Setia Alam · Hong Kong · Singapore · Setia Alam
#igotXERFed
I flew to Hong Kong to sit in the chair. Then to Singapore to treat two patients. Then I bought the machine.
In February 2026 I got on a plane so that a machine I did not own could be used on my face. In March I got on another one so that I could use it on two patients. In July it arrived at my clinic in Setia Alam, all 47 kilos of it.
This is the whole thing in order, including the parts that do not flatter the machine. I paid for it with my own money, and nobody has approved a word of this.
Chapter one
There was a gap in my clinic
I own an Ultherapy. It puts focused ultrasound in tiny columns at one and a half, three and four and a half millimetres, down to the SMAS, the plane a surgeon works in. It reaches structure, and it is very good at that.
What I did not have was anything that heated the whole dermis at once. So when a patient asked me for tightening without the dots, I had nothing to offer her. That gap sat there for years.
Chapter two
Why I stayed away from monopolar radiofrequency
Monopolar radiofrequency was not new. There had been a machine on the market for years, and it works. Plenty of patients sit through it without a fuss.
But everything I heard about it was pain. I am a coward about pain, and it was never going to be me in that chair. So I never went under one, and I never bought one.
That is the honest reason the gap stayed open. Not evidence, not physics. I did not want to be hurt, and I will not sell a patient something I would flinch at.
Chapter three
Then I kept hearing about XERF
Korea in 2024, then America, then Europe. Colleagues overseas kept mentioning it, and it kept turning up in the papers. Two radiofrequency frequencies delivered at once, cooling built into the handpiece, and a stream of people online calling it painless.
I did not believe the painless part. Nothing that heats the dermis to a remodelling temperature is nothing. But the rest of it was interesting enough that reading about it stopped being enough.
February 2026
So I flew to Hong Kong
A friend there has had her XERF for a while. I asked whether I could come and be a patient for an afternoon, and she said yes.
Nothing was signed. There was no machine anywhere near my clinic, and no plan to buy one until I knew what it felt like.
Hong Kong · February 2026
It is not exactly painless
Cooling on. No numbing cream. I would put it at about a three out of ten. You feel the heat arrive through the cooling, it peaks, and then it is gone and the next shot is coming.
That is far more tolerable than I expected, and it is not painless. I would rather tell a patient it is tolerable, because then the heat is no surprise when it comes. Most people need no numbing. That is the honest sentence.
The face under the handpiece stayed mine, which was the disappointing part.
The weeks after
Nothing was instant
I looked every day, the way anyone does. For the first fortnight there was very little to see. At about two weeks, in good light, I could see some tightening along the jaw.
Then it kept improving, slowly, over the months that followed, which is how radiofrequency is supposed to behave. The heat causes immediate collagen contraction, and the rebuilding happens over the weeks after that.
That is one face, my own, in my own mirror. I am not going to dress it up as data.
16 March 2026
Then I flew to Singapore
Being under it was half the question. The other half was what it is like to hold, because a machine that is unpleasant to use gets used badly.
So I arranged to treat two patients in one morning, under supervision, at a clinic that already had one.
Singapore · 16 March 2026
My patients were braver than me
A woman of sixty who had never had an aesthetic treatment in her life, and a woman of forty-five who keeps hers up. Both sat through the machine’s highest setting, ten out of ten on its own scale, without asking me to stop.
So the comfort story is real, and it depends on two things: the person in the chair, and how the person holding the handpiece works. Comfort is not only a property of the machine.
Two flights, to use a machine I did not own yet. That is the part I would repeat.
Chapter four
Where it fits beside the machine I already had
This is the question I actually needed answered, and it is the one a patient should ask too. I already owned a device for tightening. Buying a second one only makes sense if it does a different job.
Ultherapy
Focused ultrasound. Columns of heat at 1.5, 3.0 and 4.5 mm, down to the SMAS.
The structure.
XERF
Monopolar radiofrequency, two frequencies together. It heats the dermis as a field rather than in points.
The skin.
Different jobs, so a face can need one, the other, both, or neither. In my clinic the order is Ultherapy first for the structure, then XERF four to six weeks later for the skin. Nobody has measured that interval. It is my preference, and I say so.
More on the comparison: depth or field, XERF and Ultherapy and XERF, Ultherapy, HIFU and microneedle RF compared.
Chapter five
What I saw, and what I am not showing you
I photographed both patients on the same imaging rig: day zero, day seven, day thirty, and one of them again at day seventy-nine. I showed those photographs to a hall of doctors on 21 September, with the patients’ consent, and that is where they stay. Consent for a room is not consent for the internet, and I am not going to stretch it.
What I will say in public is what I said about my own face. Change from about two weeks, improving gradually over the months after. On the day itself there is swelling and contraction, which is not a result, and I tell patients that before they go home and look in the mirror.
Day seventy-nine is my longest follow-up. The longest in the published literature is ninety days. Every one of us talking about this device is early.
The evidence, gone through paper by paper: a doctor’s evidence review.
23 July 2026
And then it came home
Forty-seven kilos of console, five months after Hong Kong and four after Singapore. My mind had been made up long before the crate arrived.
It was not only mine. On launch day XERF went into clinics across the Klang Valley, down in Johor and up in Penang.
Setia Alam · 23 July 2026
Before any patient sat in that chair, I did
That is the whole point of the five months. By the time it was plugged in I had been under it myself, watched it work on two faces that were not mine, and formed an opinion I did not have to borrow from a brochure.
Chapter six
I used to review phones, so I reviewed the machine
One week in I put the same eye on it that I used to put on handsets. The manufacturer was in the room when I read this out, which is the only way a review like this is worth anything.
One of the sleeker machines on the market. Compact footprint, the arm feels rock solid, and it is surprisingly smooth to wheel between rooms.
Lightweight and lovely in the hand. But the little screen on top is almost impossible to see while you are treating, because the handpiece is long and your eye is on the skin.
Excellent. Proper tactile feedback, and much better than the button on the handpiece.
Messy when stowed. The electrode plate connector is not magnetic and has nowhere to live. The pedal and power cables get a basic hook, so they sprawl.
Simple, intuitive, clean. Navigating it is easy, which is not a given on aesthetic hardware.
A missed opportunity. You type in your own levels instead of the machine detecting them.
Hidden. You tap a specific unlabelled spot on the screen to reset the counter. First-timers find it by trial and error.
About ten minutes for the canister before a session. I use that window for the consultation notes.
A clean, space-saving, high-performing unit. None of the cable or display quirks are dealbreakers. A version two with a proper screen on the handpiece, auto-sensing and tidier cables would be very close to perfect.
Seven months in
Where I stand
- Get under it and hold it before you buy it. Two flights before I signed anything, and I would do it again.
- It hurts a little. Cooling on, most people need no numbing, and tolerable is the honest word.
- Change from about week two, improving for months. One face and two patients, so read it as what it is.
- It suits mild to moderate laxity, and it suits maintenance on a well-kept older face.
- It will not put volume back, and it will not rescue advanced laxity. If someone is promising you that, the problem is the promise.
Who it suits and who it does not, in detail: who XERF is for, and who it isn’t. What the treatment involves at the clinic: XERF radiofrequency skin tightening.
Common questions
The three I am asked most
Does XERF hurt?
It is not painless. With the cooling on and no numbing cream I scored my own treatment about three out of ten, and the published series put the average closer to 4.3 out of ten, with roughly one in eight people finding it strongly uncomfortable. Most people need no numbing. Ask your doctor for a number before you sit down.
How soon does anything change?
Not immediately. On the day there is swelling and contraction, which is not a result. In my own case some tightening was visible at about two weeks in good light, and it kept improving gradually over the months after that, as collagen rebuilt. The longest follow-up published anywhere is ninety days.
Who should not have it?
Anyone with advanced laxity, where the deeper support has already given way, and anyone whose real problem is lost volume, because no energy device replaces volume. It also will not suit anyone expecting a different face in two weeks. That expectation usually came from somebody else, and it should be corrected before anything is switched on.