XERF at SŌMA Bali : What I learned getting certified at the Cynosure Lutronic Academy
Updated: Sep 24
By Dr Muhammad Nadim (M.Biomed) · Medically reviewed by Dr Shirley Yuliana Kwee, MBChB (Glasgow), GDFM (NUS) · Updated 23 September 2026
XERF is Cynosure Lutronic's monopolar radiofrequency treatment for skin tightening. It runs two frequencies at once, 6.78 MHz and 2 MHz, so the heat reaches the deep dermis and the SMAS, the layer a surgeon tightens in a facelift.
SŌMA Bali is among the first clinics in Bali to offer it. I completed the Cynosure Lutronic Academy XERF certification in Korea on 12 August 2026, and every XERF treatment here is done by a doctor. A session takes 45 to 60 minutes, with no needles, no numbing cream and no downtime. Prices start at IDR 6,000,000 plus 11% tax.
XERF Certification and training in Korea
In August, I travelled to Korea to train at the Cynosure Lutronic Academy at the company's headquarters. I have successfully completed the course and the assessment in Clinical Laser Training in accordance with the principles and procedures prescribed by Cynosure Lutronic Corporation for Medical and Cosmetic Applications using Dual monopolar RF (6.78 & 2 MHz) system, called XERF.
An energy device is only as good as the assessment, and the settings behind it, and the course is about exactly that: how much energy the SMAS actually needs, how to read the device's impedance feedback while you work, how to map a face so you're not guessing, and who shouldn't be treated at all.
Our rule at SŌMA is simple. XERF is performed by a doctor, on genuine Cynosure Lutronic equipment, following the manufacturer's protocol, every time.
We are proud to be a certified XERF provider, and committed to bringing the latest knowledge and technology back to Bali.
What XERF is
XERF is Cynosure Lutronic's monopolar RF platform for structural skin tightening. Monopolar radiofrequency has been used for non-surgical tightening for about twenty years, and XERF belongs to that family, with a few differences that matter in practice.
The first is the two frequencies. Cynosure Lutronic describes XERF as the first multifrequency monopolar RF system: 6.78 MHz and 2 MHz delivered together, so energy reaches the shallow, middle and deep layers of the skin, including the SMAS (the superficial musculoaponeurotic system).
Second, there's no numbing. Each pulse is paired with cryogen cooling, which the company calls its Never-Numb approach, so there's no anaesthetic cream and no injections, and you spend less time in the room.
The third is control: three depth settings and ten intensity levels, which is what lets me adjust for a jawline versus an eyelid, or for you versus the next patient.
XERF received Health Canada clearance in April 2025, launched in the United States in September 2025 and reached Europe in 2026 (Cynosure Lutronic; The Aesthetic Guide; Business Wire).
XERF, HIFU or microneedling RF?
Feature | XERF | HIFU / Ultherapy | Microneedling RF (e.g. Morpheus8) |
Energy | Monopolar RF, 6.78 + 2 MHz | Focused ultrasound | Bipolar RF through needles |
Target depth | Dermis to SMAS, in one pass | Fixed points at 1.5, 3.0, 4.5 mm | Dermis, needle depth set by doctor |
Numbing | None needed | Often needed | Needed |
Downtime | None; mild redness for hours | None to minimal | 1 to 3 days redness |
Best for | Mild to moderate laxity, jawline, neck, eye area | Laxity, brow and neck lift | Texture, scars, laxity |
Results | Immediate tightening, builds over 3 to 6 months | Builds over 2 to 3 months | Builds over 1 to 3 months |
We explain the mechanism in more detail on our XERF skin tightening page.
Who it suits, and who it doesn't
XERF works best on mild to moderate laxity: early softening along the jawline and jowls, loose or crepey skin on the neck and under the chin, and people who want lift and definition without fillers or surgery. It's also useful for maintaining results after a facelift or a thread lift.
We won't treat you with it if you have a pacemaker, defibrillator or another active electronic implant; metal implants or permanent fillers in the treatment area; an active skin infection; or if you're pregnant or breastfeeding. And if your laxity is severe, surgery will serve you better; we will say so at the consultation rather than sell you a session.
What a session is like
The consultation takes 15 to 20 minutes. Our doctor assesses your skin laxity and facial structure, confirms XERF is the right tool, and maps the treatment. Preparation is another ten minutes: cleansing, conductive gel, the mapping grid. No anaesthetic.
The treatment itself runs 45 to 60 minutes, during which the handpiece delivers a set number of dual-frequency shots; you feel strong warmth followed by cooling with each pulse. Then you walk out. Mild redness or a warm flush for a few hours is normal. Wear SPF and skip the sauna that day.
XERF prices at SŌMA (September 2026)
Area | Shots | Price (IDR) | Approx. A$ / S$ |
Forehead, eye area or double chin | 100 | 6,000,000 | A$474 / S$431 |
Neck | 300 | 23,000,000 | A$1,816 / S$1,650 |
Full face | 600 | 31,500,000 | A$2,487 / S$2,260 |
Full face and neck | 900 | 40,000,000 | A$3,158 / S$2,870 |
Prices exclude 11% Indonesian government tax; we quote your total with tax before treatment. Currency figures are approximate and based on September 2026 rates. Every treatment is on the full price list.
What the evidence says
Monopolar RF has the longest track record of the non-surgical tightening technologies.
A 2025 review in Health Science Reports lays out the mechanism: collagen begins to denature and contract when the dermis is heated to roughly 55 to 70°C, which gives an immediate tightening, and new collagen forms over the following months.
In one study cited in the review, 73.5% of patients saw improvement within two months, and satisfaction across trials ranged from 50% to 82% (Health Science Reports, 2025). The same review is careful to say that results vary with energy protocols and device design, and that complications, while uncommon, call for "individualised treatment and experienced practitioners".
Cynosure Lutronic's own in-vivo work on XERF measured internal skin temperatures of 50 to 70°C with histological confirmation of collagen remodelling. Put those two findings together, and you get the key conclusion: the operator's assessment and settings decide the result.
Questions patients ask about XERF
Is XERF the same as HIFU or Ultherapy?
No. HIFU and Ultherapy use focused ultrasound to make small points of heat at fixed depths. XERF uses monopolar radiofrequency at two frequencies (6.78 MHz and 2 MHz) to heat the dermis and the SMAS more evenly, with cooling built in and no numbing. Both tighten, but they work and feel different, and one will suit your degree of laxity better than the other. That's what the consultation is for.
Does XERF hurt?
Most people describe strong warmth rather than pain. There are no needles, each pulse comes with cryogen cooling, and the doctor adjusts intensity across ten levels to what you can comfortably tolerate.
How many XERF sessions do I need, and when will I see results?
Usually one per area. Skin tends to feel tighter on the day, and the visible lift builds over three to six months as new collagen forms. Most people consider a maintenance session after a year or more.
Can I surf, sunbathe or fly after XERF?
Yes. There's no downtime. Expect mild redness or a warm flush for a few hours; use SPF, and avoid saunas and very hot environments that day. Flying the same day is fine.
Who performs XERF at SŌMA?
A doctor, always. Dr Muhammad Nadim completed the Cynosure Lutronic Academy XERF course in August 2026, and every XERF treatment at SŌMA is always performed by one of our specialist doctors on genuine Cynosure Lutronic equipment, following the manufacturer's protocol.
How much does XERF cost in Bali?
At SŌMA, IDR 6,000,000 for the forehead, eye area or double chin (100 shots), IDR 23,000,000 for the neck (300 shots), IDR 31,500,000 for the full face (600 shots) and IDR 40,000,000 for the full face and neck (900 shots), all plus 11% government tax.
