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Why our dermatologist flew to Seoul for a device we already own.
dr. Jesslyn Amelia, Sp.D.V.E has returned from the XERF advanced programme at Cynosure Lutronic in Korea — training alongside dermatologists and plastic surgeons, and taking part in the clinical research sessions behind the technology itself.
Elea Clinic was the first provider of XERF in Bali. The machine has been in our treatment room since its launch here. So the reasonable question is why the clinic’s lead dermatologist would spend a week in Korea learning a device she already uses every week.
The answer is the part of aesthetic medicine that patients rarely see.
A device is not a protocol
XERF is a monopolar radiofrequency system that runs two frequencies at once — 6.78 MHz and 2 MHz — allowing it to treat the dermis and the deeper SMAS layer within a single session, without needles and without surgery.
What the specification does not tell you is which depth setting suits a forty-two-year-old jawline with moderate laxity and thin skin, versus a thirty-five-year-old with heavier tissue and early jowling. Or how shot count should change across the cheek when volume has already been lost. Or when to treat less, because the tissue will do the rest over the following twelve weeks.
That judgement is built from two things: clinical training in skin, and repeated exposure to how a specific device behaves across many different faces. The first is what a dermatology specialisation provides. The second is what a manufacturer’s advanced programme is for — sitting with the engineers and the physicians who have run the highest volume of cases, and comparing parameters against outcomes.
What the programme covered
- Programme
- XERF advanced clinical programme — Cynosure Lutronic, Korea
- Attended by
- dr. Jesslyn Amelia, Sp.D.V.E — Dokter Spesialis Dermatologi, Venereologi dan Estetika
- Alongside
- Dermatologists and plastic surgeons from across the region
- Focus
- Parameter selection by tissue type · treatment planning by laxity pattern · combination sequencing · clinical research sessions on the technology
- Device
- XERF — dual-frequency monopolar RF, 6.78 MHz + 2 MHz. US FDA 510(k) K251327, cleared 11 August 2025 as substantially equivalent to the Thermage FLX.
Training beside plastic surgeons matters more than it sounds. Surgeons think about facial structure and vectors of lift; dermatologists think about skin quality, collagen behaviour and healing. Energy-based lifting sits precisely between the two disciplines, and the treatment plans that work best tend to borrow from both.
What a staged protocol actually means
The clearest thing to come out of the programme is that XERF is not delivered at one setting. A full treatment is staged — a deep pass first across the lower face and under the chin, where the structural layer sits; then a mid-depth pass across the midface; then either a shallow pass on the forehead or a lower-energy pass on the neck, depending on what the face needs.
Shot count is budgeted per region and per half of the face rather than applied evenly, and total delivered energy matters as much as the number of shots. Below a certain threshold the treatment simply underperforms, which is the most common reason patients report that radiofrequency “did nothing” for them. Retreatment is measured in months, not weeks.
The part patients should actually ask about
A meaningful share of the programme was spent on where not to treat, and where to reduce energy. This is the part almost no clinic discusses openly, and it is the reason your treatment history matters more than your age:
- Recent injectables change the plan. Areas treated with botulinum toxin, filler or skin boosters can have altered local circulation and fibrosis. Energy is reduced and shot count limited over those zones, otherwise swelling risk rises.
- Previous HIFU or liposuction areas need caution. Tissue that has been treated before dissipates heat less efficiently, which raises the risk of thermal injury at standard settings.
- The thyroid and vocal cord region is avoided. Not treated with lower energy — avoided.
- Nerve pathways and bony prominences are pain-sensitive and are worked more carefully, which is also why comfort varies across the face during a session.
None of that is visible from a price list. It is why the consultation asks what you have already had done, when, and where — and why a treatment plan built without those answers is guesswork.
What this changes at the clinic in Bali
Planning is regional, not uniform. Different depths across jawline, midface and neck within the same appointment, according to where laxity actually sits.
Dosing is deliberate. Under-dosing to keep a session short or a price low produces the flat result that makes people give up on radiofrequency. If the appropriate plan for your face is larger than you expected, we will say so rather than quietly deliver less.
Your history shapes the plan. Filler, toxin, boosters, previous HIFU, melasma — each of these changes the settings, and in some cases the sequence of what to treat first.
Wondering whether XERF suits your skin?
Send a photo and a short description. dr. Jesslyn will tell you honestly whether it is the right treatment for you — or whether something else would serve you better.
Ask dr. Jesslyn on WhatsAppQuestions we were asked after this trip
Is the XERF machine in Bali the same as the one in Korea?
Yes. Elea Clinic uses the same Cynosure Lutronic XERF system, supplied through the authorised Indonesian distributor. The device, the handpieces and the software are identical to those used in Korea.
Who makes XERF?
Lutronic, part of Cynosure Lutronic, headquartered in Korea. The system holds US FDA 510(k) clearance K251327, granted 11 August 2025 as substantially equivalent to the Thermage FLX. The indication for use reads in full: “XERF is indicated for use in dermatologic and general surgical procedures for electrocoagulation and hemostasis.” The lifting and tightening effect is produced by controlled soft-tissue coagulation rather than by a separate “skin tightening” indication — which is also true of every RF device in this category, including the Thermage predicate. Elea Clinic was the first provider in Bali.
Does better training mean a different price?
No. Pricing is by treatment area and shot count, as before. Ask us on WhatsApp for the current range for the area you are considering.
Who should not have XERF?
Monopolar radiofrequency is generally avoided in patients with a pacemaker or other implanted electronic device, during pregnancy, over active skin infection in the treatment area, and in some cases where there are metal implants in the treatment field. Suitability is assessed at consultation.
I am visiting Bali — can I have XERF during a short trip?
Usually yes. Treatment takes roughly 30–45 minutes with minimal to no downtime, and most patients return to normal activity the same day. We recommend scheduling early in your stay. See international patients for how treatment is planned before you arrive.
Written and medically reviewed by dr. Jesslyn Amelia, Sp.D.V.E — Dokter Spesialis Dermatologi, Venereologi dan Estetika. Registered with the Indonesian Ministry of Health, STR JT00000382760637. Verify registration. Last reviewed 16 August 2026. Individual results vary; this article is general information and not a substitute for consultation.