Non-surgical skin tightening has become one of the most popular areas in aesthetics, but with so many devices available, it can be difficult to understand how they differ.

Three treatments patients are increasingly asking about are EXION Face, XERF, and Sofwave.

All three are designed to support firmer, smoother, more youthful-looking skin, but they use different energy technologies.

The biggest distinction is this:

• Sofwave uses ultrasound
• XERF uses monopolar radiofrequency
• EXION Face combines monopolar radiofrequency and targeted ultrasound in the same treatment

That makes EXION Face particularly interesting for patients who want a comprehensive, non-invasive treatment without necessarily pursuing two separate energy-based procedures.

What Is EXION Face?

EXION Face is a non-invasive facial treatment that combines monopolar radiofrequency (RF) with targeted ultrasound.

BTL describes the technology as a patented simultaneous delivery system designed to stimulate fibroblasts in the deeper layers of the skin and promote production of hyaluronic acid, collagen, and elastin.

This is important because aging skin is affected by more than collagen loss alone.

Over time, the skin also loses:

• elastin
• hydration
• hyaluronic acid
• firmness
• structural resilience

By combining two energy modalities, EXION Face is designed to address several of these changes in one treatment.

What Is Sofwave?

Sofwave uses Synchronous Ultrasound Parallel Beam, or SUPERB™, technology.

Its ultrasound energy is delivered primarily into the mid-dermis at approximately 1.5 mm depth, where it creates controlled thermal stimulation intended to support collagen and elastin remodeling.

Sofwave is FDA-cleared to:

• improve facial lines and wrinkles
• lift the eyebrow
• lift lax submental tissue
• lift lax neck tissue

It is a completely non-invasive, needle-free treatment with minimal downtime.

What Is XERF?

XERF uses multifrequency monopolar radiofrequency.

Rather than ultrasound, it delivers RF energy across shallow, middle, and deeper tissue levels with the goal of tightening and collagen remodeling. Cynosure Lutronic describes XERF as the first multifrequency monopolar RF treatment and markets it as a needle-free, no-numbing, no-downtime approach to structural skin tightening.

So XERF is best thought of primarily as an RF skin-tightening technology.

EXION Face vs. Sofwave vs. XERF

EXION FaceSofwaveXERFRadiofrequencyYesNoYesUltrasoundYesYesNoCombines two energiesYesNoNoPrimary focusSkin quality, firmness, hydration, collagen/elastin/HA stimulationDermal collagen remodeling and liftingMulti-depth structural tighteningNeedle-freeYesYesYesDowntimeMinimal to none expectedMinimal to none expectedMinimal to none expectedTypical approachUsually performed as a treatment seriesOften 1–2 treatmentsIndividualized

The key advantage of EXION Face is therefore not simply that it “does what Sofwave and XERF do.”

It is that EXION Face brings two complementary forms of energy—RF and ultrasound—into one treatment.

Why Use Both Radiofrequency and Ultrasound?

Radiofrequency and ultrasound interact with tissue differently.

Radiofrequency

RF creates controlled thermal energy within the tissue.

This heating can stimulate fibroblasts and support collagen and elastin remodeling.

Targeted ultrasound

Ultrasound provides mechanical and thermal stimulation at targeted tissue depths.

With EXION Face, BTL states that the targeted ultrasound is directed into the deeper dermal layer where active fibroblasts are located, while RF simultaneously heats the dermis.

Together, these energies are designed to create a combined tissue response.

That is what makes EXION Face different from technologies that rely on either ultrasound or RF alone.

Could EXION Face Replace Doing Both Sofwave and XERF?

For some patients, potentially yes—but not because the treatments are identical.

If someone is considering Sofwave primarily because they want ultrasound-based collagen stimulation and XERF because they want RF-based tightening, EXION Face provides both targeted ultrasound and monopolar RF in a single procedure.

That can make EXION Face an appealing option for patients who prefer:

• fewer different treatment modalities
• a streamlined treatment plan
• radiofrequency and ultrasound together
• improvement in skin firmness and texture
• collagen and elastin support
• additional emphasis on natural hyaluronic-acid production
• a needle-free approach

In that sense, a patient may not necessarily need to pursue one ultrasound treatment plus a separate RF treatment simply because they want benefits from both energy categories.

However, the devices are not technically equivalent.

Sofwave has its own ultrasound delivery pattern and FDA-cleared lifting indications, while XERF uses a distinct multifrequency RF system intended for multi-depth structural tightening.

The better question is therefore:

Can one EXION Face treatment plan address enough of my goals that I do not need two separate technologies?

For many patients with mild-to-moderate concerns about laxity, texture, hydration, and early signs of aging, that may be a very reasonable conversation to have.

Another Difference: Hyaluronic Acid

One of the most interesting features of EXION Face is its focus on stimulating the skin's own hyaluronic acid production.

BTL cites clinical research showing increases in hyaluronic acid, collagen, and elastin following a treatment series.

Hyaluronic acid plays an important role in:

• skin hydration
• elasticity
• volume
• smoothness
• overall skin quality

That gives EXION Face a slightly different treatment philosophy from a device focused mainly on tightening or lifting.

Rather than targeting only laxity, EXION Face is designed to improve the overall quality of the skin.

What Can EXION Face Help Improve?

Patients may consider EXION Face for:

• fine lines
• mild skin laxity
• loss of elasticity
• dry or crepey-looking skin
• early jowling
• facial firmness
• uneven texture
• lack of skin hydration
• age-related changes around the eyes, mouth, face, and neck

BTL also emphasizes the treatment's ability to support natural production of hyaluronic acid, collagen, and elastin.

Does EXION Face Require Needles?

No.

This particular EXION Face applicator is non-invasive and needle-free.

It is different from EXION Fractional RF, which is an RF microneedling treatment.

The EXION platform can offer several different treatment technologies, but the EXION Face treatment discussed here uses RF and targeted ultrasound without needles.

How Many EXION Face Treatments Are Needed?

BTL's patient materials commonly recommend a series of approximately four treatments, typically spaced about 7–14 days apart, although the exact number should be individualized.

This is an important difference from Sofwave, which is commonly performed as one or two treatments.

So EXION may involve more visits, even though it combines two forms of energy.

Which Treatment Is Best?

There is no single device that is automatically best for everyone.

Sofwave may make sense for someone who specifically wants an ultrasound-based lifting treatment with established FDA-cleared indications.

XERF may appeal to someone specifically seeking deeper, multi-level monopolar RF tightening.

EXION Face may be especially attractive for someone who wants a more comprehensive skin-quality approach combining both RF and ultrasound in one treatment.

For patients who are considering both an ultrasound treatment and a separate RF treatment, EXION Face may offer a simpler option worth discussing first.

One Treatment Strategy Instead of Two Technologies

Aesthetic treatment plans do not always need to involve more devices.

Sometimes the goal is not to do the most treatments—it is to choose the technology that addresses the greatest number of concerns in the most efficient way.

EXION Face combines:

Monopolar Radiofrequency
+
Targeted Ultrasound

to support:

Collagen
+
Elastin
+
Hyaluronic Acid

For the right patient, that combination may provide a comprehensive approach to skin rejuvenation without having to separately pursue both an ultrasound-only treatment and an RF-only treatment.

Discover EXION Face at Origin Health Center

At Origin Health Center, we individualize aesthetic treatment plans based on your skin quality, degree of laxity, age, anatomy, and goals.

If you are considering Sofwave, XERF, or another non-invasive skin-tightening treatment, we can help you determine whether EXION Face may address your goals with one combined RF + ultrasound platform.

Origin Health Center
4333 Piedmont Ave, Oakland, CA 94611
Text 530-464-5024 to book
originhealthcenter.com

Individual results vary. EXION Face, Sofwave, and XERF use different technologies and should not be considered identical treatments. A consultation is necessary to determine which treatment is appropriate for an individual patient.

‍