XERF Lifting Series Part 2 - Why Design is Important in XERF Lifting

In the previous article, we explained the principles and characteristics of XERF Lifting.

We discussed how radiofrequency (RF) energy stimulates collagen in the skin, leading to improved skin elasticity through the processes of:

Collagen contraction

Fibroblast activation

New collagen production

However, during actual consultations, patients often ask this question:

‘Why do the results differ from clinic to clinic even when using the same equipment?’

The reason is that ‘design’ is the most important aspect of a lifting procedure.

Lifting is not simply a ‘shooting’ procedure

Lifting equipment is a tool for delivering energy to the skin.

However, because facial sagging varies from person to person, the process of designing where and how to deliver the energy is crucial.

For example, in cases of:

Sagging cheeks

Blurred jawlines

Deepened nasolabial folds

Even if the same lifting equipment is used, the location and direction of energy delivery must be different.

Therefore, rather than simply ‘firing many shots,’ where and how they are placed is far more important in a lifting procedure.

Facial sagging does not occur in only one direction

Facial aging is not just about sagging downwards; changes occur simultaneously in multiple directions.

Typically, these appear together as:

Mid-face cheek sagging

Jawline sagging

Nasolabial folds

Marionette lines

Therefore, in a lifting procedure, the lifting vector is important to:

✔ Analyze the direction of sagging

✔ Set the direction to pull

Important elements in lifting design

The design of a lifting procedure can be broadly divided into three elements.

1️⃣ Shot placement

What matters in a lifting procedure is not simply firing a lot of shots, but where the energy is concentrated.

Facial sagging does not occur randomly; it often centers around specific retaining ligaments.

So, in actual procedures, shots are placed focusing on:

Lifting points where sagging accumulates

Areas around the retaining ligaments that support the face

Structural boundary areas where sagging begins

Another important factor is energy density.

Even with the same number of shots, overlapping shots at lifting points can have a greater impact on the lifting effect than spreading them widely.

Therefore, rather than simply distributing shots overall, a design that concentrates energy on lifting points while considering facial structure is essential.

2️⃣ Lifting vector

When explaining lifting procedures, the expression ‘lifting vector’ is commonly used.

This refers to the concept of which direction to pull the skin.

However, since laser or RF lifting does not physically pull tissues up like thread lifting, the vector direction itself is hard to consider as the absolute factor determining the outcome.

Rather, in clinical practice, more important factors often include:

The retaining ligaments where facial sagging begins

The lifting points where sagging starts to accumulate

How sufficiently energy was delivered to those specific areas

Therefore, rather than simply setting a direction, accurately identifying lifting points, overlapping sufficient shots in necessary areas, and increasing energy density can have a greater impact on the results.

In other words, the design of a lifting procedure is less about ‘which direction to shoot’ and more about how accurately and sufficiently energy is delivered to which specific points.

3️⃣ Facial structure analysis

Understanding the facial structure is a highly important process in lifting procedures.

This is because everyone has different:

✔ Skin thickness

✔ Fat distribution

✔ Retaining ligament structure

✔ Location of sagging

For instance, a face with a lot of fat may experience sagging more easily due to the weight of the skin, whereas for thin skin, energy intensity and shot density must be adjusted more carefully.

In some cases, sagging appears more distinctly around specific retaining ligaments.

Therefore, rather than just using the equipment, analyzing the facial structure first, finding the starting points of sagging, and designing the appropriate energy density for those areas is a crucial process.

Ultimately, lifting design can be seen as ‘the process of understanding facial structure and deciding where to concentrate energy.’

Characteristics of XERF Lifting Design

XERF uses dual-frequency RF (6.78 MHz + 2 MHz) to deliver energy to multiple depths.

So, when designing the procedure, a treatment plan is established by comprehensively considering:

Elasticity improvement in the central dermis

Deep layer tightening

Jawline contouring

In other words, a lifting design that considers the overall balance of the face is important, rather than simply pulling the skin.

What is more important than equipment in lifting procedures

Many people ask,

‘Which equipment is the best?’

But in reality, how the equipment is used is much more important.

Even with the same equipment, results can vary depending on:

Design

Clinical experience

Patient-customized approach

In the next article

In the next article, we will explain the differences between lifting devices: XERF Lifting vs. Thermage vs. DENSITY.

We will discuss in detail the differences between RF lifting devices, which cases each is more suitable for, and the selection criteria in actual clinical practice.