middle, and Deep—allowing practitioners to adapt treatment according to tissue thickness, anatomical area, and individual skin characteristics.

With real-time impedance synchronization, adjustable RF output, surface-temperature monitoring, Wave Fit Pulse technology, and three-level ICD cooling, XERF supports precise energy delivery while helping improve treatment comfort and epidermal protection.

Belangrijkste kenmerken

• Dual-frequency monopolar RF: 6.78 MHz and 2 MHz
• Shallow, Middle, and Deep treatment modes
• Ten adjustable RF output levels
• Real-time impedance synchronization
• Wave Fit multi-pulse energy delivery
• Three-level ICD cooling
• Surface-temperature monitoring
• Four Effector sizes
• Niet-invasieve behandeling
• Minimal or no significant downtime

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Why Skin Becomes Loose

Skin firmness and elasticity depend on an organized extracellular matrix containing collagen, elastin, fibroblasts, and other structural components.

With age and environmental exposure, the skin gradually experiences:

• Reduced Type I and Type III collagen
• Fragmentation of existing collagen fibres
• Decreased elastin organization
• Lower fibroblast activity
• Reduced extracellular matrix renewal
• Changes in subcutaneous tissue support
• Progressive weakening of facial contours

These changes can lead to:

• Fijne lijntjes en rimpels
• Reduced skin elasticity
• Sagging cheeks
• Loss of jawline definition
• Loose skin around the face and neck
• Changes in facial volume and tissue support

Effective skin-tightening treatments should therefore address more than the visible surface. Controlled energy must be delivered into the appropriate tissue depths to initiate collagen contraction and longer-term tissue remodelling.

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Why Monopolar RF?

Monopolar radiofrequency delivers electrical energy from the treatment electrode through the tissue toward a return electrode.

As RF energy passes through tissue, electrical resistance converts the energy into controlled heat.

The RF Tissue-Remodelling Process

Monopolar RF Energy

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Electrical Resistance within Tissue

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Controlled Thermal Energy

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Immediate Collagen Fibre Contraction

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Fibroblast -activering

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Collagen and Elastin Remodelling

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Progressive Improvement in Skin Firmness

The controlled thermal response can cause existing collagen fibres to contract while stimulating the biological processes involved in collagen renewal and reorganization.

Some patients may notice an initial feeling of firmness after treatment. Further improvements may develop gradually as collagen remodelling continues over the following weeks and months.

Results vary according to individual skin condition, treatment area, selected parameters, number of shots, and treatment plan.

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Why Dual-Frequency RF?

Traditional monopolar RF platforms commonly operate at a single frequency, creating a relatively fixed thermal profile.

However, facial and body anatomy is not uniform. The forehead, cheeks, jawline, neck, abdomen, and thighs differ in:

• Skin thickness
• Connective tissue density
• Subcutaneous fat distribution
• Surface contours
• Electrical impedance
• Required treatment depth

XERF combines 6.78 MHz and 2 MHz monopolar RF to provide greater flexibility in the distribution of thermal energy.

The practitioner can select Shallow, Middle, or Deep mode based on the treatment area and desired degree of thermal diffusion.

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Why 6.78 MHz?

The 6.78 MHz frequency is used in both Shallow and Middle modes.

By changing the system parameters, XERF can use the same frequency to create different degrees of thermal diffusion.

Shallow Mode

Shallow mode applies 6.78 MHz using parameters designed to produce the lowest degree of thermal diffusion among the three modes.

It may be selected for:

• Voorhoofd
• Periorbital region
• Areas around the mouth
• Narrow facial areas
• Relatively thin tissue

Treatment objectives may include:

• Supporting dermal collagen remodelling
• Improving the appearance of fine lines
• Enhancing superficial skin firmness
• Refining skin texture

Middle Mode

Middle mode also applies 6.78 MHz but uses parameters designed to create moderate thermal diffusion.

It may be selected for:

• Wangen
• Lower face
• Nek
• Areas with moderate tissue thickness
• General facial tightening

Treatment objectives may include:

• Improving skin elasticity
• Supporting facial contour definition
• Addressing mild to moderate skin laxity
• Creating more comprehensive dermal heating

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Why Add 2 MHz?

Lower-frequency RF can create a broader and deeper thermal field.

In XERF Deep mode, 6.78 MHz and 2 MHz are delivered sequentially, producing the deepest thermal diffusion of the three selectable modes.

Deep Mode

Deep mode may be selected for:

• Lower face
• Kaaklijn
• Submental area
• Areas with thicker subcutaneous tissue
• Deeper structural tightening objectives

Official histological research cited by Lutronic reported collagen changes extending from the dermis through deeper subcutaneous tissue toward the fascial or SMAS region following combined 6.78 MHz and 2 MHz RF application.

The treatment objective is not simply to heat a single layer, but to create a controlled multi-depth thermal response according to the patient’s anatomy.

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Three Depths, One Personalized Treatment

XERF allows the practitioner to combine three thermal diffusion modes within one treatment plan.

Treatment mode	RF -frequentie	Thermal diffusion	Typical treatment consideration
Oppervlakkig	6.78 MHz	Lowest thermal diffusion	Thin, narrow or delicate areas
Middle	6.78 MHz	Moderate thermal diffusion	General facial and neck treatment
Diep	6.78 MHz followed by 2 MHz	Deepest thermal diffusion	Thicker tissue and deeper structural support

The appropriate mode should be selected by a trained practitioner following an assessment of:

• Treatment area
• Tissue thickness
• Huidlaxiteit
• Patient comfort
• Clinical objective
• Previous treatments
• Relevant medical history

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Wave Fit Pulse Technology

Controlled Energy Delivery with Coordinated Cooling

The effectiveness of monopolar RF depends not only on peak energy, but also on how that energy is distributed and maintained within the tissue.

Traditional fixed-pulse systems may deliver energy through a smaller number of concentrated pulses, potentially producing a rapid increase in temperature and greater discomfort.

XERF’s Wave Fit Pulse technology distributes RF energy across multiple controlled sub-pulses. Depending on the selected treatment setting, energy may be divided into up to 12 pulses.

ICD cooling is coordinated with the pulse sequence to support:

• A more gradual temperature increase
• Controlled thermal accumulation
• Improved epidermal protection
• More stable energy delivery
• Greater treatment comfort

The system adapts pulse delivery according to the selected RF energy and treatment parameters, helping maintain a balance between heating and cooling.

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Three-Level ICD Cooling

XERF incorporates an Integrated Cryogen Delivery cooling system at the treatment tip.

The ICD system uses controlled refrigerant-gas delivery to cool the treatment surface and help protect the epidermis during RF application.

Practitioners can select three ICD cooling levels:

• ICD Level 1
• ICD Level 2
• ICD Level 3

The cooling level can be adjusted according to:

• Effector type
• Selected depth
• Energieniveau
• Treatment area
• Weefselreactie
• Patient feedback

Additional ICD cooling may be selected when greater surface protection or improved comfort is required.

The main unit also uses an internal air-cooling system. The internal system cooling and the ICD treatment-tip cooling are separate functions.

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Real-Time Impedance Synchronization

Electrical impedance differs between patients and can also vary across anatomical regions.

Before RF energy is delivered, XERF performs an impedance synchronization process by placing the Effector in contact with the treatment area.

The system evaluates the impedance of the treatment area and synchronizes RF delivery accordingly.

This supports:

• More consistent RF energy transmission
• Area-specific treatment settings
• Personalized energy delivery
• Improved treatment reproducibility
• Detection of unsuitable electrode contact

If impedance synchronization is unsuccessful, the system returns to standby and requires the process to be repeated before RF output can continue.

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Surface-Temperature and Energy Monitoring

After each RF shot, the practitioner can review important treatment information on the graphical user interface and handpiece display.

Displayed treatment data include:

• Tip-surface temperature
• Energy delivered in a single pulse
• Total accumulated delivered energy
• Aantal schoten
• Selected treatment depth
• RF output level
• ICD cooling level

This real-time information helps practitioners monitor treatment progress and make appropriate adjustments during the procedure.

Surface-temperature monitoring should be used together with continuous observation of tissue response and patient feedback.

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Intuitive Treatment Interface

The 10.1-inch LCD touchscreen provides direct access to the principal treatment parameters.

Practitioners can control:

• Shallow, Middle, or Deep mode
• RF output Level 1–10
• ICD cooling Level 1–3
• Shot interval
• Finger-switch or foot-switch activation
• Impedance synchronization
• Effector information
• Delivered pulse energy
• Accumulated energy
• Tip-surface temperature
• Treatment progress

The shot interval can be set to:

• Off
• 200 ms
• 500 ms
• 800 ms

When the interval is turned off, the system delivers one RF shot each time the finger switch or foot switch is activated.

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Four XERF Effectors

XERF offers four disposable Effector sizes for different treatment areas and tissue contours.

Effector	Contact size	Maximum RF energy	Available shot configurations	Recommended application
Effector 05	5 × 10 mm	18.7 J	600	Narrow, thin and precise areas
Effector 10	10 × 10 mm	38.1 J	600	Small or curved facial areas
Effector 40	20 × 20 mm	140 J	600	General facial and neck coverage
Effector 60	20 × 30 mm	220 J	600	Large or thicker treatment areas

Effector 05

The 5 × 10 mm Effector is designed for narrow and relatively thin treatment areas where precise contact is important.

Possible applications include:

• Areas around the eyes
• Areas around the mouth
• Narrow facial contours
• Small localized treatment zones

Effector 10

The 10 × 10 mm Effector provides controlled contact over small or curved areas.

Possible applications include:

• Forehead contours
• Lower face
• Perioral region
• Localized facial laxity

Effector 40

The 20 × 20 mm Effector is suitable for efficient general facial coverage.

Possible applications include:

• Wangen
• Voorhoofd
• Kaaklijn
• Nek

Effector 60

The 20 × 30 mm Effector provides a treatment area 1.5 times larger than a conventional 20 × 20 mm tip.

Its larger electrode surface allows more energy to be delivered over a broader area per shot.

Possible applications include:

• Broad facial areas
• Lower face
• Submental area
• Larger or thicker treatment zones

Treatment effectiveness should not be evaluated only by the number of shots. Effector size, pulse energy, accumulated delivered energy, treatment depth, and tissue characteristics must also be considered.

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Spider-Pattern Electrode Design

The XERF Effector incorporates a distinctive spider-pattern electrode.

The distributed electrode structure is designed to support more uniform energy delivery across the contact surface and reduce excessive concentration of RF energy around the edge of the electrode.

This design supports:

• More even RF distribution
• Stable tissue contact
• Reduced edge concentration
• Controlled treatment of curved areas
• Improved epidermal protection

The Effector must remain in proper contact with the skin throughout RF delivery.

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Clinical Science

Multi-Layer Collagen Response

Official research cited by Lutronic evaluated tissue changes following the application of combined 6.78 MHz and 2 MHz RF energy.

Reported histological observations included:

• Collagen fibre thickening
• Collagen fibre shortening
• Thermal changes within the dermis
• Changes extending into deeper subcutaneous tissue
• Collagen response near the deep fascial or SMAS region
• Continued tissue remodelling following treatment

The research supports the concept that combining two monopolar RF frequencies can produce a deeper and more comprehensive thermal profile than a single 6.78 MHz frequency alone.

Immediate and Progressive Response

Controlled RF heating may cause an immediate contraction of existing collagen structures.

Longer-term improvement is associated with:

• Activering van fibroblasten
• Neocollagenese
• Collagen reorganization
• Gradual improvement in tissue density
• Progressive contour refinement

Improvements may continue to develop after treatment as the tissue-remodelling process progresses.

No specific result can be guaranteed, and individual responses vary.

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Behandelingsgebieden

XERF may be used by qualified practitioners to address suitable facial and neck areas, including:

• Voorhoofd
• Periorbital area
• Wangen
• Nasolabial region
• Perioral area
• Lower face
• Kaaklijn
• Kaken
• Submental area
• Nek

Depending on the local regulatory status, available Effectors and authorized indications, larger treatment areas may also be considered.

The practitioner should select the Effector, depth, output level and cooling setting according to the individual treatment area.

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Treatment Objectives

XERF may support improvements in the appearance of:

• Milde tot matige huidlaxiteit
• Reduced facial definition
• Loose skin around the jawline
• Sagging cheeks
• Fijne lijntjes
• Rimpels
• Reduced skin elasticity
• Uneven skin firmness
• Loose skin around the neck
• Age-related changes in facial contours

XERF is not a substitute for surgery and does not produce surgical facelift results.

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Who May Be Suitable for XERF?

XERF may be considered for adults who:

• Have mild to moderate skin laxity
• Want non-invasive skin tightening
• Prefer minimal or no significant downtime
• Want to improve facial contour definition
• Are concerned about loose skin around the face or neck
• Want a treatment that can be adapted to different tissue depths
• Prefer a treatment designed to reduce heat-related discomfort
• Want to incorporate RF treatment into an ongoing skin-maintenance plan

A professional consultation is required to determine whether the treatment is appropriate.

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XERF Treatment Process

1. Consultation

Before treatment, the practitioner evaluates:

• Skin condition
• Degree of laxity
• Tissue thickness
• Behandelingsdoelen
• Medical history
• Previous procedures
• Contra-indicaties
• Expected treatment response

Clinical photographs may be taken for treatment planning and follow-up comparison.

2. Skin Preparation

The treatment area is cleaned and all relevant accessories are checked.

A patient return pad is connected and positioned according to the operator’s manual.

A thin layer of ultrasound coupling gel is applied to the treatment area. RF treatment must not be performed on dry tissue without the required coupling gel.

3. Parameter Selection

The practitioner selects:

• Effector size
• Shallow, Middle, or Deep mode
• RF output level
• ICD cooling level
• Shot interval
• Activation method

Parameters must be adjusted according to the anatomical area, tissue thickness and patient feedback.

4. Impedance Synchronization

The Effector is placed in contact with the treatment area and the impedance synchronization process is completed.

RF output cannot proceed until successful synchronization has been confirmed.

5. RF Energy Delivery

The practitioner maintains full contact between the Effector and the skin and activates RF delivery through the handpiece switch or foot switch.

During treatment, the practitioner monitors:

• Patient comfort
• Skin response
• Surface temperature
• Pulse energy
• Accumulated energy
• Electrode contact
• Treatment symmetry

6. Post-Treatment Assessment

After treatment, the coupling gel is removed and the skin is evaluated.

Temporary warmth, redness, mild swelling or sensitivity may occur. These reactions are generally transient but should be monitored according to professional protocols.

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Behandeltijd

Treatment time depends on:

• Treatment area
• Effector size
• Number of shots
• Selected depth
• Energieniveau
• Individual treatment plan

A typical facial treatment may take approximately 15–30 minutes, although larger or combined treatment areas may require additional time.

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Does XERF Require Anesthesia?

XERF is designed to balance RF energy delivery with coordinated ICD cooling.

Many treatments can be performed without anesthesia. Patients generally experience a warm sensation during RF delivery.

Sensitivity varies between individuals, and the practitioner should assess patient comfort throughout the procedure. The use of topical anesthesia should follow the treatment protocol and applicable clinical requirements.

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Downtime and Aftercare

XERF is non-invasive and generally involves minimal or no significant downtime.

Most patients can return to normal daily activities shortly after treatment.

Possible temporary responses include:

• Roodheid
• Warmth
• Mild swelling
• Tenderness
• Temporary sensitivity

General aftercare may include:

• Avoiding excessive heat immediately after treatment
• Avoiding aggressive exfoliation until the skin feels normal
• Applying gentle skincare products
• Using broad-spectrum sunscreen
• Following the practitioner’s individual instructions

Makeup may generally be applied once the skin is comfortable and there is no significant irritation.

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XERF vs Traditional Single-Frequency Monopolar RF

Functie	Traditional single-frequency RF	XERF dual-frequency RF
RF -frequentie	Usually one fixed frequency	6.78 MHz and 2 MHz
Depth selection	Relatively fixed thermal profile	Shallow, Middle and Deep modes
Deep mode	Limited by single-frequency delivery	Sequential 6.78 MHz and 2 MHz
Energie levering	May use a fixed pulse structure	Wave Fit multi-pulse delivery
Koeling	Depends on the platform	Three-level ICD cooling
Impedance feedback	Depends on the platform	Impedance synchronization
Temperature monitoring	Depends on the platform	Tip-surface temperature display
Output adjustment	Platform dependent	Ten output levels
Treatment tips	Limited or fixed sizes	Four Effector sizes
Treatment customization	More limited	Area- and tissue-specific selection

The clinical performance of any RF treatment depends on the system configuration, operator technique, selected parameters and individual patient characteristics.

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Technische specificaties

Specificatie	XERF
RF type	Monopolaire RF
Frequencies	2 MHz and 6.78 MHz
Maximum RF output at rated load	2 MHz: 150 W @ 200 Ω
	6.78 MHz: 140 W @ 200 Ω
Maximum RF output at reference load	2 MHz: 129 W @ 100 Ω
	6.78 MHz: 125 W @ 100 Ω
RF output levels	Level 1–10
Treatment depths	Shallow / Middle / Deep
Shot intervals	Off / 200 / 500 / 800 ms
ICD cooling	Level 1–3
System cooling	Luchtkoeling
User interface	10.1-inch LCD touchscreen
Afmetingen	389 mm W × 856.4 mm L × 1604.1 mm H
Gewicht	47 kg
Electrical classification	Class I, Type BF applied part
Electrical rating	Single-phase AC 100–120 V, 50/60 Hz
Stroomverbruik	1 kVA
RF activation	Handpiece finger switch or foot switch
Treatment electrode	Disposable XERF Effector
Patient circuit	Patient return pad

Specifications may vary according to the market, device version and regulatory configuration.

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Veelgestelde vragen

What is XERF?

XERF is a non-invasive monopolar RF system that combines 6.78 MHz and 2 MHz frequencies to create Shallow, Middle and Deep thermal diffusion modes.

How is XERF different from conventional monopolar RF?

Conventional platforms commonly use one RF frequency. XERF uses 6.78 MHz and 2 MHz, allowing the practitioner to select different thermal diffusion depths according to the treatment area and tissue characteristics.

How does Deep mode work?

Deep mode delivers 6.78 MHz and 2 MHz sequentially, creating the deepest thermal diffusion of the three available modes.

Does XERF reach the SMAS?

Official histological research cited by Lutronic reported collagen changes extending toward the deep fascial or SMAS region after combined 6.78 MHz and 2 MHz RF application. Actual energy distribution depends on the selected parameters and individual tissue characteristics.

Is XERF painful?

Patients generally experience warmth during treatment. Wave Fit Pulse and ICD cooling are designed to reduce discomfort and control surface heating. Individual sensitivity varies.

Is anesthesia required?

Many treatments can be performed without anesthesia. The practitioner should determine the appropriate comfort-management approach for each patient.

How long does treatment take?

A typical treatment takes approximately 15–30 minutes. Treatment time varies according to the area and number of shots.

Is er downtime?

XERF is non-invasive and generally requires minimal or no significant downtime. Temporary redness, warmth, swelling or sensitivity may occur.

When can results be seen?

Some patients may notice early firmness following treatment. Progressive improvement may develop over the following weeks and months as collagen remodelling continues.

How many treatments are required?

The appropriate number of treatments depends on skin condition, degree of laxity, treatment area and clinical objectives. A qualified practitioner should recommend an individualized treatment plan.

Which Effector should be used?

Effector selection depends on the size, contour and thickness of the treatment area. XERF provides 5 × 10 mm, 10 × 10 mm, 20 × 20 mm and 20 × 30 mm options.

Are 600 shots always equivalent between different RF systems?

No. Shot count alone does not determine total treatment energy. Effector size, pulse energy, depth, output level and accumulated delivered energy should also be considered.

Can patients return to daily activities after treatment?

Most patients can return to normal activities shortly after treatment, subject to their individual skin response and practitioner’s instructions.

Is XERF safe?

XERF incorporates impedance synchronization, surface-temperature monitoring, adjustable RF levels, three-level ICD cooling and system alerts to support controlled treatment. The system must be operated by appropriately trained professionals according to the operator’s manual.

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Important Safety Information

XERF must be operated by trained professionals after reviewing the patient’s medical history and suitability for treatment.

The system must not be used on patients with:

• A cardiac pacemaker
• An automatic implantable cardioverter-defibrillator
• Other implanted electrical devices

Additional contraindications, warnings and precautions in the official operator’s manual must be reviewed before treatment.