Everything you need to know about Houston's most advanced non-surgical skin tightening — how it works, what to expect, and how it compares.
XERF is the world's first multifrequency monopolar radiofrequency system — designed to remodel skin from the inside out. Developed by Cynosure Lutronic and FDA-cleared in August 2025, it combines two RF frequencies (6.78 MHz + 2 MHz) to deliver controlled thermal energy across shallow, middle, and deep tissue layers, including the SMAS — the same layer targeted during surgical facelifts.
The result: immediate collagen contraction with progressive remodeling over 3 to 6 months. Firmer, tighter, more youthful skin — no numbing, no needles, zero downtime.
6.78 MHz + 2 MHz target shallow, mid, and deep tissue simultaneously — something single-frequency systems cannot do.
Adjusts energy delivery 1,000 times per second based on real-time tissue impedance. Consistent heating, no hotspots.
Integrated cryogen cooling protects the skin surface while RF energy works deep. Comfortable with no numbing required.
Each session takes approximately 1.5 to 2 hours for the full face and neck. The cryo-cooled handpiece keeps things comfortable throughout — no numbing cream, no anesthesia needed. You may notice an immediate subtle tightening and glow. Return to all normal activities, including makeup, right after.
Subtle tightening and a visible glow. Mild warmth or redness may last a few hours.
Skin starts looking smoother and firmer as new collagen production kicks in.
New collagen and elastin fibers strengthen skin structure. Most dramatic improvement happens here.
Results last 12 to 18 months. Annual maintenance sessions recommended to sustain.
How does XERF skin tightening in Houston compare to other non-surgical options available at Houston-area med spas?
| Feature | XERF | Ultherapy | Thermage FLX |
|---|---|---|---|
| Technology | Dual-frequency monopolar RF | Focused ultrasound | Single-frequency monopolar RF |
| Depth | Shallow + mid + deep + SMAS | Single depth per pass | Mid-depth only |
| Comfort | Cryo-cooled, no numbing | Often painful, may need sedation | Moderate discomfort |
| Sessions | 2 sessions | 1 to 2 sessions | 1 session |
| Downtime | None | Swelling, bruising possible | Mild redness |
| Results | 12 to 18 months | 12 to 18 months | 12 to 24 months |
XERF is ideal for patients who want visible skin tightening without surgery, needles, or downtime. It works best for mild to moderate laxity on the face, neck, jawline, and under the chin.
Good candidates include anyone noticing early jowling, neck banding, crepey texture, or loss of jawline definition. It also pairs well with injectables and other PH Regenerative Systems protocols for a comprehensive plan.
No. The cryo-cooled handpiece keeps treatment comfortable. Most patients describe a warm, tolerable sensation — no numbing cream required.
XERF is a 2-session protocol. Annual maintenance sessions are recommended to sustain results long-term.
Some patients notice subtle tightening immediately. Peak results develop over 3 to 6 months as new collagen forms.
Yes. XERF pairs well with PRF microneedling, injectables, and other PH Regenerative Systems protocols.
Zero. Return to normal activities — including makeup — immediately after your session.
Most practices won’t publish a number, and there is a legitimate reason: XERF is priced by treatment area and by how many sessions your skin actually needs. A single lower-face treatment and a full face-and-neck protocol are not the same purchase.
What we can tell you plainly is how the pricing works, so you can compare offers around Houston without guessing:
XERF works on structure — the collagen scaffolding that holds skin lifted. That single fact determines who it helps and who it doesn’t.
In practice, the strongest results come from sequencing rather than choosing — structure first, surface second. That is the logic behind stacked treatment protocols.
XERF is now offered at a growing number of practices around greater Houston, including several outside the loop marketing to Houston patients. A few things separate how it is done here.
Schedule a consultation at PH Med in Houston Heights to find out if XERF skin tightening is right for you.
Book Your ConsultationAn XERF treatment is a single appointment, typically forty-five to sixty minutes. The applicator is moved across the treatment area in passes while the device holds the deeper tissue at a therapeutic temperature. You feel warmth that builds and then eases between passes. There is no incision and no downtime that keeps you home.
What separates an XERF treatment from the radiofrequency devices that came before it is where the energy lands. Older RF tightened the surface, which is why results read as subtle. XERF delivers into the deeper dermis and the fibrous layer beneath, which is the tissue that actually holds the face up. That is a structural change rather than a surface one, and it is why the result develops over months rather than appearing on the day.
Most plans run to three sessions spaced roughly a month apart, though the number is set at your assessment rather than sold as a package beforehand. Some faces need fewer. Some need something other than XERF entirely, and you will be told that rather than sold a course.
At PH Med the assessment and the XERF treatment are both performed by Dr. Bui. Several Houston practices now offer the device; what differs between them is who is holding the applicator and whether anyone examined your tissue before deciding the settings.
Most people are quoted a plan rather than a single session, because structural change accumulates across treatments. What that plan costs depends on how many sessions the assessment indicates — which is decided after looking at your skin, not before.
You will have a written quote for the whole plan before anything is scheduled. Nothing gets added to your invoice partway through a treatment.
The comparison people usually make is to a surgical lift, which runs many times this and carries anaesthesia, incisions and weeks of recovery. The more useful comparison is to the radiofrequency devices XERF replaced — cheaper per session, working at the surface, and needing to be repeated indefinitely because they never reached the tissue that holds the face up.
A physician performs the treatment here, not a technician. That is part of what you are paying for, and it is the part that decides whether the energy goes where it should.
