Keeping a Firmer Face Without Starting Over: How Long It Lasts, and What Maintains the Result
How long XERF radiofrequency results last: what the clinic and the Cleveland Clinic say, and how the yearly upkeep session helps keep the result.
Yes, XERF treats the neck: it is included in the session, along with the full face. Radiofrequency tightens loose skin. It does not remove skin, it does not relax the vertical cords of the neck, and it does not go after fat under the chin.
What people call "a loosening neck" is really several things. Here is which ones, and which answers what.
Four things people call "the neck"
A changing neck can come from the skin, the muscle, fat, or a marked excess of skin. Each one answers a different treatment.
| What you see | What it relates to | What answers it |
|---|---|---|
| Skin that slackens, less taut than before | The skin and its collagen | XERF, done by a medical esthetician |
| Vertical cords that stand out when the neck tenses | The platysma muscle | A neuromodulator, given by a nurse |
| A pad under the chin, even a small one | Fat | A lipolysis injection, given by a nurse |
| A lot of excess skin | An excess that energy does not remove | Surgery |
The StatPearls chapter (NCBI Bookshelf) on neck rejuvenation describes the same three complaints: loose skin, platysmal bands and loss of the angle between chin and neck. It also lists the options: neck lift, injections, skin resurfacing.
Three questions to place yourself
They don't replace the assessment, but they help you see what bothers you:
- Is your neck mostly slack, with no visible cords? That is radiofrequency territory.
- Do vertical cords stand out when you tense your neck? That is a muscle, so a job for a neuromodulator, given by a nurse.
- Is there a small pad under the chin, even when you are slim? That is fat, which radiofrequency does not remove.
Several answers can be yes at once. That is common, and it is why we look at your neck before suggesting anything.
What XERF does to neck skin
XERF is a monopolar radiofrequency. It heats the deep layers of the skin to tighten it and restart collagen production, with no needle and no incision. According to the manufacturer, Cynosure Lutronic, the device combines two frequencies (6.78 MHz and 2 MHz), reads the skin's resistance in real time and cools the surface while it fires.
What research reports about the neck in particular is modest, and we say so:
- The systematic review by Austin et al. (Lasers in Surgery and Medicine, 2022), on radiofrequency for the face and neck, reports improved skin laxity and elasticity. Only one patient had a complication, a neck fistula.
- A retrospective study by Dendle et al. (Dermatologic Surgery, 2016) followed 35 people after one monopolar radiofrequency session on the face, neck or jawline: 77% reported improvement at 180 days. It is a single center, with no control group, using a different device than XERF.
So we draw no percentage to promise you. According to the Cleveland Clinic, radiofrequency works best in people who are starting to show signs of aging, and less well on very sagging skin.
Where non-surgical stops
When the neck skin hangs a lot, no energy removes it. Only surgery does. If that is you, the assessment tells you before we start: if XERF is not indicated, we don't do it. To place the two options, this article compares radiofrequency and a facelift.
The décolleté is not treated with XERF: we don't offer it yet.
XERF tightens neck skin. The vertical cords are a muscle, the pad under the chin is fat: that takes another treatment.
What it takes, in practice
The neck is treated in the same session as the face. The plan is the XERF one: two sessions about a month apart, then one upkeep a year. The neck is included in the session price, $1,500, taxes extra, with no add-on.
Before the first session, we look at your neck with the 3D analysis (LINE VU device) and confirm with you what comes from skin, muscle or fat. For skin, it is XERF. For the others, we tell you, and we point you to the nurse. Sagging neck and jawline also describes this area, and the XERF page gives the full procedure.
Questions we are asked
Does it remove excess skin under the chin?
No. Radiofrequency tightens skin, it does not remove it. A marked excess is a surgical matter.
Do the vertical cords of the neck go away?
Not with radiofrequency: those cords are a muscle, and the device acts on the skin. A neuromodulator, given by a nurse, relaxes that muscle. The effect is temporary.
Can the décolleté be treated at the same time?
No. For now, XERF covers the full face and the neck, and we don't offer the décolleté yet.
Does the neck cost extra?
No. The full face and the neck are included in the session price.
Sources
- Austin GK, Struble SL, Quatela VC. Evaluating the effectiveness and safety of radiofrequency for face and neck rejuvenation: a systematic review. Lasers in Surgery and Medicine, 2022. PubMed
- Dendle J, Wu DC, Fabi SG, Melo D, Goldman MP. A Retrospective Evaluation of Subsurface Monopolar Radiofrequency for Lifting of the Face, Neck, and Jawline. Dermatologic Surgery, 2016;42(11):1261-1265. PubMed
- Cleveland Clinic. Radio Frequency (RF) Skin Tightening. my.clevelandclinic.org
- StatPearls. Neck Rejuvenation. NCBI Bookshelf. ncbi.nlm.nih.gov
- Cynosure Lutronic (manufacturer). XERF, Structural Skin Tightening. cynosure.com/xerf
