Will Radiofrequency Make a Difference for You? No Injections, No Surgery
Too early, too late or right on time: how to tell whether facial radiofrequency suits you, and when only surgery answers.
It depends on what bothers you. If it's your complexion, your pores or spots, it's the fractional laser, which works on the surface of the skin. If it's your jawline or neck loosening, it's radiofrequency, which works on the structure underneath. If it's a bit of both, we do both, in a certain order.
"I want good skin": everyone says it, but not for the same reasons. Some people are looking at their complexion and a spot settling in on the cheekbone. Others are looking at the lower face, a jawline going soft, a neck that no longer holds its line. If a treatment that was done well has ever left you disappointed, you're not to blame. Often, the device simply worked the wrong layer.
Here's how to tell the difference, and why downtime often ends up deciding the order.
The surface and the structure of the skin
Skin has two layers that matter here. The epidermis, on top, carries colour, texture, marks and radiance. The dermis, underneath, is a mattress of collagen and elastin that keeps everything taut.
When the epidermis is struggling, you see it in the light: the complexion loses its glow, pores show from further away and summers leave brown spots that no longer fade by October. When the dermis loosens, it's the shape of the face that changes, with a cheek that drops and a less defined jaw.
A surface treatment lifts nothing, and a structural treatment erases no spots. Each type of energy does one thing well, whatever its power or price.
Not sure where you stand? Take a photo of yourself in natural light, no makeup, and ask what bothers you first: the colour of the skin, or the line of the face. If you can't decide, both have usually started. We come back to that further down.
| What bothers you first | The layer involved | The treatment that answers it |
|---|---|---|
| Dull tone, visible pores | The surface | The fractional laser |
| Spots that stay after summer | The surface | The fractional laser |
| A cheek that drops, a jawline going soft | The structure | Radiofrequency |
| A neck that no longer holds the line | The structure | Radiofrequency |
| A bit of everything | Both | Both, in a set order |
What a non-ablative fractional laser does
The LaseMD Ultra is a non-ablative fractional laser. Both terms matter.
"Fractional" means it doesn't treat the whole surface at once. It lays down a grid of micro-columns and leaves intact skin between them, so the area repairs itself from its own edges, and faster. "Non-ablative" means it doesn't vaporize the top layer. It passes through and heats underneath, and the surface stays in place.
This principle is called fractional photothermolysis. It was described in 2004 in Lasers in Surgery and Medicine (Manstein et al.), and it made it possible to rework skin with far less recovery than lasers that remove the whole surface. The LaseMD Ultra applies it with a 1,927 nm thulium laser.
Have you read elsewhere that a laser can tighten skin dramatically? Those pages are nearly always talking about ablative CO2, which removes the surface layer and needs one to two weeks of recovery. We don't use that technology here, so that's not the result to expect from us.
The non-ablative laser goes after:
- the look of pigmentation and the evenness of your complexion;
- skin texture and pores that show too easily;
- radiance, the glow skin loses when its turnover slows down.
It also supports collagen production, which gives a firming effect. That effect is gradual and subtle, though. If what bothers you in the mirror is a jawline on the move, you may find the result thin.
Does it hurt? Not really. Most people describe warmth and mild tingling, like after sun exposure, and we apply a numbing cream before the session. The treatment is done as a series, with a few weeks between sessions to let the skin recover. The exact number is set at your assessment, based on what we see on your skin.
What radiofrequency does
XERF produces no light. It runs a radiofrequency current through the skin, and the tissue's own resistance generates the heat, deep down and in a controlled way.
According to its manufacturer, Cynosure Lutronic, XERF combines two frequencies (2 MHz and 6.78 MHz) to heat at more than one depth, and reads the skin's resistance with each pulse to adjust the energy. Health Canada has cleared it for skin laxity of the face and neck.
That heat tightens the collagen already there right away. It then triggers the making of new collagen over the following weeks and months. You may see a small effect as you leave the session, then the improvement builds over several months.
Radiofrequency targets the lower face, the jawline and the neck. Here, the session covers the full face and neck, with no zone to add along the way. We don't offer the décolleté yet.
We clean the skin and apply a conductive gel, then move the handpiece zone by zone, raising the heat gradually. There's no needle and no anesthesia, and the intensity is adjusted to your comfort throughout.
Because it heats through resistance rather than aiming at a pigment, radiofrequency doesn't depend on your skin tone. Anything light-based does, and that affects the schedule, as we'll see further down.
Its limit: no energy removes skin. With significant laxity and real excess skin, surgery is what gets the result, and we'll tell you so rather than sell you a session.
The two side by side
| Fractional laser (LaseMD Ultra) | Radiofrequency (XERF) | |
|---|---|---|
| The energy | Light, a 1,927 nm thulium laser | A radiofrequency current, on two frequencies |
| The layer targeted | The surface: the epidermis and upper dermis | The structure: the deep dermis and what supports it |
| What improves | Tone, texture, pores, the look of spots | Firmness, the jawline, the neck |
| During the session | Numbing cream, warmth and prickling | No needle, no numbing |
| After | About 24 to 48 h of redness, sometimes light flaking | A light redness that fades, no downtime |
| The sun | Avoid tanning before and after | No seasonal constraint |
| Skin tone | Settings adapted to skin type | Does not depend on skin colour |
| The result | Gradual, session after session | A first effect, then 3 to 6 months of building |
Downtime
In practice, downtime often decides, more than the theory of layers.
Radiofrequency asks nothing of you. Light redness may show up and fade, and you go back to work. You can have it done on a Thursday and go out on Friday without anyone noticing a thing.
The laser asks for a few days. Expect redness and a sunburn-like feeling for roughly 24 to 48 hours, sometimes followed by light flaking. Makeup covers it, but it shows up close.
No resurfacing is downtime-free, even non-ablative. If someone promises you zero recovery days for a laser, be wary.
Got a wedding in ten days or family photos next weekend? The plan stays the same, but we change the order we do it in.
Why laser is planned around the season
A laser needs skin that isn't tanned. You avoid tanning and direct sun for roughly 2 to 4 weeks before and after the session, and SPF 30 or higher is a must during recovery. That's why laser skin treatments get planned for fall and winter: your skin is back to its own colour, and the weeks that follow aren't beach weeks.
Radiofrequency has no such constraint, since it targets no pigment. It can be done year-round, even in July.
The American Academy of Dermatology is clear: tanned or sunburned skin doesn't get lasered, because the risk of a burn or a spot becomes real. So before a laser, we check:
- no tan, from the sun or a booth, in the weeks before;
- SPF 30 or higher, every day;
- a date that doesn't fall right before a sunny vacation.
In practice, radiofrequency can be done whenever you like, and laser preferably when the sun is scarcer.
Doing both, and in which order
Often, the right answer is to do both, one after the other.
At forty-five, skin can easily have a complexion marked by past summers and a jawline starting to move. If only one layer is treated, the other stays visible, and it feels like the treatment did nothing when in fact it did its job.
We don't do them on the same day, because two kinds of heat on the same skin within the hour is too much for it. We sequence them, letting the skin settle in between.
Which one first? We often start with structure, because collagen takes months to build, and work on the surface in the meantime. When an event is coming up, we flip it: the laser is done early enough for the skin to calm down, and radiofrequency can be done almost anytime, even late.
| Your situation | What we do first | What follows |
|---|---|---|
| No date pressing | Radiofrequency | The laser, while collagen rebuilds |
| An event in a few weeks | The laser, early enough for the skin to settle | Radiofrequency, even close to the date |
| Summer coming | Radiofrequency | The laser, in the fall |
For both treatments, a medical esthetician holds the handpiece. The combined plan is decided in consultation, after we've seen your skin.
What we look at during the assessment
You don't need to arrive knowing whether your issue is on the surface or deeper. That's what the assessment is for.
We first look at your skin quality with the 3D skin analysis. It shows the pigmentation below the surface that the naked eye can't see yet, the state of your texture and where colour is collecting. That keeps us from treating one visible spot while ignoring the five building up underneath.
Then we look at the shape of your face, at rest and in movement, because laxity shows far better in person than in a straight-on photo. We also factor in your skin type, which changes nothing for radiofrequency but does change the settings of a laser.
We also tell you what neither treatment will do. A deep fold, lost volume or tissue that has descended call for other solutions, and we name them even if they're not what we offer you that day.
Frequently asked questions
Does laser tighten skin?
A little, and slowly. The LaseMD Ultra supports collagen production, so skin can gain tone over a series of sessions. But if what bothers you is a softening jawline or a dropping neck, radiofrequency is what works that layer. Laser stays the better pick for complexion, texture and the look of spots.
Does radiofrequency do anything for pigmentation?
No. It heats a volume of tissue without targeting pigment, so it has no effect on a brown spot. That's also what makes it usable on every skin tone.
Can you do both in the same month?
Yes, but not on the same day, and with a plan. We let the skin settle between the two sessions. The interval depends on which treatment came first and how your skin reacted, and we set it at your assessment.
How many days does skin flake after a fractional laser?
Count on roughly 24 to 48 hours of redness and a sunburn-like feeling, sometimes followed by light flaking for a few days. Makeup covers it, but it shows up close, so plan the session around your week.
Do you have to stay out of the sun afterward?
After a laser, yes. Avoid tanning and direct sun for roughly 2 to 4 weeks before and after, with SPF 30 or higher every day through recovery. After a radiofrequency session there's no such restriction, though daily sun protection remains a good idea year-round.
Sources
- Manstein D. et al., "Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury," Lasers in Surgery and Medicine, 2004, vol. 34, pp. 426-438. Read the abstract
- American Academy of Dermatology, "How dermatologists treat sun-damaged skin." Read the page
- Cleveland Clinic, "Radio Frequency (RF) Skin Tightening." Read the page
- Cynosure Lutronic, XERF product page (manufacturer). Read the page
- Cynosure Lutronic, Health Canada clearance of XERF (press release). Read the release
- Cynosure Lutronic, Ultra 1,927 nm laser product page (manufacturer). Read the page
