If you have been researching non-surgical skin tightening, you have probably run into a wall of device names: Ultherapy, Thermage, Morpheus8, and now XTherma. It is a reasonable question to ask what actually sets one apart from another, and what XTherma specifically does.
XTherma by BENEV is a monopolar radiofrequency device built around a single idea: deliver enough heat to the deep layers of the skin to trigger real collagen remodeling, without making the treatment miserable to sit through. At Allen Medical Aesthetics in Des Moines, WA, we offer XTherma as both a standalone treatment and as part of a combination protocol with SylfirmX RF microneedling, depending on what a patient's skin needs.
This guide covers how XTherma works at the tissue level, what a treatment session actually involves, who tends to be a good candidate, and what a realistic results timeline looks like.
XTherma is a monopolar radiofrequency (RF) device by BENEV that delivers high-frequency energy (6.78 MHz) to the deeper layers of the skin while an integrated cryogen cooling system, called Smart Temperature Cooling (S.T.C.), protects the surface and keeps the treatment comfortable. The RF energy causes immediate contraction of existing collagen fibers and triggers new collagen and elastin production over the following weeks and months, producing gradual, non-surgical tightening of the face, neck, or body. A session takes 45 to 60 minutes, most patients complete an average of two to three sessions spaced four to six weeks apart, and results generally last 12 to 18 months or longer.
XTherma is not a one-and-done fix. It works by prompting your own body to rebuild collagen, so results build gradually over weeks and months rather than appearing overnight. What is different from older RF and ultrasound devices is the integrated cooling, which is designed to make that process considerably more tolerable to sit through.
How XTherma Works: Monopolar RF Meets Cryogen Cooling
XTherma is a monopolar RF device that operates at 6.78 MHz, delivering high-frequency energy to the deeper layers of the skin. This thermal energy does two things. It causes an immediate, mechanical contraction of existing collagen fibers, and it initiates a remodeling process in which the body produces new collagen and elastin over the following weeks and months. The visible result is gradual, progressive tightening and lifting of the treated area rather than an instant change.
What sets XTherma apart from earlier RF and ultrasound-based tightening devices is its Smart Temperature Cooling (S.T.C.) technology. The handpiece delivers seven integrated cooling pulses per shot, before, during, and after each RF pulse, which protects the surface of the skin and significantly reduces discomfort during treatment. Most patients describe the sensation as a deep warmth paired with simultaneous cooling on the surface, rather than the sharper heat associated with older devices.
The device also supports a continuous glide technique, which lets a provider move the handpiece steadily across larger areas, including the neck, jawline, and body, with even, consistent energy delivery rather than treating in isolated spots. Learn more about how we use XTherma at Allen Medical Aesthetics, including how it fits into a broader treatment plan.
The mechanism is straightforward: heat at depth triggers collagen contraction now and collagen production later. The cooling system is what makes reaching that depth tolerable without sedation.
What to Expect During an XTherma Treatment
Treatments at Allen Medical Aesthetics are performed by ARNPs and licensed master aestheticians, under the oversight of board-certified medical director Tod Work, ARNP, and are tailored to each patient's anatomy, skin quality, and goals. A typical appointment follows four steps.
- 1. Consultation and skin evaluation. Your provider evaluates your degree of skin laxity, facial anatomy, and any additional concerns such as texture or pigmentation. If appropriate, they will discuss a combination protocol with SylfirmX.
- 2. Pre-treatment preparation. The skin is cleansed and a conductive gel is applied. Because of the integrated cooling system, topical numbing is generally not required, though it can be offered for patients with a lower pain tolerance.
- 3. XTherma treatment. The handpiece is moved over the treatment area using the continuous glide technique. RF energy heats the deep tissue while the cryogen system maintains surface comfort. Treatment time runs 45 to 60 minutes depending on the areas addressed.
- 4. Post-treatment care and follow-up. There is minimal to no downtime. Mild redness may be present for a few hours. Patients can return to normal activities immediately, and a follow-up schedule is set based on your goals and the number of sessions recommended.
“What I appreciate about XTherma is the precision it gives us. The thermal sensor technology means we can deliver consistent energy at depth without compromising the surface. When we layer it with SylfirmX, we are addressing the full architecture of the skin: deep structure and surface refinement, in a way that was not possible with a single device.”
Guidance from the clinical team at Allen Medical Aesthetics
Who Is a Good Candidate for XTherma?
XTherma is appropriate for patients with mild to moderate skin laxity who are seeking non-surgical improvement in skin firmness and contour. It is effective on both the face and body, and treats a specific range of concerns.
XTherma Tends to Be a Good Fit For
Patients with mild to moderate skin laxity who are not ready for surgical intervention, those who have researched Ultherapy but are concerned about pain or cost, patients who want to address both deep laxity and surface texture in a single treatment plan by combining XTherma with SylfirmX, anyone experiencing early jowling or loss of jawline definition, patients who need a treatment with no recovery time, and those who want a gradual, natural-looking improvement rather than an abrupt change.
Who Should Avoid XTherma
XTherma is not appropriate for patients who are pregnant, have active skin infections in the treatment area, have implanted electronic devices such as pacemakers, or have metal implants in the treatment zone. Your provider will review your full medical history during the consultation to confirm candidacy before any treatment is scheduled.
- Skin laxity on the lower face and jawline
- Laxity in the neck and submental area
- Loss of facial contour and definition
- Body skin laxity, including the abdomen, arms, inner thighs, and knees
- Overall loss of skin firmness and elasticity
- Early jowling or loss of jawline definition
Questions about skin rejuvenation?
Our providers offer consultations to discuss your options. The $50 fee is applied toward your first treatment.
Talk to a ProviderResults Timeline: How Long Until You See Results, and How Long Do They Last?
XTherma results follow a gradual, predictable arc. There is minimal recovery involved. The integrated cryogen cooling protects the surface of the skin, so most patients experience only mild, transient redness that resolves within a few hours, and makeup can be applied the same day.
Some patients notice an immediate firmness right after treatment, a result of the initial collagen contraction. The longer-term changes, from new collagen and elastin production, develop over the following months as shown below.
| Timeframe | What You Can Expect |
|---|---|
| Day 1 | Mild redness or warmth may be present for a few hours. Some patients notice an immediate firmness. Normal activities can be resumed right away. |
| Weeks 2 to 4 | The initial surface response settles. Deep collagen remodeling is underway, though visible changes are still developing. |
| Months 1 to 3 | Progressive tightening becomes noticeable. Jawline definition improves, and skin firmness increases as new collagen matures. |
| Months 3 to 6 | Peak results are typically reached as the collagen matrix fully remodels. Skin is measurably tighter and more lifted. |
Most patients see meaningful improvement after one to two sessions. A series of two to three treatments spaced four to six weeks apart is recommended for more significant laxity, or for patients combining XTherma with SylfirmX as part of a comprehensive plan. Results generally last 12 to 18 months or longer, with maintenance treatments recommended annually.
XTherma Compared to Other Skin Tightening Options
Both XTherma and Ultherapy use energy to heat the deep layers of the skin and stimulate collagen production, but the technology and treatment experience differ. Ultherapy uses focused ultrasound (HIFU) to target specific tissue planes. XTherma uses high-frequency monopolar RF with integrated cryogen cooling. The difference patients notice most is comfort: the S.T.C. cooling system makes XTherma significantly more tolerable than older RF and ultrasound devices. From a value standpoint, XTherma paired with SylfirmX typically costs the same or less than a single Ultherapy session while addressing a broader range of concerns.
XTherma is also frequently paired with SylfirmX RF microneedling rather than used as a substitute for it. XTherma delivers deep, monopolar RF energy for foundational lifting and contouring. SylfirmX targets the mid-dermal and superficial layers to improve texture, tone, redness, and pigmentation. Because the two devices work at different depths and through different mechanisms, combining them in a single treatment plan produces more comprehensive results than either treatment alone.
A $50 consultation fee applies toward your first treatment, and financing is available through Cherry, CareCredit, and Sunbit for patients who want to spread out the cost of a treatment series.
Frequently Asked Questions
What is XTherma, in simple terms?
XTherma is a monopolar radiofrequency device made by BENEV that heats the deeper layers of the skin to contract existing collagen and stimulate new collagen and elastin production, producing gradual skin tightening. An integrated cryogen cooling system keeps the treatment comfortable while the RF energy works at depth.
Does XTherma hurt?
Most patients describe the sensation as a deep warmth with simultaneous surface cooling. The integrated S.T.C. cryogen system significantly reduces discomfort compared to older RF and ultrasound devices. Topical numbing is available but generally not necessary.
How many XTherma sessions do I need?
Most patients see meaningful improvement after one to two sessions. A series of two to three treatments spaced four to six weeks apart is recommended for patients with more significant laxity, or for those combining XTherma with SylfirmX as part of a comprehensive plan.
How long does an XTherma treatment take?
A typical XTherma session takes 45 to 60 minutes, depending on how many areas are being treated.
How is XTherma different from SylfirmX?
XTherma delivers deep, monopolar RF energy for foundational lifting and contouring. SylfirmX is an RF microneedling device that targets the mid-dermal and superficial layers to improve texture, tone, redness, and pigmentation. Because they work at different depths and through different mechanisms, combining them produces more comprehensive results than either alone.
Who should not get XTherma?
XTherma is not appropriate for patients who are pregnant, have active skin infections in the treatment area, have implanted electronic devices such as pacemakers, or have metal implants in the treatment zone. A full medical history review during your consultation confirms candidacy.
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