You heard about Thermage from a friend, or saw it on a price list. It is one of the names people link with firming without surgery, and often the first one they look up when the jawline starts to soften.
XERF aims for the same thing, with the same family of energy. It arrived in Canada in spring 2025, three weeks before Thermage FLX, and we chose it after comparing the two. Here is what we found, prices included.
XERF: a radiofrequency that firms the face and neck.
XERF is made by Cynosure Lutronic and authorized in Canada since April 2025. It heats the skin below the surface to tighten it and restart collagen, while built-in cooling protects the surface. Here is what the treatment looks like at Clinique DC.
| What is treated | The full face and the neck |
|---|---|
| The session | 90 min, no needles or numbing |
| How often | Two sessions, then yearly upkeep |
| Afterwards | No downtime |
| The result | Immediate, then gradual over 3 to 6 months |
| The price | $1,500 per session, taxes extra |
The same family of energy: monopolar radiofrequency.
Thermage and XERF send a high-frequency current that heats a volume of skin at depth. The heat tightens the collagen already there and prompts the skin to make new collagen. Neither cuts, and neither needs a needle.
- They don’t remove excess skin: when skin hangs and folds at rest, the honest answer is surgery.
- They don’t restore volume to a hollowed cheek: that is what filler does.
What sets them apart, point by point.
What comes from a manufacturer is labelled as such. The rest comes from the studies cited at the end.
| Criterion | XERF | Thermage FLX |
|---|---|---|
| Energy | Monopolar radiofrequency, two frequencies in the same pulse (manufacturer) | Monopolar radiofrequency |
| During the session | No numbing, built-in cooling (manufacturer) | Built-in cooling and vibration for comfort (manufacturer) |
| Length | 90 min | 30 to 60 minutes depending on the area (manufacturer) |
| Afterwards | No downtime | Back to activities right away, according to the manufacturer |
| Sessions | Two sessions, then yearly upkeep (at Clinique DC) | One, according to the manufacturer |
| Full result | Immediate, then gradual over 3 to 6 months | Gradual, over 4 to 6 months, according to the manufacturer |
| In Canada | Authorized in April 2025 | Thermage FLX authorized in April 2025 (in the United States since 2017) |
| Published studies | Few, recent, tied to the manufacturer | A body of work on monopolar radiofrequency, mostly on earlier generations |
| At Clinique DC | $1,500 per session, full face and neck | Not offered |
What the full face and neck cost, on each side.
Few clinics post the price of Thermage FLX for the face and neck. We kept those that do, with the exact area. XERF is done in two sessions, so we compare the full protocol, not one session against one session.
| Where | What is treated | Posted price |
|---|---|---|
| Thermage FLX, Quebec | Face and neck, 600 pulses | $2,700 |
| Thermage FLX, Quebec | Face and neck, 900 pulses | $3,450 |
| Median, Thermage FLX | Full face and neck, one session | $3,075 |
| Clinique DC, Laval | The ultimate XERF offer: 2 XERF sessions, 2 LaseMD Ultra face and neck sessions, ZO Firming Serum | $3,000 |
For roughly the price of one Thermage face and neck session, the XERF protocol includes two radiofrequency sessions, two laser sessions for the surface and a serum. A higher price doesn’t guarantee a better result: no study compares the two devices.
XERF sells at the same price in every clinic, since its manufacturer sets a price floor. You don’t pay for the address.
Prices posted online, gathered October 3, 2026, before taxes. The clinic’s name is in the sources. The offer is for a first visit, once per person; its conditions are on its page. À la carte, a XERF session is $1,500. Taxes extra.
Same family, one more frequency and a posted price.
Four points where the difference is clear, each with where the fact comes from.
Two frequencies in the same pulse
According to its manufacturer, XERF sends 6.78 MHz and 2 MHz in the same shot, and the person holding it chooses the depth and intensity for each area.
No numbing
XERF’s manufacturer says no numbing is needed: built-in cooling protects the surface during every pulse.
Full face and neck, one price
$1,500 per session covers the full face and the neck. The price is posted, taxes extra.
No downtime
You resume your day as you leave. And a session that goes well is one you agree to repeat at the yearly upkeep.
Thermage has the name and the literature, and it should be said.
An article that only praises one device doesn’t help you choose. What Thermage has going for it:
- A long-known name: Thermage FLX is the latest generation of a brand whose earlier versions were studied over thousands of treatments.
- A single session, according to the manufacturer, with a result that settles in over 4 to 6 months.
- More published studies on monopolar radiofrequency, even if few are on FLX itself. Those on XERF are recent, small and tied to the manufacturer.
No study compares XERF and Thermage FLX.
The pages pitting the two against each other at the top of Google are clinic pages, not studies. Here is what actually exists.
| Study | Device | What it shows, and its limit |
|---|---|---|
| Rohrich et al., 2022 | Radiofrequency | Review of 23 papers on monopolar and bipolar radiofrequency: measurable firming, acceptable complications |
| Dover et al., 2007 | Thermage | Survey of 5,700 treatments; earlier generation, not FLX |
| Erlich et al., 2026 | XERF | 16 women, one session, 3-month follow-up; first author is a manufacturer trainer |
| Hong et al., 2024 | XERF | Tissue analysis, no patient results; authors employed by the manufacturer |
What it means: monopolar radiofrequency is a documented technique, XERF is still thinly documented, and neither has been shown superior. The choice comes down to your skin, what you want to go through during the session, and the price.
The right choice depends on what you are looking for.
| If… | Rather |
|---|---|
| You want the full face and neck, at a price known in advance | XERF |
| You don’t want numbing cream | XERF |
| You want the name you have known for years | Thermage |
| You want a single session | Thermage |
| Your skin hangs and folds at rest | Neither: surgery |
| It is mostly volume that is missing | Neither: filler |
Why we chose XERF.
We wanted a radiofrequency our patients would agree to repeat. Firming is maintained: a session without numbing or downtime is one you come back for the following year.
We also wanted to treat the face and neck in the same appointment, at a price we can post. And we wanted to know it inside out: the clinic’s owner has trained clinicians for Cynosure, the XERF supplier.
A good device is one you agree to come back for the following year.
Questions we get asked
Are XERF and Thermage the same technology?
They are in the same family: two monopolar radiofrequencies. XERF sends two frequencies in the same pulse, according to its manufacturer. No study directly compares their results.
Do you offer Thermage at Clinique DC?
No. For firming the face and neck we chose XERF, and TempSure for a smaller budget (from $100 per zone). The prices other clinics post for Thermage are in the “The price” section, with their source.
Which one hurts more?
No study compares them. Both manufacturers built in cooling; Thermage adds vibration, and XERF’s manufacturer says no numbing is needed.
Why two XERF sessions when Thermage advertises one?
It is how we do it: two sessions, then yearly upkeep. That is why the price section compares the full protocol, not one session against one session.
Is it too late at 60?
Age doesn’t decide, the skin does. XERF tightens loosening skin; it doesn’t remove skin that hangs and folds at rest. The free 3D skin analysis is there to tell you before you pay anything.
How much does XERF cost in Laval?
$1,500 per session at Clinique DC, full face and neck, taxes extra. Payment can be spread over instalments with Klarna.
Sources
- Rohrich RJ, Schultz KP, Chamata ES, Bellamy JL. Minimally invasive approach to skin tightening of the face and body: systematic review of monopolar and bipolar radiofrequency devices. Plast Reconstr Surg. 2022;150(4):771-780.
- Dover JS, Zelickson B, et coll. Results of a survey of 5,700 patient monopolar radiofrequency facial skin tightening treatments. Dermatol Surg. 2007;33:900-907.
- Erlich G, Dahan E, Wolf Y. Objective and subjective retrospective evaluation of XERF, a novel single-shot dual-frequency non-invasive monopolar radiofrequency. Lasers Med Sci. 2026;41:194.
- Hong J, Ryu HG, Park C, et coll. Efficacy of dual-frequency noninvasive monopolar radiofrequency in skin tightening: histological evidence. Skin Res Technol. 2024;30:e13821.
- Solta Medical. Thermage FLX, information aux patients.
- Bausch Health. Autorisation de Santé Canada pour le Thermage FLX, communiqué du 29 avril 2025.
- Cynosure Lutronic. XERF, fiche produit.
- Prix : Elle Clinic, liste de prix consultée le 3 octobre 2026.
Facts attributed to a manufacturer come from its documents. Other clinics’ prices are those they post online, as of the date gathered; Clinique DC’s are before taxes. Results vary from person to person.