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ReFirme is a skin treatment meant to tighten sagging skin, reduce jowls, and minimize wrinkles without invasive surgery. The ReFirme device emits bi-polar radiofrequency (RF) and optical energy (laser or light), a combination ReFirme has branded "elōs technology". The ReFirme process is designed to stimulate collagen production. Ultherapy uses ultrasound to produce heat and do the same but has an element of more pain. I personally prefer the Sciton BBL/SkinTyte combination but ThermiRF may also be a good alternative.