What does OPUS lifting do for thick skin that has lost elasticity?

If skin is thick, isn't it also firm?

Skin thickness and elasticity are different things. Even when the dermis is thick, if the collagen structure loosens, the skin sags and the jawline and cheek contour look blunted. Pores that look stretched vertically and rough texture come from the same change.

How skin responds to lifting devices is not decided by thickness alone. It also depends on the amount of subcutaneous fat, the fibrous septa connecting the dermis and subcutaneous fat, and how firm the tissue is. So we do not choose a device based on the impression that a face is "full" or "thick-skinned"; we first check the actual tissue with ultrasound.

Xerf and OPUS are both radiofrequency. How are they different?

Xerf uses 2MHz and 6.78MHz, and OPUS uses 40.68MHz radiofrequency. Both create heat in tissue to induce collagen contraction and remodeling, but they play different roles at Serene Clinic.

Repositioning sagging tissue is the job of Xerf and Ulthera, reducing unwanted volume is the job of ONDA, and the elasticity and texture of the skin itself is the job of OPUS. Rather than asking which device is stronger, we see them as working on different layers with different goals, and divide them within one face.

You may hear that "40.68MHz is dielectric heating, so it melts fat," but this claim lacks evidence. Where and how much heat forms in living tissue depends on each tissue's electrical properties[1], the electrode design, power and exposure time, so heating depth or target cannot be determined from the frequency number alone.

Why does thick skin tighten right after OPUS?

Director Kim Serim has observed that in people whose skin is thick and has lost elasticity, and who felt little change from Xerf alone, the skin itself tightens right after OPUS. Along with a smaller, more refined facial contour, the taut tightening of the skin surface stood out in particular. This is the director's clinical experience, not the result of a trial directly comparing the two devices.

There are two possible mechanisms. Heat above a certain temperature can contract dermal collagen immediately[2], and a change in tension of the fibrous septa connecting the dermis and subcutaneous fat can show up as tightening of the skin surface.

However, the change right after treatment also includes temporary fluid shifts and swelling, so we cannot say that the immediate tightening will last as is. The pressure of the rotating tip, which helps with swelling and lymphatic flow, also adds to the refined look right after treatment. Long-term elasticity change is a separate process that appears through collagen remodeling over the following weeks.

What have studies found?

In a study published in Lasers in Medical Science in 2026, adults with mild to moderate facial laxity received 40.68MHz unipolar RF three times at 4-week intervals. In the 26 people analyzed, 3D imaging at week 20 measured volume reductions of −2.2mL in the cheek, −1.7mL along the jawline and −2.9mL under the chin, and an elasticity measure (R2) rose from 0.62 to 0.69[3]. It was a single-arm study without a control group and did not directly measure fat layer thickness, so it is best read as a preliminary result.

In a 2016 mouse study, skin repeatedly treated with 40.68MHz radiofrequency showed increased collagen along with histological atrophy of subcutaneous fat[4]. Because this is an animal result, a reduction of fat cells in the human face has not been proven.

If fat can decrease, where do you take care?

Facial fat is not tissue to be removed; it maintains the face's three-dimensional shape. So we use energy conservatively on the temples, front cheeks and under-eyes to preserve volume, and give enough energy to areas where reducing volume helps, such as the jawline, under the chin and the deep cheeks.

Before treatment, we check fat thickness with ultrasound in separate zones: above the nasolabial folds, the deep cheeks, the jawline and beside the cheekbones, and distribute energy by zone. We are more careful with people who have little facial fat or already have hollow cheeks.

How is the treatment done, and what should I watch out for?

After cleansing, a dedicated gel is applied and the rotating tip is moved along the facial contour. Most people receive it without anesthesia, as it feels like warmth.

Temporary redness or mild swelling may occur after treatment but usually settles quickly. In the study above, no serious adverse events were reported apart from temporary redness and mild swelling[3]. The study used three sessions 4 weeks apart; the actual interval and number of sessions are decided based on your skin.

Prices (as of the October 2026 menu)

Prices are per session. The energy (kJ) is decided after an exam based on skin thickness and the fat layer in each area.

Frequently asked questions

References

1. Gabriel S, Lau RW, Gabriel C. The dielectric properties of biological tissues: II. Measurements in the frequency range 10 Hz to 20 GHz. Phys Med Biol. 1996;41(11):2251-2269.
2. Elsaie ML. Cutaneous remodeling and photorejuvenation using radiofrequency devices. Indian J Dermatol. 2009;54(3):201-205.
3. Kim J, Sung K, Park Y, Yi KH. Facial contour modulation and skin tightening using 40.68-MHz unipolar radiofrequency. Lasers Med Sci. 2026;41(1):163.
4. Kim M, Kim KE, Jeong SW, et al. Effects of the Ultra-High-Frequency Electrical Field Radiofrequency Device on Mouse Skin: A Histologic and Molecular Study. Plast Reconstr Surg. 2016;138(2):248e-255e.