XERF vs Ultherapy: Which Skin Tightening Treatment Is Better for Me?

XERF is a non-invasive skin tightening procedure that employs dual-frequency monopolar radiofrequency. Its system provides energy at 6.78 MHz and 2 MHz in order to achieve controlled heating at various tissue depths.

Radiofrequency energy causes heating of the targeted tissues, which is expected to promote collagen contraction and remodeling.

XERF is not a laser, although some people look online under the term “XERF laser.” It is radio frequency.

The critical difference is between what a device is capable of doing in design and its actual clinical effect on the body. The technology provides evidence for the use of the treatment, while the size of the clinical benefit needs to be evaluated by clinical trials.

What conditions could be addressed with XERF?

Treatment may be used for the following concerns depending on the authorised indication and patient evaluation if:

• Skin laxity is mild.
• Skin firmness is reduced.
• Facial shape changes due to laxity.
• Some concerns in the jaw area or around the neck region where treatment is needed.

XERF is not a cure for every reason of ageing in the face. Skin laxity, loss of fat in the face, changes in facial bone structure, deep wrinkles, and muscles are different concerns. Treatment that helps in one case is not always helpful in all others.

What Is Ultherapy?

Ultherapy is a non-surgical procedure that uses micro-focused ultrasound to target controlled thermal energy to certain tissue depths. The Ulthera system also offers ultrasound imaging to visualize tissue while treatment planning and delivering energy.

An important distinction of this imaging feature is between Ultherapy and non-Ultherapy treatments based on the same type of imaging real-time visualization. It serves as a guide to the practitioner of the depth of the tissue and the depth of the treatment, however it does not give any assurances of a certain outcome or completely remove all risks.

Ultherapy is indicated in certain concerns for lifting and tightening that have been selected. It is best to determine what is appropriate based on the area to be treated, the level of laxity, and the anatomy of the person and their treatment objectives.

Like XERF, the potential mechanism is not a promise of a clinical outcome.

How XERF and Ultherapy are Different?

The two main differences lie in the way each device provides the energy to the tissue.

How XERF works?

XERF uses radiofrequency (RF) energy. It’s a dual-frequency energy system that shoots out 6.78 MHz and 2 MHz energy in one treatment pulse. The goal is to generate controlled heating in targeted tissues to stimulate collagen remodelling and make the tissues firmer.

All of this is important: The treatment plan, the applicator, the energy level and the practitioner’s technique. The frequencies do not indicate the level of improvement each person will receive.

How Ultherapy works?

With Ultherapy, the focused ultrasound energy is used to create small zones of thermal treatment at a selected depth. It has an imaging system which aids the practitioner in visualizing tissue and treatment placement.

It can be helpful in treating areas of the face. But still, it is dependent on the proper patient selection, technique of treatment and individual responses.

Is there a correlation between depth and lift?

No – for not everybody, not every concern is better with depth.

The treatment should target the tissue that is relevant to the problem being treated. Inappropriate treatment of the wrong area or inappropriate treatment approach may result in an unfulfilling outcome or risk.

Someone having a mild skin laxity experience may need different needs as compared to another person who has significant drooping and clear volume loss on the face. The practitioner should inform the patient which changes in the tissues are causing the concern before suggesting a device.

Must Read: How to Choose Skin TIghtening Clinic in UAE? Expert Insights 

Compare XERF and Ultherapy for Jawline, Jowls and Neck Skin Tightening.

While both treatments can be considered for certain concerns including skin laxity, it is dependent on the cause of skin laxity.

Between the two jowls, which is the best?

Jowls can occur due to a variety of changes in the skin, fat distribution, deeper facial supportive tissues and changes in the facial skeleton with age.

If it is the skin’s looseness that is a primary concern, a non-surgical tightening procedure may be worth discussing. In cases where the jowls are primarily due to deeper tissue descent or volume loss, an energy-based procedure might help a bit.

It is important to not market XERF or Ultherapy as a sure cure for jowls. The clinician must determine the cause of the contour change before deciding on treatment.

What’s preferable for the jawline?

The answer will vary based on the type of concern: Loose skin, fullness under the chin, loss of definition or a mix of the above.

There is no guarantee that a treatment, which is focused on firmness, won’t cause a decrease in fat and the shape of the jaw will not alter. Your practitioner should be able to let you know which aspect of the concern the proposed treatment might help to tackle.

Which of the two is better for tightening necks?

Neck laxity may present as loose skin, changes in underlying tissues and prominent neck muscles. Not all of these concerns can be addressed in the same manner.

The practitioner should evaluate the neck on its own and not presume that a therapy that works well for the lower half of the face will be effective for the neck. Treatment area and instructions for the device should also be checked.

If you don’t have a full face, what should you do?

Before you decide on either treatment, notify your practitioner if you have a naturally thin face or if you have already lost facial volume.

The different goals are skin tightening and facial volume restoration. When designing a plan to increase laxity it is important to consider the volume you already have and not assume that it will be better if there is more.

Ask the practitioner how they will measure your anatomy, what will be the degree of change that they expect to achieve, and what other options are available if it is the loss of volume that you are concerned about.

One of the important questions that comes to mind is if the jawline problem is primarily due to the excess skin, loss of volume or alteration in underlying structures. These worries cannot be addressed in the same way. In her clinical review, Dr. Priya Kumari 10+ year in Dermatology & Aesthetics highlights the need for a thorough assessment of the root cause before proposing skin tightening procedure. Patients should be made aware of the change it is supposed to correct and that there are limits to the treatment.

XERF vs Ultherapy – Which one Works Better?

There is no universal solution which is applicable to all patients.

Results will vary based upon the cause and extent of laxity, the treatment area, the device protocol, the practitioner’s technique and the individual’s response. The proof supporting every gadget additionally must be taken into account.

What are the conclusions from the research on XERF?

There is emerging clinical research on XERF. In 2026, a prospective multi-centre study was carried out on 39 patients treated with two doses. It found that aesthetic outcomes were better at 30 and 90 days using clinician ratings. The study offers preliminary clinical data and conclusions on the durability and comparisons to other devices are limited by the sample size and duration of the study.

In a separate retrospective study of 16 women (2026) follow up was performed at 1 and 3 months after 1 treatment. The authors noted changes in facial measurements and assessment of skin quality, but said more large-scale prospective controlled studies are required.

These studies are just early findings, and do not prove that XERF is better than Ultherapy. They also do not set out to determine how each patient will react.

Must Read: XERF Before and After: Results Timeline, Photos, Benefits and What to Expect

What about Ultherapy?

There is a longer research history of the device used in Ultherapy. But it doesn’t guarantee a significant lift or guaranteed results for every patient.

The results from studies will vary according to the population, treatment protocol, area treated, outcome measures and the duration of the follow-up. Research with comparable results recorded over similar time frames should be used for a fair comparison.

What should you do when comparing before- and after- claims?

Search for photographs which were made under the similar conditions, where the treatment area and the period of follow-up are well defined. Discuss if the pictures are typical results or chosen examples.

Also question if the evidence is for the specific device recommended. Results from another radiofrequency or ultrasound device cannot automatically be considered to be the result of using XERF or Ultherapy.

Is XERF more painful than Ultherapy?

What is comfortable for one is not necessarily comfortable for another. This may vary based on treatment area, energy level, and personal sensitivity and application.

During this energy-based skin tightening treatment, there can be warmth, tingling, pressure or discomfort. Some people have a more comfortable treatment compared to others.

XERF doesn’t always hurt and Ultherapy does not always hurt. No one can predict how another person might feel based on their experience.

Before treatment is given to a practitioner:

1. What does it feel like when you are in the procedure?
2. If I feel uncomfortable, what can I do?
3. How will the settings for the treatment be changed in a safe way?
4. If I have unusual or extreme pain, what should I do?

Avoid assuming that if you’re not feeling as much pain it’s working better.

XERF vs Ultherapy: How Long Do Results Last?

Both treatments seek to make changes that can take a while to come, but that do happen.

There are three things to be noted:

1. Immediate appearance: Skin’s appearance or feel immediately after treatment.
2. Follow-up results: Results obtained at a later time (weeks/month).
3. Durability: The percentage of the improvement that will be present in the long run.

It’s not the same result. Just because there is an early change doesn’t mean for a year or more.

The above published clinical studies for XERF extend to around three months. This is helpful to record early results, but is not necessarily a reliable long-term duration for any individual patient.

If comparing Ultheria to XERF, request a history of the results for a similar length of time. Don’t make statements about longer-lasting results, if the studies that back them up are of different design or duration.

Our practitioner should also discuss when results will be reviewed and whether or not there is any clinical rationale for further treatment. Do not automatically retest.

Is XERF more expensive than Ultherapy?

The expenses of each treatment will depend on the clinic, the region being treated, the proposed treatment plan and what’s included in the cost.

A quote should include the treatment plan, not just the headline price.

What affects the cost of XERF?

The price may vary according to:

• The area being treated.
• The difficulty of the treatment plan.
• The number of proposed sessions and the clinical rationale for these sessions.
• Assessment and follow up arrangements of practitioner.
• Whether consultation and review is included or not.

So what factors influence the price of Ultherapy?

The price may also depend on the treatment area, the treatment plan, the clinic and what services are included in the treatment. The cost of a smaller area should not be isolated and placed in comparison with a full face or face and neck package.

How to make a wise comparison of quotes?

When looking for a clinic, ask:

• What type of device will be used exactly?
• Which areas are included in the price?
• Is it a one shot or multiple shots?
• Does consultation and follow-up help are provided?
• Do you have any extra charges?
• What do you do if the outcome is not as apparent as you thought?

What’s the cheapest isn’t always the best. Likewise, a higher price does not mean that a treatment will yield better results.