Barry Keoghan sat down for his second needle-free skin tightening session last week, and his facialist filmed it. “I feel better about myself. I look better,” he says in the video. “I think it’s important to look after yourself inside and outside.”
Two sessions, about $6,000, according to the Daily Beast. The device is called Xerf. No needles, no numbing cream, no downtime. In March he had told a radio host, “There’s a lot of hate online. There’s a lot of abuse of how I look.”
Nobody at Southwest Plastic Surgery has examined him. No doctor is named in the story. This is not about his face; it is about what he bought. Dr. Frank Agullo runs every version of it, so here are the questions patients ask, in his words.
Are the home devices and the needle-free office devices the same thing?
No. Radiofrequency is heat, and the gadgets sold online fall short for one reason. Dr. Agullo tells patients who ask about them that they are safe:
“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.”
Xerf is the next rung: a needle-free office device. NewBeauty calls it a dual-frequency radiofrequency device from Cynosure Lutronic, cleared in the United States in 2025, heating two depths with built-in cooling. Southwest Plastic Surgery does not run it. What it runs is one rung higher.
The ladder
| Needles | Where the heat goes | Downtime | Best for | |
|---|---|---|---|---|
| Home RF device | None | Surface only, below the remodeling range | None | Keeping skin a little firmer between treatments |
| Needle-free office RF (Xerf-type) | None | Dermis, from the surface, with cooling | None | Mild laxity, patients who want nothing invasive |
| Morpheus8 Cool | Tiny microneedles, cooled tip | Dermis and the fat just beneath it, multiple depths per pass | 24 to 48 hours | Mild to moderate laxity, texture, pores, acne scars, festoons |
| QuantumRF, BodyTite, Renuvion | A 4 mm incision, probe under the skin | Deep fat and the underside of the skin | Days to two weeks | Loose skin with or without liposuction |
| Facelift, neck lift, tummy tuck | Surgery | Skin removed and repositioned | Weeks | Skin that will not contract on its own |
Aren’t Morpheus8, BodyTite and Renuvion 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.”
“Morpheus8 can be used independently in nonsurgical sessions in the med spa. It’s mostly used on the face and neck, but it can be used on the abdomen, buttock, thighs, really any body part to create skin contracture and also to soften stretch marks. I also use it in the OR by stacking it with all the other modalities to potentiate the contractile effects.”
Why not just do the needle-free one? It doesn’t hurt.
Comfort is why needle-free sells. Dr. Agullo tried Morpheus8 Cool on his own face first:
“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. I did feel a little, almost needle-like sensation every so often, but very tolerable. I also noticed that the handpiece vibrates as it’s performing the treatment, so that camouflages the pain even further.”
“Morpheus8 Cool changes that dramatically. The treatments are the same, the depth of treatment is the same, the power is the same. It just makes the procedure so much more comfortable.”
“You will feel the cool head of the applicator on your face. You will feel some vibration, and every now and then you may feel a small needle prick, similar to when you get Botox.”
What does recovery look like, and when do results show?
“In terms of recovery, you may have some redness depending on how aggressive the treatment is and the depth of the treatment, and you may feel some itchiness or mild burning on the skin. Depending on the depth and aggressiveness of the treatment, the recovery could be anywhere between 24 and 48 hours, at which time you’ll start noticing the results. You will see the skin is smoother and tighter, the pores are smaller, and the skin looks refreshed.”
“We still recommend two to three sessions with Morpheus8 Cool.”
Who is a good candidate for RF alone, and who needs surgery?
“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.”
“Radiofrequency is going to give us mild to moderate improvement in skin laxity. It is important to note that every patient is going to react differently to the radiofrequency energy, and the amount of skin contracture can really not be predicted, but will tell itself over the following three months.”
“Massive weight loss patients will rarely respond to radiofrequency by itself, and although it can still be used, excisional surgery is necessary.”
A celebrity video cannot show that part. Good skin, no weight swings, a patient in their thirties: ideal at any rung. Heavy jowls, a loose neck, skin stretched by weight loss: not, and no needle-free session changes it.
When does the ladder go to the operating room?
“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.”
“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.”
How long does it last?
“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.”
What is the biggest misconception people pick up from social media?
“I think the biggest misconception is that on social media, practitioners only show their best results. This gives patients a certain expectation which may not actually happen to them.”
His reason was months of abuse over his looks. Common, and a poor one on its own. A plan starts with what a face needs, not with what strangers said about it. Low risk, yes. Also low yield.
What does it cost here?
“Morpheus8 Cool is priced the same as Morpheus8. Full face $700, or three sessions for $2,100. Face and neck $1,200, or three for $4,000. Small body area $1,500, large body area $1,750. Pricing is listed on the fees page.”
Those are the figures as of this writing. Surgical RF (QuantumRF, BodyTite, Renuvion) is quoted at consultation and listed on the fees page.
Why choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor every year from 2014 through 2026. He runs every rung of the RF ladder in one office, from Morpheus8 Cool in the med spa to QuantumRF, BodyTite and Renuvion in the operating room, and he had Morpheus8 Cool done on his own face before offering it to a patient.
Ready to talk?
To find out which rung of the ladder fits your skin, call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful
Find Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
