The aesthetics industry is evolving quickly. Patients are asking for fewer fillers, more collagen stimulation, minimal downtime, and treatments that help them look refreshed - not different. At the same time, providers are looking for technologies that produce reliable results while fitting seamlessly into a modern aesthetic practice.
That combination is why EVERESSE, Cartessa Aesthetics' advanced monopolar radiofrequency (RF) platform, has become one of the most talked-about innovations in skin tightening.
In two recent Cartessa webinars — Debunking Myths About Monopolar RF, featuring Natalia Guzman, FNP-C, CANS, and EVERESSE: The Unicorn Device for My Impossible Problem, featuring dermatologist Corinne Erickson, MD, FAAD — both speakers described how EVERESSE addresses many of the challenges providers have experienced with traditional and even more recent monopolar RF technologies.
One trend came up repeatedly throughout both presentations: patient preferences are changing. Today's aesthetic patients increasingly ask for treatments that:
Dr. Erickson noted that many of her patients now prioritize collagen-building treatments over traditional volumizing fillers, describing growing interest in “collagen banking” and long-term skin health.
Natalia Guzman shared similar observations from her Beverly Hills practice, explaining that conversations have shifted toward natural rejuvenation and collagen regeneration rather than simply adding volume.
Monopolar radiofrequency itself isn't new. According to both speakers, what differentiates EVERES is how it delivers energy.
Traditional monopolar RF systems often rely on pulsed energy and cryogen gas cooling. EVERESSE instead combines continuous RF energy delivery with continuous water cooling, allowing providers to maintain therapeutic tissue temperatures while helping keep the epidermis comfortable throughout treatment.
According to Natalia Guzman, this design helps achieve three priorities providers consistently seek:
EVERESSE is designed to deliver volumetric bulk heating within the papillary and reticular dermis - the layers where collagen and elastin remodeling occurs.
Rather than targeting deeper tissue, the goal is controlled thermal stimulation within the dermis to encourage neocollagenesis while preserving the epidermis through continuous cooling. Dr. Erickson describes the treatment as having both:
Historically, monopolar RF earned a reputation for being uncomfortable. Dr. Erickson shared that her earlier experience with legacy monopolar RF devices involved significant patient discomfort, lengthy treatment times, and concerns about burns if skin contact was interrupted.
Her experience with EVERESSE has been markedly different. She describes most treatments as feeling similar to a hot stone massage, with only occasional brief warm spots over areas where nerves are close to bone.
Natalia Guzman echoed this experience, saying many patients are surprised by how comfortable treatment feels because of the continuous water cooling system.
Both providers highlighted EVERESSE's approach to protecting the epidermis. Continuous water cooling helps preserve surface tissue while allowing therapeutic heating within the dermis. Dr. Erickson also emphasized that the system's smart tip detects skin contact and will not deliver energy if proper contact is lost, helping reduce the risk of arcing associated with earlier technologies.
She also noted that she has safely treated patients across skin types without concerns about post-inflammatory hyperpigmentation in her experience.
In her “Debunking Myths About Monopolar RF” webinar, Natalia Guzman addressed a claim she hears often in the industry: that certain monopolar RF devices can reach and tighten the SMAS (superficial musculoaponeurotic system) — the fibrous layer surgeons manipulate during a facelift.
As an injector trained by plastic surgeons, Guzman explained that reaching the SMAS would mean passing through the subcutaneous fat layer first, and fat density varies significantly by treatment area and patient. Her view is that a monopolar RF device can't reliably confirm it's reaching the SMAS without also affecting the fat above it - and technologies marketed at higher frequencies for that purpose are, by their own FDA clearance, designed to target fat rather than the SMAS specifically. True SMAS or muscle-layer targeting, she noted, is the domain of a different technology: high-intensity focused ultrasound (HIFU).
This is the reasoning she gave for choosing EVERESSE, which operates at 6.78 MHz and is designed to stay within the papillary and reticular dermis - above the fat and SMAS layers. She also raised a downstream consideration: treatments that affect the SMAS can create tissue fibrosis that makes it harder for a surgeon to safely dissect that plane later, if a patient eventually pursues a surgical facelift.
For providers evaluating monopolar RF options, her talk's practical takeaway is to ask any manufacturer for the clinical evidence behind a stated treatment depth, not just marketing language. EVERESSE's manufacturer points to results from more than ten published clinical studies conducted globally, plus ongoing U.S. clinical trial sites, as its evidence base.
One reason providers are enthusiastic about EVERESSE is that patients often see visible improvement immediately after treatment while collagen remodeling continues over time. According to Dr. Erickson, patients commonly notice:
This combination of immediate gratification and long-term collagen stimulation helps improve patient satisfaction and treatment adherence.
While facial rejuvenation remains the primary indication, both speakers discussed expanding treatment applications. Providers are using EVERESSE for:
Rather than replacing other technologies, both speakers emphasized how easily EVERESSE integrates into comprehensive treatment plans. Dr. Erickson frequently combines EVERESSE with:
She refers to the EVERESSE + CoolPeel combination as Radiant Lift, pairing skin tightening with improvements in texture and pigmentation.
Natalia Guzman also described combining EVERESSE with CoolPeel, Sculptra®, fillers, and other collagen-stimulating treatments depending on patient goals.
Both speakers were candid about the financial side of adding EVERESSE to a practice.
Dr. Erickson said her practice brought EVERESSE on in July and generated $120,000 in revenue over the following five months, including $45,000 in August alone — a period she described as typically slow for her aesthetics department. She also reported that raising prices after an initial introductory offer did not cause patient drop-off. Paired with CoolPeel as the Radiant Lift combination, she said net revenue per treatment increased from roughly $750 for a CoolPeel alone to around $2,500.
Natalia Guzman reported treating four to eight EVERESSE patients per week in her Beverly Hills practice, with pricing around $2,100 for the face, $2,900 for face and neck, and body treatments starting at $2,500 for the first area plus $1,500 per additional area. She said demand has been strong enough that her practice considered purchasing a second unit.
Figures above are self-reported by individual practices in specific markets (Atlanta and Beverly Hills) and will vary based on market, pricing strategy, and practice size. These are not guaranteed outcomes for any practice.
Dr. Erickson walked through a practical framework for evaluating new technology — one worth borrowing regardless of which device a practice is considering.
Her conclusion was that EVERESSE filled a gap none of her other tools addressed — a useful lens for any provider comparing devices, not just this one.
As patient demand continues shifting toward natural-looking rejuvenation, providers are increasingly looking for technologies that support collagen production while fitting today's expectations for comfort and convenience.
Across two independent provider perspectives, EVERESSE consistently emerged as a solution that addresses many longstanding challenges associated with monopolar RF - combining collagen stimulation, immediate visible improvement, patient comfort, and minimal downtime into one treatment platform.
For practices looking to expand their non-invasive skin tightening offerings, EVERESSErepresents a modern approach designed around what both providers and patients are asking for today. Contact us today to learn more.