Dual-Frequency Non-invasive Monopolar Radiofrequency for Periorbital Tightening: Introduction of Novel Small Treatment Tips

Periorbital aging involves progressive alterations in the dermis, superficial musculoaponeurotic system (SMAS), and ligamentous support, leading to eyebrow descent, upper-eyelid redundancy, and periorbital rhytids. Noninvasive monopolar radiofrequency (NMRF) is designed to address tissue laxity across multiple anatomical layers, yet conventional small applicators are limited by their shallow penetration, reducing their effectiveness. A novel dual-frequency NMRF platform (XERF, Cynosure-Lutronic, South Korea), incorporating two newly engineered small applicators, was developed to address this depth constraint. This report aims to describe our standardized approach to periorbital rejuvenation using XERF's novel small applicators, with the primary objectives of improving eyebrow position and achieving upper eyelid tightening. At the time of reporting, across all procedures performed to date, no unexpected or persistent adverse reactions were observed. Limited early imaging demonstrated the expected immediate tissue contraction, and qualitative impressions suggested interval improvements in eyebrow position, upper-eyelid redundancy, and periorbital rhytids at three months; however, these observations are anecdotal and not presented as quantitative outcomes. The author assumes that the novel small applicators may facilitate more controlled vector-based energy delivery, and that the dual-frequency deep mode may theoretically reduce the superficial penetration limitations of conventional small tips. As this manuscript is intended solely to outline a standardized procedural protocol, these assumptions should not be interpreted as evidence-based conclusions. Objective and subjective outcome measures are being collected in an ongoing prospective study. In conclusion, the XERF dual-frequency NMRF system, equipped with its novel small tips, appears to deliver safe, precise, and reproducible nonsurgical periorbital rejuvenation.