November 01, 2026 | Body Contouring, Facial Rejuvenation, Skin Tightening
Barry Keoghan’s facialist filmed his second needle-free skin tightening session last week, and the Daily Beast put the bill in the headline: about $6,000 for two. The device is called Xerf. No needles, no numbing, no downtime. He said he feels better about himself and looks better.
I have not examined him. No doctor is named in the story. So I will leave his face alone and answer the question I actually get, which is never “does RF work.” It is “which one, and will it be enough for me.” These are my answers from the exam room, verbatim.
Aren’t Morpheus8, BodyTite, Renuvion and the needle-free machines different technologies?
“Well, the mistake here is that RF is the energy used by Morpheus8, BodyTite, AccuTite, FaceTite, and Renuvion. The only difference is that Renuvion, or J-Plasma, also has the helium plasma component. Otherwise, all these technologies are using radiofrequency effectively, and I like all of those modalities. Each is used in different areas.”
“I prefer BodyTite on thinner skin, which is usually in the arms and thighs. I prefer Renuvion J-Plasma in larger areas like the abdomen, the back, the lateral chest wall, and the flanks. I prefer FaceTite in the lower face and neck. And AccuTite around the eyes and nasolabial lines.”
“BodyTite treats the external skin and the internal fat as a bipolar radiofrequency device. Renuvion J-Plasma treats the subcutaneous tissue, the tissue below the skin, with radiofrequency and helium plasma. And Morpheus8 is limited to treating the superior layers of the skin, dermis, and subcutaneous tissue. QuantumRF treats the deep subcutaneous tissue and skin, creating contracture using higher delivery powers in a safe fashion. So far, we’ve seen far greater contracture with QuantumRF than with any other device.”
So where does a needle-free device sit?
On the gentle end. It warms the dermis from the surface, with cooling, and no deeper. The home gadgets show why the gentle end stays gentle:
“The main reason being that these devices do not deliver the same energy as medical grade office devices, and do not heat the dermis up to the 40 to 45 degrees Celsius range, which is what actually remodels collagen. This is also the reason why the results are very mild.”
A needle-free office device does reach the dermis, so it beats the gadget. It still works from the top down, and loose skin on a neck, an abdomen or an arm does not live at the top.
Why not stop at needle-free for the face?
Because Morpheus8 Cool took away the reason to. I tried it on myself before offering it.
“When I tried it, it was night and day. The pain level I perceived was a one or two out of ten, without any topical anesthesia or medications on board. This made the treatment a lot faster. I noticed less swelling of the tissues because of the cooling technology.”
“It’s important to realize that Cool has the same power and effectiveness as the latest Morpheus8. There are several versions of Morpheus8, and we’ve always had the latest one, which includes Burst, which can treat multiple layers with each activation. So the difference between Morpheus8 and Morpheus8 Cool really is that it is much more comfortable. Everything else is the same.”
“We still recommend two to three sessions with Morpheus8 Cool.”
When do you go under the skin?
“The latest and most promising innovation in plastic surgery has been radiofrequency. Before radiofrequency, the only skin tightening we would see was from some fibrosis created after liposuction or VASER treatments, but it wasn’t truly skin tightening. Since I’ve been using radiofrequency treatments, we’ve had better and better results in body contouring. You see, body contouring is not just about removing fat. It is about shaping and tightening the skin for better overall 360-degree contours, and even muscle enhancement.”
“Overall, I always recommend skin tightening after liposuction, because liposuction itself is emptying out the tissue, but leaving the skin envelope looser than before, since the volume is not there to stretch it out. Delivering radiofrequency will create contracture, which will give us smoother results.”
“If I had to pick just one, I would pick QuantumRF over all the other devices, mainly because it delivers more power, and does so much faster, in a safe and controlled fashion.”
What does the surgical treatment look like?
“QuantumRF tightening is meant to be performed with or without liposuction. More often than not, we’re performing it with liposuction, if we want to remove some excess volume in those areas. It is performed through a small incision, about four millimeters, the same incision we use for liposuction. The probe is inserted through the incision on a long cannula, and the radiofrequency treats the tissues under the skin.”
“As we’re delivering the energy during the surgery, we actually hear the fat and the connective tissue crackle, which translates into contraction we can visualize immediately. About 30% of the contracture is seen right away during the procedure. Another 30% occurs in the first one to two weeks, and the final third occurs toward the two-month mark.”
“Recovery is the same as with traditional liposuction without radiofrequency. It’s usually five days to get back to normal, easygoing activity, and as soon as two weeks to return to exercise. Lymphatic massages are still recommended, as are compression garments.”
“We usually perform the procedure in one session, with IV sedation or general anesthesia. It is an outpatient procedure, and it can be repeated in future procedures if further skin tightening is wanted.”
Who should not expect RF, at any rung, to be enough?
“Radiofrequency energy is going to work well for mild to moderate cases where the skin is still good quality. By good quality, I mean that the skin has good elasticity and is usually absent of stretch marks. In more severe cases, or when the skin quality cannot give us predictable contracture, then surgical excision is indicated.”
“Massive weight loss patients may not be candidates. If we see a lot of stretch marks on the skin, or large folds with loss of collagen and dermal tears, the likelihood that the skin will contract is lower, and this would require excisional plastic surgery procedures.”
“In the area of GLP-1s, which are Ozempic, tirzepatide, and Retatrutide, small amounts of weight loss cause some skin looseness because of the loss in volume. A lot of times, the tightening effect is done by adding volume, but it can be improved in the early stages with radiofrequency, whether it’s Morpheus8 or something more invasive.”
Twenty pounds down on a GLP-1 with a little looseness: an RF patient, often an early one. A hundred pounds down: a lift or a tummy tuck, and I say so at the first visit instead of selling three sessions of something that cannot reach the problem.
What lasts?
“With some of the radiofrequency technologies, we can repeat the treatments for further tightening. And the results that you obtain really are permanent. We create contracture, and we keep going in that timeline from that result. So obviously, as time passes, the skin can begin to lax again, but the actual contracture obtained sets the clock back.”
True at every rung. Needle-free moves the clock a little. Under the skin moves it a lot. Surgery resets it.
And his reason?
He said the sessions were about looking after himself after months of online abuse over his looks. I hear versions of that in my office. The plan has to start with what the face needs, not with what strangers said about it. His choice was low risk. By design, it was also low yield.
Why choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor every year from 2014 through 2026. I run every rung of this ladder in one practice, from Morpheus8 Cool in the med spa to QuantumRF, BodyTite and Renuvion in the operating room, and I do the lifts and tummy tucks for the patients RF cannot help.
Ready to talk?
Bring your questions. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. Fees are listed at agulloplasticsurgery.com/fees. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
