Sarah Jacoby is a health reporter at TODAY.
Kim Kardashian called Xerf her 'new fave' tightening device earlier this month. But, for those who follow the world of Korean beauty treatments, Xerf was already a long-time favorite. 'I heard about it for the first time about two years ago,' Dr.
David Kim, a board-certified dermatologist in New York City, tells TODAY.com. He goes to Korea every year and visits his dermatology colleagues there. They were all raving about Xerf, Kim says, and after the non-invasive radiofrequency device hit the U.S. market last summer, he decided to meet with the company. Kim got the treatment himself — on the 'most aggressive' setting, he says — and was so impressed with the results and lack of pain that when he opened his own practice in New York City last month, he knew he wanted Xerf to be among the first services he offered. Dr. Nina Desai, a board-certified dermatologist based in Los Angeles, tells TODAY.com that her office started offering the treatment in December. After getting Xerf herself without the need for anesthesia, all the practitioners in her office have gotten it now, too. Results start to show up immediately, the experts say, with no need for anesthesia or down time. So it's no wonder that the dermatologists TODAY.com spoke to are intrigued and excited about the device's potential. But, as with anything new, there are still some uncertainties about long-term results and figuring out who is likely to have the best outcomes. What Is Xerf? Xerf is a non-invasive radiofrequency device. That means it 'delivers heat and converts that into energy, which allows your skin to make new collagen and to revitalize itself,' Dr. Evan Rieder, a New York City-based dermatologist, tells TODAY.com. It's sort of like 'tricking your body into building new collagen,' Rieder says. There are bipolar radiofrequency devices and monopolar devices. Bipolar devices have two little electrodes on them and the energy bounces between those, making their effects a little more superficial, Rieder explains. When using a monopolar device, like Xerf, the patient gets a grounding pad on their back to complete the circuit, he notes, which allows them to target deeper parts of the skin. Xerf is unique in that it uses two radiofrequency wavelengths, which each target a different layer of the face, Kim says. The 6.78 MHz frequency targets more superficial layers of skin. And the 2 MHz reaches all the way to the superficial musculoaponeurotic system , which is the layer of connective tissue below your skin and fat that surgeons use in certain facelifts, Rieder explains. 'That potentially has the ability to give you more profound tightening on a deeper level than you can get with other technologies that are available on the market,' Rieder says. The end result is tighter, lifted skin, especially in areas around the jawline, Kim says. What About Fat Loss? Going that deep with a radiofrequency device poses a risk for unwanted fat loss in the face, Rieder says, leaving a patient with sagging skin. But Kim says that's more of a concern with radiofrequency microneedling procedures, which use needles to deliver the energy deeper into the skin. 'The risk for fat loss is not really there ,' he says, because the heat is more dispersed rather than 'very focused heating.' Desai agrees. 'These different depths do not target fat, so the energy actually doesn't get to the fat,' she says. 'So we're really not worried about that.' Is Xerf Painful? It doesn't feel like nothing, but it is far less painful than other options, Kim says, which is one of Xerf's big selling points. Desai puts Xerf at about a 2 or 3 out of 10. Although many people are able to tolerate it without numbing cream, 'we do offer numbing for our clients because we have some clients that are a little bit more sensitive,' she says. For Kim, it's more like a 1 out of 10 in terms of pain, he says, noting that the lack of topical numbing helps speed up the appointment. However, Desai and Kim note that there are some 'hot spots' on the face that will feel more painful than other areas. 'For me, were closer to my jaw bone and the ear area, just little areas of more sensitivity,' Desai says. 'Even with that, it was manageable.' And there's no need for downtime. A patient's skin 'may be pink for 30 minutes or so from the heat,' Kim says, 'but otherwise they can go back to their office, and it'll be completely undetectable that they did anything.' How Long Does it Take to See Results? You'll see results immediately after Xerf. In fact, Kim likes to use the device on half of his patients' faces at a time so they can see the instant difference in the mirror. 'You do get some of that immediate lifting of the tissue,' Desai explains. 'But, really, what we're doing is building deep collagen, and that happens about four to six weeks after the treatment.' That's why she encourages patients not to judge the treatment based on the immediate results. While many people notice an initial lifting, others won't. Either way, Desai says, you should see results within weeks. You should expect to get a second treatment at least a few weeks after your first, the experts say. In Korea, they often recommend the second session after just a month, Kim says, but he has his patients come back after about three months. Desai schedules her patients for their second treatment between four and six week after the first. And those results last for about a year, Kim says, with the most dramatic results around the jawline. How Much Does Xerf Cost? Generally, you should expect to pay between $1,500 and $3,000 per Xerf session, Kim says. But the exact cost will differ from office to office. Desai's office charges $2,500 per Xerf session, which covers the full face and neck. But it's a 'very customizable device,' she says, noting that the cost may be less if you're only getting certain areas treated. Keep in mind that you will need two sessions for the best results, according to Desai and Kim. Should You Try Xerf? The ideal patient for Xerf is someone who's 'looking for lifting and tightening of their skin but is not ready for surgery or doesn't need surgery,' Desai says. On average, that's likely someone in their mid-30s or 40s who is just starting to see the first signs of skin laxity, Kim explains. 'It's a great treatment for someone who wants to dabble into the anti-aging journey in a non-invasive way,' he says. It's perfect for people 'like young moms who are starting to develop those very mild, mini-jowls,' Kim says, 'When you do treatments like Xerf and top it off with a little bit of filler, it's really kind of a game-changer.' But, Desai says, 'in my practice, I really haven't met the wrong client for it yet.' And Xerf is safe on skin of color, she notes, unlike some other treatments that people with darker skin tones may need to approach with more caution. For her, it's all about setting the right expectations. 'If someone wants a tremendous amount of skin gone, then that becomes a surgical candidate,' she says. 'That's just the conversation that needs to be had with each individual person.' While Kim and Desai were among the first practitioners in the U.S. to offer Xerf, Rieder isn't quite ready to add it to his office. Unless they were previously practicing in Korea, 'no one in the United States has enough clinical practice with this yet because it only hit the market in August,' he says. 'So, at best, someone that did a lot of procedures in their first month is just finding out what happens at the six-month mark.' The initial results from published studies of Xerf used on pig skin have been 'actually pretty compelling in that they showed an initial tightening, which is rare,' Rieder says. But questions remain around selecting the right patients and what the long-term results look like, he says. 'We'll know more in the next six to 12 months,' Rieder adds. Of course, that hasn't stopped others for forging ahead. So far, Kim and Desai are happy with their own results and say the feedback from their patients has been great. 'The beauty of this device is it’s very safe,' Desai says, 'and in the right patient, you can really do a beautiful job with it.'
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