Introducing XERF: 3D Lifting Innovation for Fat Reduction and New Collagen Generation at ENTRIO Clinic
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- 6 days ago
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Introducing XERF: 3D Lifting Innovation for Fat Reduction and New Collagen Generation at ENTRIO Clinic
Hello! I'm Dr. Nono (Dr. Chanaphat Chinwechkitwanich), the Dermatologist and owner of Entrio Clinic, a Ratchaprasong Aesthetic Clinic.
My educational foundation in dermatology began with a Doctor of Medicine (M.D.) from the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, before I decided to specialize deeply in the science of skin, completing a Master of Science in Clinical Dermatology (Distinction) from Cardiff University, United Kingdom.
The knowledge and experience gained from these two world-class institutions have made me realize the importance of merging innovation with a genuine understanding of skin structure. This is the philosophy we uphold in delivering a Refined Aesthetic Experience to every patient.
In the fast-moving world of aesthetic treatments like facial lifting and tightening, various devices are developed to meet the demand for "non-surgical rejuvenation." However, they often have limitations, typically working on only one layer of the skin.
Today, I'd like to use my expertise in Dermatology to guide you through the latest technology we are proud to introduce: the XERF Program. This Radiofrequency (RF) innovation is a game-changer for lifting and tightening, especially in the crucial aspects of fat reduction and heat control, clearly surpassing other tools on the market.
This article will be detailed and in-depth, covering everything from the complex scientific mechanisms to the personalized treatment techniques used at Entrio Clinic, ensuring you understand why XERF is the most complete answer for your rejuvenation journey.
Part 1: The Grand Challenge - Decoding Facial Aging and the Need for Comprehensive 'Lifting and Tightening'
1.1 Anatomy of Aging: 5 Layers of Skin to Understand Before 'Lifting and Tightening'
Facial sagging and a tired appearance do not originate from a single skin layer. It is a simultaneous process across all facial structures. Understanding these structures is crucial for selecting the correct lifting and tightening technology.
Epidermis: The outermost layer, focusing on cell turnover and hydration.
Dermis: The essential structure of collagen and elastin. The degradation of the Dermis leads to loss of elasticity and shallow wrinkles (the primary target of general RF).
Fascia and Muscle Layer (SMAS - Superficial Musculoaponeurotic System): The critical layer connecting facial muscles and skin. The stretching of the SMAS layer is the main reason the face "drops" and appears jowly (the primary target of Ulthera).
Fat Compartments: Some fat pockets atrophy (causing a hollow look), but fat in the submental area and lower cheeks accumulates and shifts downward due to gravity, leading to a double chin and loss of jawline definition.
Bone and Ligaments: As we age, bone volume decreases, causing the retaining ligaments that support the fat pads to loosen.
The Challenge Summary: Current lifting and tightening technologies often target only 1-2 main layers. For example, Ulthera focuses on SMAS layer lifting but does not manage fat, while Thermage focuses on the Dermis but cannot effectively reduce fat. Our challenge is to find an innovation that can deliver energy to manage "all dimensions."
1.2 The Necessity of 'Fat Reduction' Alongside 'Lifting and Tightening'
In Asian patients, particularly those consulting at Entrio Aesthetic Clinic in Ratchaprasong, we often observe significant fat accumulation in the neck and under the chin (Submental Fat). Therefore, lifting and tightening alone is insufficient to create a sharp jawline.
Reason: The presence of excess fat adds continuous weight, causing the skin structure to constantly sag. Managing the weight of the accumulated fat is as vital as collagen stimulation.
The XERF Program is specifically designed to address this challenge with its Dual-Frequency mechanism, which I will delve into in the next part.
Part 2: XERF Genesis - The Birth of Dual-Frequency Monopolar RF and In-Depth Functionality
2.1 Monopolar RF vs. Bipolar RF: Why We Choose Monopolar?
Radiofrequency (RF) in the aesthetic industry is categorized into various types, with Monopolar and Bipolar being the most popular.
RF Type | Working Principle | Penetration Depth | Advantage |
Bipolar RF | Current flows between positive/negative electrodes on the same tip. | Shallow/Limited (Upper Dermis) | Suitable for tightening small, localized areas. |
Monopolar RF (XERF) | Current flows from the handpiece to a Grounding Pad on the body. | Multiple and Deeper Levels (Dermis to Fat Layer) | Focuses on widespread lifting, deep collagen stimulation. |
Explanation: XERF uses Monopolar RF, enabling energy to penetrate through the fat layer to the targeted tissue, which is fundamental to achieving a 3D result.
2.2 The XERF Breakthrough: 6.78 MHz + 2 MHz is the Core of the Treatment
The XERF Program doesn't just use Monopolar RF; it employs a Dual-Frequency approach that works intelligently in coordination with every pulse delivered to the skin.
Frequency | Target Tissue | Biological Mechanism | Clinical Result |
6.78 MHz | Dermis and Fibrous Septae | Collagen Denaturation & Neocollagenesis: Generates heat (45-55°C) to immediately contract existing collagen and stimulate fibroblasts. | Lifting skin, firmer, plumper skin, reduced wrinkles. |
2 MHz | Subcutaneous Fat Layer | Adipocyte Lipolysis & Shrinkage: Generates appropriate heat to induce fat cell breakdown (Lipolysis) and shrinkage in excess fat cells. | Reduces accumulated fat, less double chin, sharp jawline. |
Physiological Depth: The choice of 2 MHz for fat management is meticulous because lower frequencies can transmit better through tissues with higher resistance, such as the fat layer. Meanwhile, 6.78 MHz is a proven optimal frequency for collagen stimulation. This combination is the winning formula that allows XERF to manage both "skin quality" and "fat volume."
2.3 3 Depth Levels: The Precise Targeting of XERF
The ability to adjust the function of both frequencies to penetrate at 3 distinct depths allows the physician to design highly specific, millimeter-level treatments:
Shallow Mode (Dermis-Focused): Ideal for collagen stimulation in thin-skinned areas (e.g., forehead, around the eyes) or for patients who wish to preserve their fat volume for a fuller appearance.
Middle Mode (Dermis & Upper Fat): Suitable for the upper and middle cheek areas, requiring firmness alongside organization of the fat structure.
Deep Mode (Deep Fat Focused): The mode that maximizes the 2 MHz frequency for intensive fat reduction in dense areas like the double chin and jawline for deep lifting and tightening of the lower face structure.
Part 3: The XERF Advantage - Unprecedented Safety, Comfort, and Precision
One of the most significant barriers to lifting and tightening with RF is pain and the risk of burns. The XERF Program is engineered to eliminate these weaknesses entirely.
3.1 ICD Cooling System: The Science of Comfort (Cryogen Protection)
ICD (Integrated Cryogen Delivery): This is the precise, 3-phase spraying of a Cryogen cooling agent (similar to that used in laser treatments): before, during, and after the RF energy release.
Skin Protection Mechanism: The sprayed Cryogen rapidly reduces the temperature of the Epidermis (Transient Epidermal Cooling), while the RF waves penetrate to create heat in the Dermis/Fat layer.
The Difference from Thermage: Older RF devices use Cooling Pads or Vibration systems with inconsistent cooling that cannot reduce skin temperature as quickly as Cryogen, leading to a noticeable deep heat sensation and pain. XERF is minimally painful, often eliminating the need for anesthetic cream, a direct result of the ICD System.
3.2 Wave Fit™ Pulse Technology: Uncompromising Energy Delivery
The success of lifting and tightening with RF depends on the consistency of energy delivered to the target (Uniform Heating).
Impedance Management: Each person's skin has unique electrical resistance (Impedance), and this resistance varies across different facial areas. Wave Fit™ Pulse Technology is a system that detects skin resistance in Real-time and adjusts the energy delivery pattern for each shot accordingly.
Clinical Impact: By customizing the energy for each point on the skin, the physician can ensure the heat generated in the Dermis/Fat layer reaches the threshold required for optimal collagen stimulation in every shot. This reduces the risk of Hot Spots and minimizes the chance of energy failing to reach the target (Under-treatment).
3.3 Spider Web Pattern Tip: Superior Treatment Area
The XERF tip is designed to be large with a precise energy distribution pattern, contributing to:
Faster Area Coverage: Reduces the duration of the procedure.
Uniform Energy: The broad, consistent treatment area helps the RF energy transmit smoothly into the skin, reducing the creation of energy gaps.
Part 4: The Dr. Nono Protocol - Specialized XERF Technique at the Ratchaprasong Aesthetic Clinic
My experience in Dermatology teaches me that "no matter how good the tool is, it takes the doctor's hand to unleash its full potential." Therefore, XERF treatment at Entrio Clinic, Ratchaprasong Aesthetic Clinic, is defined by a meticulous 3-Phase Protocol.
4.1 Phase 1: Customized Pre-Treatment Planning (The Science of Assessment)
3D Structure Analysis: I use both vertical and horizontal facial assessments to pinpoint the location of fat pads that have dropped down and evaluate collagen density.
SMAS and Ligaments Assessment: Although XERF is not a direct SMAS layer lifting device, I assess the strength of the retaining ligaments around the eyes and jaw to determine which areas require the XERF Deep Mode to contract the tissue connecting to the SMAS for optimal lifting and tightening.
Dual-Frequency Ratio Calculation: For patients with dense submental fat (double chin), I emphasize Deep Mode for maximum 2 MHz function. For patients with a hollow face seeking only firmness, I focus on Shallow Mode to stimulate collagen while preserving fat volume.
4.2 Phase 2: Execution and Zone-Specific Technique (The Art of Application)
I divide the face into 4 main zones to apply different XERF pulsing techniques:
Upper Zone | Middle Zone | Lower Zone (Jawline) | Neck/Double Chin Zone |
Goal: Reduce wrinkles, Skin Tightening | Goal: Restore firmness, reduce mid-face sagging | Goal: Create Sharp Jawline (Contouring & Tightening) | Goal: Reduce fat and lift |
XERF Mode: Shallow & Middle | XERF Mode: Middle | XERF Mode: Deep (Emphasis on 2 MHz) | XERF Mode: Deep (Maximum 2 MHz) |
Technique: Fast and Overlapping Motion (for uniform Dermis heat) | Technique: Slow and Consistent Motion (for deep heat penetration to upper fat) | Technique: Linear Vectoring (pulsing along the lifting vector from bottom to top to pull up sagging skin) | Technique: Focused Heating (concentrating energy on the double chin to accelerate fat reduction) |
4.3 Phase 3: Post-Treatment Care & Combination Therapy (Sustainability of Results)
To ensure the results of XERF last as long as possible, I recommend strict post-care instructions, including planning for Combination Therapy.
XERF + Ulthera: For patients with severe sagging (Ligament Laxity), I might recommend starting with Ulthera to lift the SMAS layer first, followed by XERF to reduce fat and stimulate collagen in the remaining skin layers.
XERF + Definisse Filler: Using XERF to restructure and lift first, then using a filler (e.g., Definisse) to replenish areas with volume loss will create a more dimensional and complete aesthetic result.
Part 5: Advanced Clinical Review - XERF from an Evidence-Based Dermatology Perspective
As a Dermatologist who emphasizes Evidence-Based Medicine, the choice to use XERF comes not from marketing but from superior clinical efficacy.
5.1 XERF and Neocollagenesis: Long-lasting Collagen Generation
Histological Evidence: Histological studies show that applying RF waves at an appropriate frequency (e.g., 6.78 MHz) and a temperature of 45-55°C stimulates fibroblasts to produce Pro-Collagen for up to 6 months post-treatment.
XERF Superiority: The presence of Wave Fit™ Pulse Technology in XERF ensures that the heat generated in the Dermis consistently reaches the Threshold necessary for collagen stimulation in every shot. This is a crucial factor that makes the lifting and tightening results last up to 9-12 months.
5.2 XERF and Adipolysis: A Safe Fat Reduction Mechanism
Selective Heating: The 2 MHz wave of XERF can generate higher heat in the fat layer than in the Dermis due to the electrical properties of the tissues. Therefore, fat reduction is Selective (specific).
Thermal Destruction: Heat reaching 48-52°C in the fat layer causes fat cells (Adipocytes) to be damaged and enter the process of cell death (Apoptosis). The destroyed fat cells are then eliminated by the body's natural mechanism (Phagocytosis), leading to a permanent reduction in submental fat (double chin).
5.3 XERF and Burn Risk: The Efficacy of ICD
The risk of RF burns arises from heat accumulation in the outermost skin layer. However, with the high-precision ICD Cooling System of XERF, the Epidermis is continuously protected, significantly reducing the chance of burns. This is why XERF is minimally painful and highly safe compared to older RF devices lacking equally precise outer-skin protection.
Part 6: Q&A by Dr. Nono - Addressing All Your Questions About XERF and Entrio Clinic
Q1: Is the XERF Program painful? Do I need to apply anesthetic cream?
Dr. Nono: The answer is that XERF is minimally painful, often eliminating the need for anesthetic cream. The sensation during the procedure is similar to a deep warmth accompanied by a comfortable cooling sensation from the continuously operating ICD Cooling System. This differs from older RF devices that caused a sudden, sharp heat sensation. Therefore, at our Entrio Clinic, a Ratchaprasong Aesthetic Clinic, most patients undergo the procedure comfortably without needing anesthetic cream.
Q2: Can XERF truly 'lift the SMAS layer'?
Dr. Nono: We must clearly differentiate this. XERF is an RF technology that cannot penetrate deep enough into the SMAS layer to create precise thermal coagulation points like Ulthera. However, XERF can effectively reduce excess fat and contract the fascia connecting to the SMAS. This results in overall skin firmness, a sharp jawline, and reduces the weight of the sagging skin, yielding a natural and complete lifting and tightening result in terms of skin quality.
Q3: How many XERF treatments are needed to see results, and how long do the results last?
Dr. Nono: Generally, patients will start seeing some results immediately after the procedure, with the most noticeable results appearing about 2-3 months after treatment when new collagen is fully generated. For mild to moderate sagging, a single treatment once a year is usually sufficient. Results can last approximately 9-12 months, depending on self-care post-treatment.
Q4: Which is better: XERF or OligioX?
Dr. Nono: Both devices are New Generation Monopolar RF that provide excellent results and are minimally painful. However, what makes XERF superior is the Dual-Frequency (2 MHz), which has supporting research showing better efficacy in fat reduction compared to OligioX (which uses a single 6.78 MHz technology). Therefore, if you also have issues with a double chin or cheek fat, XERF may be the more targeted and effective option for creating a sharp jawline.
Conclusion: Refined Aesthetic Experience at Entrio Clinic, Ratchaprasong Aesthetic Clinic
I, Dr. Nono (Dr. Chanaphat), believe that the journey to rejuvenation requires both art and science. The XERF Program is an innovation that addresses patients' needs across all dimensions: lifting and tightening, fat reduction, collagen stimulation, high safety, and comfort during the procedure.
At Entrio Clinic, a Ratchaprasong Aesthetic Clinic, we don't just sell technology; we sell the expertise in designing and Customizing the XERF treatment to ensure your face receives the most complete rejuvenation possible.
I am delighted to use my knowledge and experience in Dermatology to analyze and design the lifting and tightening treatment plan that is most suitable for you.
Dr. Chanaphat Chinwechkitwanich (Dr. Nono)
Entrio Clinic - Refined Aesthetic Experience
“We believe that true beauty comes from healthy skin and an understanding of science.”
📍 Location: https://maps.app.goo.gl/X9WpN51pnK5otKip8
4th Floor, Erawan Bangkok Building, Ratchaprasong Intersection (behind Erawan Shrine), Bangkok
💬 Line: @entrioclinic or click bit.ly/EntrioLine
📞 Call: 097-154-2222
🌐 Website: entrioclinic.com
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