Benefits of Combining XERF and Re2O

The synergistic combination of XERF and Re2O!

Everything from the underlying principles and procedure steps to pain management and precautions.

Have you noticed firmer skin or more defined contours after XERF, but still feel that your skin texture or density could improve? Conversely, have you had multiple skin booster treatments but still feel dissatisfied because sagging contours remain?

These concerns may persist because the two treatments target different aspects of the skin and underlying tissue.

XERF is a lifting treatment that uses dual monopolar radiofrequency to deliver heat to tissue layers ranging from the dermis to the subcutaneous fat and fascial layers.
Re2O, on the other hand, is a skin booster that delivers acellular human dermal matrix (hADM) directly into the dermis to replenish skin components. One takes a structural approach to tissue tightening, while the other focuses on replenishing the skin.

So, what are the potential benefits of combining these treatments? In what order and at what intervals should they be performed, and what results can you realistically expect? Let’s explore these questions based on the ones we frequently hear during consultations at DORÉ Clinic.

Q1. Seoul Clinic What kind of treatment are XERF and Re2O, respectively?

XERF is a monopolar radiofrequency (RF) lifting device that uses a dual-frequency system combining 6.78 MHz and 2 MHz. The 6.78 MHz frequency is described as delivering energy to the epidermis and dermis, while the 2 MHz frequency targets deeper tissue layers, including the subcutaneous fat and superficial musculoaponeurotic system (SMAS). Treatment depth can be adjusted across three levels (Shallow, Middle, and Deep), with 10 intensity settings available. Different-sized treatment tips are used depending on the area being treated. Treatment plans commonly involve 300 or 600 shots.

Re2O is a skin booster from Hugel’s Elravie line, made from human-derived acellular dermal matrix (hADM). It contains extracellular matrix (ECM) components found in human skin, including collagen, elastin, and hyaluronic acid. Unlike conventional skin boosters that primarily focus on hydration, Re2O is designed to replenish dermal components.

In short, XERF uses heat to tighten tissue, while Re2O delivers dermal matrix material to help replenish components of the skin. Since they are fundamentally different treatments—one using a device and the other involving an injectable material—they are best understood in terms of their complementary roles rather than compared in terms of which is superior.

Q2. Seoul Clinic Why combine the two treatments?

The skin is made up of multiple layers, each of which ages differently. Over time, changes in collagen and elastin can contribute to rougher skin texture and the appearance of fine lines in the epidermis and dermis. In deeper layers, changes in the supporting structures of the subcutaneous fat and fascia may contribute to less-defined facial contours and sagging.

💡XERF focuses on tissue tightening and structural support. Radiofrequency heat can cause collagen fibers to contract and may stimulate subsequent collagen remodeling. Its 2 MHz mode is designed to deliver energy to deeper tissue layers, including the subcutaneous fat and fascia, while its shallow mode targets more superficial skin layers. Re2O, on the other hand, focuses on replenishing dermal components. It is designed to introduce extracellular matrix (ECM) material into the dermis, with the aim of supporting skin texture, density, and elasticity.

💡The rationale behind combining the two can be summarized as “support the structure, then replenish the skin.” XERF alone may help improve facial contours, while concerns about skin texture and density may remain. Re2O alone may help improve skin quality, but it may not adequately address more pronounced sagging. By targeting different aspects of the skin and underlying tissue, the two treatments may complement each other.

The rationale behind combining the two can be summarized as “support the structure, then replenish the skin.” XERF alone may help improve facial contours, while concerns about skin texture and density may remain. Re2O alone may help improve skin quality, but it may not adequately address more pronounced sagging. By targeting different aspects of the skin and underlying tissue, the two treatments may complement each other.

Q3. Seoul Clinic What are the benefits of combining XERF and Re2O?

There are five main potential benefits to combining XERF and Re2O.

• Elasticity (structure) and density (material) can be addressed together in one treatment plan.

• XERF works from shallow to deep layers, while Re2O fills the dermis, reducing the gaps in each layer.

• The scope expands to texture-related concerns such as pores, skin texture, and pigmentation.

• Both treatments have short downtime, so the burden of returning to daily life is relatively small.

This combination may be particularly beneficial for those experiencing early signs of sagging alongside concerns about skin texture and quality. Rather than repeatedly relying on a single treatment, a tailored approach that targets different tissue layers may offer more comprehensive results.

On the other hand, there are points where expectations must be clear. This combination is not a treatment that physically pulls up loosened skin, and XERF does not destroy fat cells, so it is not aimed at reducing volume. If sagging has progressed beyond a moderate degree or volume deficiency is the main concern, other approaches such as Ulthera, Thermage, thread lifting, or fillers may be more realistic.

Q4. Seoul Clinic How does this differ from XERF alone or XERF combined with Juvelook?

Even when XERF is used, the treatment goals can vary depending on what it is combined with. Re2O is designed to replenish components of the extracellular matrix (ECM), helping support overall skin density and elasticity. Juvelook, on the other hand, focuses on stimulating the skin’s own collagen production through PDLLA and hyaluronic acid. XERF alone primarily focuses on facial contouring and skin tightening.

Rather than asking which combination is better, the right choice depends on your individual concerns—whether you want to improve overall skin density, pigmentation, and pores; address fine lines, scars, and skin texture; or improve sagging and facial contours.

Q5. Seoul Clinic What about pain, downtime, and side effects?

XERF is described as having relatively little pain. A method of delivering pulses in divided portions according to skin resistance is applied, so it is often performed without anesthesia. There may be warmth and prickling during treatment, redness may remain for a few hours to a day afterward, and downtime is described as around 0-1 day.

Since Re2O is injected at multiple points, the procedure typically takes about 10–20 minutes. Bruising or swelling may persist for 1–3 days, but most patients can resume their daily activities immediately after treatment.

With Re2O in particular, injecting an excessive amount in one spot or misjudging the injection depth can make the skin surface uneven. That is why it is important to distribute it evenly into the deep dermal layer.

The following points are checked for safe treatment.

• Please inform us of any medications you are taking (including anticoagulants), allergies, autoimmune conditions, and whether you are pregnant or breastfeeding.

• For XERF, we verify the authenticity of the treatment tip and the number of shots. For Re2O, we verify the product’s authenticity and the dosage.

• For about one week after treatment, avoid saunas, alcohol, strenuous exercise, and applying strong pressure or massage to the treated area.

• If swelling or redness persists, or if you notice a nodule, do not press or massage the affected area. Please visit the clinic for an evaluation.

With both treatments, results depend in part on the practitioner’s clinical judgment and technique. In particular, since Re2O is derived from human tissue, patients should receive a thorough explanation of the procedure beforehand, including the possibility of foreign body reactions, and provide informed consent before proceeding with treatment.

Q6. Seoul Clinic When do results become noticeable,and how long do they last?
How does DORÉ Clinic approach treatment?

With XERF, some patients may notice a tightening sensation immediately after treatment, while changes in facial contours develop over the following 2–4 weeks as collagen remodeling progresses. With Re2O, in addition to the immediate feeling of hydration after injection, improvements in skin density and texture may become noticeable from around 2–4 weeks.

XERF results typically last 6 months to 1 year, while Re2O results may last 6 months to over a year. However, the duration of results can vary depending on skin thickness, lifestyle habits, UV exposure, treatment area, and number of sessions. Therefore, these timeframes are general estimates rather than guarantees of how long the results will last for each individual.

At DORÉ Clinic, we approach this combination not as two separate treatments, but as a single, carefully designed treatment plan. We first assess which layers of the face have lost firmness and whether skin texture or facial contours are the primary concern before determining the appropriate combination and treatment sequence.

More specifically, we follow four key principles.

• First, verification of authenticity and dosage. The authenticity of the tips and products is verified in front of the patient, and the amount used is documented.

• Second, layer-specific assessment. The XERF mode and shot count, as well as the Re2O injection areas, are tailored to whether sagging originates in the fascial and fat layers or is associated with reduced dermal density.

• Third, treatment interval planning. To help each treatment work as intended without interfering with the effects of the other, the sequence and intervals are carefully planned in advance and followed throughout the treatment process.

• Fourth, avoid overcorrection. Rather than administering a large amount in a single session, a gradual approach that adjusts treatment based on the skin’s response may help reduce the risk of nodules and excessive heat stimulation.

Of course, the same combination isn’t right for everyone. In many cases, XERF alone may be sufficient, while others may benefit more from a different treatment first. Combining treatments is worthwhile only when there is a clear purpose, and every consultation takes into account that results may vary from person to person.

If you are considering XERF and Re2O, the first step is to understand which layer of your skin needs attention before determining which treatment is right for you.

DORE CLINIC | Seoul Clinic The XERF + Re2O Synergy Combination

Structure by XERF, density by Re2O.

This content is intended to provide general medical information; the suitability and expected results of an actual treatment must be confirmed through a consultation and examination with a medical professional.