Jawline definition
Softening along the jaw and early jowling, where structural lift makes the clearest difference.
XERF Structural Skin Tightening
Lift and firm, without needles or downtime.
XERF is a next-generation radiofrequency treatment that tightens lax skin and builds new collagen — comfortably, in a single visit, with nothing to recover from.
What XERF actually does.
XERF is a non-invasive, FDA-cleared radiofrequency system that delivers controlled heat beneath the skin's surface. That heat causes existing collagen to contract right away, and prompts the body to build new collagen over the following weeks.
What sets it apart is the dual-frequency design. A 6.78 MHz frequency treats the dermis, where smoothing and tightening happen, while a 2 MHz frequency reaches deeper toward the structural layer that a surgical lift addresses. The result is tightening at more than one level rather than only at the surface.
Because XERF uses radiofrequency rather than light, it does not target pigment — which makes it appropriate across all skin tones, including deeper complexions that some laser devices cannot safely treat.
Who it suits best
XERF is designed for mild to moderate laxity — a jawline starting to soften, early jowling, loosening along the cheeks or neck. It is also used preventively by younger patients. It is not a substitute for surgery: significant sagging or heavy excess skin is better addressed surgically, and Dr. Bhandari will tell you honestly if that is the case.
Call (210) 493-1568Concerns treated
What XERF addresses.
Neck and submental laxity
Loosening under the chin and along the neck, treated without incisions or recovery.
Cheek firmness
Loss of firmness through the midface as collagen naturally declines.
Fine lines and crepiness
Fine lines and thinning, crepey texture that creams alone cannot reach.
Brow position
Subtle lifting through the brow for a more open, rested eye area.
Preventive collagen support
Slowing early laxity before it becomes established — a common reason younger patients start.
What to expect
How a visit works.
Assessment
We evaluate your skin quality, degree of laxity, and goals, and confirm XERF is genuinely the right tool. Contraindications are reviewed before anything is scheduled.
Treatment
Most sessions run 30 to 60 minutes depending on the area. Built-in cooling and real-time skin feedback mean no numbing and no needles — most patients describe a deep, even warmth.
Review
Because results develop gradually, a follow-up visit matters. We compare against your baseline and decide together whether maintenance or a different approach makes sense.
No numbing. No needles. No downtime.
Results
How results unfold.
There are two distinct stages. Immediately after treatment, existing collagen fibers contract, and many patients see some visible lift the same day — though not everyone does, and that is normal.
The more meaningful change comes later. New collagen forms over roughly four to six weeks, with many patients seeing their fullest result somewhere around the three-month mark. Depending on individual collagen response, age, and lifestyle, results commonly hold for about a year, and some patients choose a periodic maintenance session rather than waiting for laxity to return.
Common questions
XERF, answered.
Does XERF hurt?
For most patients, no. The system pairs integrated cryogen cooling with real-time impedance feedback, which lets it deliver meaningful energy while keeping the skin surface comfortable. No numbing cream or injections are needed. Most people describe a deep, even warmth, and settings can be adjusted at any point during the session.
Is there any downtime after XERF?
There is effectively none. You can return to normal activities immediately. Some patients notice mild pinkness or a warm, tight sensation for a few hours afterward, which fades on its own.
How many XERF sessions will I need?
Many patients are treated in a single session. Others benefit from a short series spaced several weeks apart, depending on how much laxity is present and how the skin responds. We will give you a realistic number at your consultation rather than committing you to a package up front.
How long do XERF results last?
Results commonly last around a year, though this varies with your natural collagen production, age, sun exposure, and lifestyle. Many patients return periodically for maintenance to hold the result rather than waiting for laxity to fully return.
Is XERF safe for darker skin tones?
Yes. Because XERF uses radiofrequency energy rather than light, it does not target melanin, so it can be used safely across all Fitzpatrick skin types. This is a meaningful advantage over some laser-based tightening options.
How is XERF different from a facelift?
They do different jobs. XERF tightens and stimulates collagen without surgery, anesthesia, or recovery, and is best for mild to moderate laxity. A facelift repositions and removes tissue and remains the right answer for advanced sagging. If surgery would serve you better, we will say so.
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Find out if XERF is right for you.
Every plan starts with a consultation in our San Antonio office.