Subscription-Based Aesthetic Technology The Venus Concept Model Dom Serafino & Chad Zaring

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you know it was in 2009 2010 and we were just  coming out of the the massive recession you know   in in 08 and 09 and you know the the device  business was completely decimated nobody was   getting really any kind of traction banks  weren't lending money and so on but what   was interesting during that time is that clinic  traffic actually was pretty stable and in some   cases actually increased so it gave me hope that  if we could put together the right business model   we could continue to expand this market  and actually sort of i'll set it restart it   again and basically how the model worked  is we avoided the doctors having to go   to third party lenders and so on and we became  a subscription model with our technologies   so that a doctor didn't have to worry about  credit ratings per se we held the paper   didn't have to worry about tying up their personal  credit that was available if they want to do   something personally etc and even if they'd  overextended themselves in their clinics they   could bring in the latest greatest technologies  from us under this model and what that did is   it actually forced us as an organization to have  a much higher bar i guess to achieve because the   paper was with us so it wasn't like you know  we could sell something that didn't function   didn't work and so on and because we would  be on the hook and you'd be left with two   scenarios the doctor could either stop pain and  you could either sue them which is usually not   good for your creational brand you know or you  take the machine back which is also not good   hello everyone and welcome back to the technology  of beauty where i have the opportunity to   interview the movers and shakers of the beauty  business and today is no exception today we're   going to get to know a little about venus the  company that dom started 11 years ago yesterday   and both dom and chad will be uh talking to  us here i'd like to welcome both of you guys   dom is the ceo and founder chad is the chief  commercial officer is that right that's correct   and uh we are so fortunate to have both of  them on a zoom call today and uh let's get   started with you dom where are you from yeah  that's great thanks ranta we've been looking   forward to being on this unfortunately travel  restrictions forced us to do this over zoom but   you know living in toronto and canada we finally  got the clearances that we can travel without   restrictions if you have your double  dose so i've got my double dose and   i'll be able to get back on the road and spend  time you know with guys like yourself but   you know it's it's a pleasure to be on your show  um you know we've been in the industry a long time   we've known each other an awful long time as well  um but it's it's funny when we look back and sort   of see the evolution of the industry from you know  essentially the mid-90s when i was a distributor   in canada and we represented pretty much all of  the technologies that were available at the time   and we also owned a plastic surgery clinic with  a plastic surgeon partner so it gave us a little   bit of a you know very real life experience to  understand you know what happens at the clinic   level and i think we we gained a real appreciation  for the challenges that docs have every day you   know not only with technologies but just running  a business and and that so you know we we we   appreciate that and i think that that's part and  parcel to how quite frankly is venus became venus   concept as a company and the programs and the way  we've positioned ourselves as a company in general   and where did you go to school i went to school  in toronto business school here in toronto focused   on marketing interestingly enough on the device  side i started in the cardiology cardiovascular   care area uh in the mid 80s and uh with a company  called marquette electronics out of milwaukee and   um you know you start to learn about you know the  importance of technology and how the role it plays   in medicine and it just evolved into aesthetics  when aesthetics really on the device side was   you know really in its infancy in 92 93 right  and uh it was it was fun to watch it sort of grow   and continue to grow which makes it so exciting i  call it sort of my my beauty drug you know you you   just can't get away from it because it's always  something happening and always something exciting   to talk about and and if you've got a really  great team that you know are sort of you know   very open-minded about where to take technologies  and work with docs that can you know really   make it work um that's that's the excitement  here for us and we think we're still at the   you know i'll call it uh teenage stage of the  industry right where there's still lots of room   for growth and lots of room for improvements but  we're excited to be part of it for sure yes indeed   how about you chad where are you from uh yeah  thanks uh again it's an honor to be on the show   grant um so i grew up in pennsylvania i live in  nashville tennessee now franklin it's been pretty   open for a while i will tell you nashville and  florida have kind of led the way um i married two   daughters um moved to nashville from florida about  seven years ago um dominic's path converged so i   spent about 17 years in surgical robotics okay it  was with a few companies intuitive surgical which   soft tissue surgery urology gynecology it's become  the standard of care you know i was there when you   really couldn't give a robot away and now most  surgeries are done minimally invasively and then   i spent some time at an israeli company robotic  spine surgery that was acquired by medtronic and   then maybe a year and a half ago i met dom he was  on the board of one of the companies i was with   and you know when he when he talked about bringing  the artist robot which i'm sure we'll talk about   for hair restoration into the venus portfolio and  you know basically he wanted to define the next   decade of devices for cosmetic and aesthetic  surgery by incorporating robotics ai advanced   vision i said samya so um and then covet hit about  two weeks later so uh you know it's uh it was a it   was a great time but it was a great experience  to go through and um got the wheels back on the   bus and really optimistic about the future well  that's fantastic and i guess welcome is in order   absolutely the business into the marketplace dump  we threw into the fire right yeah and i'm kidding   for sure so dom tell me when did you first  get into the aesthetics arena going back   with the 94 like it was co2 lasers that  sort of thing yeah it was co2 um you know we   then that evolved as you know into erbium  and so on and as you know you know co2 was   this really hot category everybody was going crazy  finding ways to use it and then you know you learn   a year later with delayed hypopigmentation so we  were able to make faces look like a woman that   was 60 look 40 but her neck looked 70 you know  and it was all of the the challenges that went   along with that and then ipl came along as you  know and yep with esc back in the day and uh you   know and the thing was interesting because you  know we worked with candela and we worked with   palomar that was just getting started at that  point and that's when hair removal came onto the   scene and really that was the first i i'll call  it commercially viable mass appeal technology that   was the good news the bad news is in the clinic  when we were using things like the epi laser   that as you remember was very large and you know  good lifting in canada where you need a building   heated you could certainly build it with the  btus the heated excuse me with the btus that   you put out but it was a spot size that you know  you did hair removal with a seven millimeter spot   size one pulse every three seconds and i remember  our first patient that we actually signed up at   the clinic wanted all of her legs done and we had  to charge her twenty five thousand dollars to do   a treatment on her legs it took 24 hours to do so  you can imagine sitting three or eight hours a day   for three days in a row to do this ladies legs in  a clinic and that that made it quite challenging   so clearly technology has evolved since then but  you know we we've had the the privilege quite   frankly of really understanding how most of the  companies in the space even today you know operate   and you know where their strengths are and kind of  where their weaknesses are and hopefully hopefully   we're able to leverage that into the models  and the things that we do with our technology   you know i don't think everybody knows about  the venus uh model uh could you share with us   uh one of you the the venus model yeah i think  it's important to recognize i mean you know   venus became an idea i started to look at you  know where we could manufacture i had a partner in   israel which is you know as we all know a hotbed  for technology development and so on in aesthetics   and you know it was in 2009 2010 and we were just  coming out of the the massive recession you know   in no 1809 and you know the the device business  was completely decimated nobody was getting really   any kind of traction banks weren't lending money  and so on but what was interesting during that   time is that clinic traffic actually was pretty  stable and in some cases actually increased so   it gave me hope that if we could put together  the right business model um we could continue   to expand this market and actually sort of i'll  set it restart it again and basically how the   model worked is we avoided the doctors having  to go um to third-party lenders and so on and we   became a subscription model with our technologies  so that a doctor didn't have to worry about credit   ratings per se we held the paper didn't have  to worry about tying up their personal credit   that was available if they want to do something  personally etc and even if they'd overextended   themselves in their clinics they could bring  in the latest greatest technologies from us   under this model and what that did is it actually  forced us as an organization to have a much higher   bar i guess to achieve because the paper was  with us so it wasn't like you know we could sell   something that didn't function didn't work and so  on and because we would be on the hook and you'd   be left with two scenarios the doctor could either  stop pain and you could either sue them which is   usually not good for your creational brand you  know or you take the machine back which is also   not good right and i remember you were one of  the first customers really with the venus freeze   really early on and and so what we really focused  on as a as a mantra for the company was we weren't   going to reinvent the wheel with some new energy  source or wavelength or pulse duration per se   we wanted to take a look at technologies that had  already been really well developed over the last   20 years and and modified a little bit i mean uh  i'm going to call him a quasi mentor dr gary lask   which i'm sure you know oh yeah i remember  i remember yeah exactly right so we went to   cheesecake factory in marina del rey for lunch one  day and he and he sat down and he goes uh you know   all you laser guys are jerks  and i said well thanks thanks   yeah thanks gary am i paying for lunch or you  right but but but i took it very seriously   because i said tell me more right and and so he  said you know he goes you guys don't understand   how doctors are wired you know everybody comes  into our clinics and are always preaching about   and he goes i'd like to use a baseball analogy my  technology is like i hit home runs right he goes   that's not what doctors are looking for they're  not looking for the home run they're not they're   not wired that way they don't think that way they  want to look at technology as like hitting singles   you know make it a little safer make it a little  faster make it a little bit more comfortable   maybe a broader audience of patience that can  be treated and you know keep moving the ball   or the you know along the bases with each of  the singles because whenever you're swinging   for the fences you may hit a home run but nine  times out of ten years you're within right and   i took that very seriously and i think that we we  sort of built our entire model and our expectation   based on that sort of premise because technologies  have continued to evolve and and the customers the   14 000 systems we've shipped globally one of the  things that's the common denominator has always   been that you know you guys are under promising  and over delivering because we don't want to set   a bar that is so ridiculously you know  unattainable that it disappoints right and that   doesn't mean everybody's perfect in the  technology by by no means is that the case   but because we have a direct relationship  through our unique subscription model   with the customer it does force us to pay more  attention quite frankly post sale than than most   other companies because they move on to their next  sort of sale chad how does that subscription model   work for the actual uh for the physician who  puts one of the technologies in their office   yeah sure it's a it's a great question so we take  um i mean we try to emphasize as dom said we want   this to be a repeat relationship so we really we  try to we try to make lower the financial burden   up front so we take a nominal fee up front to  cover a license fee to license the technology and   then it's just pay as you go for 36 months it's  a monthly payment but what we really try to do is   like i'll give you an example with bliss you know  our bliss our fat reduction device it also has the   the rf body contouring and skin typing is you know  we've added we just you may have seen we signed a   global ambassadorship with venus williams recently  which was a lot of press and publicity about that   especially around the wimbledon time of course um  we do we've developed bliss academy so you know   for a lot of these clinics of course non-invasive  fat reduction is getting a lot of legs globally   and so um new clinics are getting into it but they  don't it's not build it they'll come right they   need some coaching and how do you talk about  it with your patients how do you close them   so we develop bliss university and then we've  um we have a pretty strong practice enhancement   team so they really latch themselves onto  these customers for the first year or longer   so we so basically we lower the financial burden  you know we take a nominal fee up front it's 36   payments um but we what we try to do is emphasize  the roi you know how do we increase clinic traffic   how do we provide great outcomes to the patient  how to recreate this domino effect so that the   next patient can influence the next patient um and  then we of course we provide a three year warranty   so we just don't want the customer to really  worry about anything but maximizing revenue and   offsetting this this monthly fee that they have  to pay yeah and i think that there's one other   element to that that you know cost certainty is  really important for physicians who are you know   bringing technologies into their clinic so that  they can understand the competitive landscape   and price their procedures accordingly and the  second part to that is you know obsolescence as   you know grant i mean this industry you know every  two years there's some new story right and so   historically what companies have done is said hey  let me give you a trade in value on the device   that you still have three years left on your lease  and you know the doctor gets rinsed you know at 20   cents on the dollar or has to now be a laser sales  rep and sell it themselves on uselasers.com uh and   you know and then they still have a payment with  their leasing company and they double down and   they do the exact same thing for the next platform  what we prided ourselves on is no matter where you   are in that 36 month sort of spectrum whether it's  at 12 months 24 or whatever if you if you want to   now change gears and you want to move from hair  removal to fat or you want to go to hair removal   2.0 or whatever we simply do it like a cell phone  model we we forgive the balance of the contract   that was on the first one we replace it with the  new one we start the clock again for 36 months so   the clinic the doctor is only using the technology  that they're actually monetizing and there's   nothing sitting in a closet that's not being  used that's still being paid for and that was   we recognized that certainly only in a clinic i  appreciated you know the burden of having you know   these costs that are really not generating any  kind of revenue for you for one reason or another   sitting in closets or back rooms while you're  always trying to chase your tail to stay ahead of   the i'll call it the technology advancement curve  and that was a big part of our model as well that   i think has differentiated us from everybody  else and and the benefit to us on that quite   frankly is you don't see a lot of our devices in  the used market so we're not we're not competing   against ourselves per se you know we're able to  control our distribution channel we're able to   refurbish those devices put them back and play for  a tier 2 tier 3 customer that for whatever reason   may not be able to afford the original full you  know program or whatever the case would be or we   ship them you know overseas to other markets  that are more price sensitive than say north   america at the end of 36 months then does the  practice own the uh the they're on the device   and uh in terms of the payments are they spread  out just equal payments 136 if you will per month   or is it based on consumption yeah so what we  what we do just to be uh clear like so we have   like as chad said a licensing fee up front right  and then the first 12 months typically represents   40 of the total value of the contract so that  get paid in the first year in the second year   that goes to like 35 or sorry 25 of the payments  okay of the total value and so by the time you   get to third year the the payment schedule sort of  mimics depreciation so the it that's an advantage   to the doctor as well so that they're not getting  rinsed if you will on the trade-in when they give   it back to us because they've got disproportionate  amount of payments we know that the maximum time   or the best time to monetize the investment  is usually within the first two year window   and so therefore the payments mimic the earning  opportunity off of that device so that when they   get to the end of year two which is normally when  we upgrade customers uh to another platform and   they and we forgive the last year of the contract  there's very little left on the contract so the   doctor doesn't feel like you know um i i have  you know a big payment that has to be made or you   know there's still value in the machine and so on  and then you know at the end of that the machine   always has a sort of an intrinsic value at the end  of the day after 36 months but what this allows us   to do is really position the payment schedule  so that it cash flows properly with the clinic   when there's peak earning periods in the clinic  versus non-peak as time goes on yeah that's a very   interesting model very creative and very user  friendly and i applaud you guys for doing that   can you guys go through your product line and what  you have you mentioned uh fat reduction so let's   start with the fat reduction technology and then  go from there because i'd like our our viewers to   hear about all the different things that venus  offers because it's quite it's a quite broad uh   offering and so why don't you guys pick it up from  there and start with the fat reduction technology   yeah sure i mean i think in many ways we're the  we're the best kept secret in the market with 12   different platforms that we make available and  i think there's going to be a secret after this yeah that i appreciate so chad maybe you  can talk about you know the the clinical   efficacy the number of treatments that you know  typically the cost certainty that type of stuff   would be great on the fact that and then i  will talk to you absolutely absolutely so   you know we're focused on as dumb said we have  12 commercial products but we're really focused   on six and i'll start with two you brought up the  bliss 1064 diode uh with also our um rf device for   octopolar for skin tightening and so so far  you know we're in the kind of call it the   first phase of launch we've been customers have  been really happy with it the clinical data shows   after one treatment up to a 41 reduction in  the adipose layer at 12 weeks 27 at six weeks   41 percent of 12 weeks often times are what we're  learning from our clinics is they're packaging it   differently some combine it with the rf treatment  and they want to do multiple treatments and they   want the patient to come in every week some  clinics package it as a package of three laser   treatments perhaps but what we've the anecdotes  we've gotten back is it's very tolerable for the   patient um our iot data is is pretty promising  it's as the brand recognition's increasing and   the custom clinics are getting comfortable it's  increasing to i believe it's now over six thousand   dollars per week so when there's there's no  consumable and it's a three-year warranty   so you start to look at the roi if you if you take  advantage of the investments we've made recently   in the b2c campaigns like with venus  williams if you attend bliss academy   and you really understand you know how to  counsel the patients how to position it in a   competitive market how to price it you know how  to create this brand recognition of your clinic   and and you're using this as much as possible  we're not taking anything back there's no direct   cost associated with consumables there's no direct  costs associated with warranty for three years   so the customers have been really really  happy and we're generating a payback now in   six months you know in a lot of these clinics and  we have some clinics that are far exceeding that   so we're starting to get a little traction a  lot of traction with it as you know the global   market for fat reduction body contouring is really  exploding right now and um you know the results   have been really good so far how many installs do  you have on that so we're we're over a hundred now   um and happy to say um we're starting with clients  are you know we have one chain that has a lot and   they're starting to look at second units which is  great um we've seen our pipeline consistently grow   we've we've also in conjunction really hired a  ton of people in the u.s you know we're making  

serious investments in the u.s and north america  and that's starting to pay dividends so i think   you know once the idea was to hit that first  hundred you know get a stable product out there   that is getting good results that patients can  tolerate that the clinics can learn how to use   it doesn't have a lot of technical issues and then  really turn on hit the gas and that's really where   we're at right now one element to be added to  that just because chad touched on it but the iot   our system has internet of things built into  it so we can see in real time exactly how many   treatments are being done what areas of the body  are we treating how long who the operator is so   we can actually audit the technician that's doing  the treatments to make sure that they're getting   consistency in the clinical outcomes and that's  really important for a clinic because it gives   you valuable information you know you can't  be in the room all the time so it ties into   just how effective you are the payback periods  i mean as chad alluded to right now on at this   is the average not the best performing clinics  the average clinic in the us is paying back the   act the total acquisition cost in 34 weeks i think  is the number 34 weeks that's pretty damn good i'm   here for a platform that has an asp of about 120  000 so you know they're they're easily monetizing   their investment that we have one clinic that  has done over three million dollars in the first   12 months i i mean to a point where i'm i'm asking  myself why don't i have a disposable on the device   right yeah but we're letting look my attitude  again having run a clinic my attitude is a happy   you know doctor is usually going to reinvest  in himself and so that's the best possible in   the shortest distance to making a doctor happy and  you know if they're making money we're ultimately   going to make money and that's why 43 of our  customers are repeat customers that have bought a   second platform or some or a third or whatever the  case may be so fat is you know kind of one of our   key leading products certainly as a growth driver  uh in 2021 and beyond um as chad mentioned i think   grant one of the most exciting things i've  heard this just in the past two weeks being   out in the field you know i started to travel  again finally you know from from some select   plastic surgeons and dermatologists the the the  category has been pretty well established now   so patients are coming in asking for this they're  not necessarily they may be identifying with a   coolsculpting name you know because it's been  around but now that the category is established   they're you know the patients are pretty open  you know if the doctor believes in it if they've   gotten good results if the patient tolerates  it well if they can point to some clinical   study or white paper they're really open to it  especially since it's a better economic model   as don points out why should we you  know why should we continue to pay high   high cost of consumables when we can just bring  this technology and use it as frequently as we   possibly can and then just pay the subscription  agreement so so we're super excited about that   we're also very focused kind of the second  strategic category is hair restoration and   robotics yeah let's talk about that the  artist yeah so that's that's actually um   that we're pretty optimistic on that you know just  from traveling around uh we're meeting with some   of the largest dermatology groups you know that  that market's consolidated to 25 large groups   sure and and it's it's really interesting a lot  of them dermatologists early on did a lot of hair   restoration procedures and then got sidetracked  and it was tedious and manual and so a lot of   them abandoned it and now you find these these  huge clinic chains that see tens of thousands   of patients and they treat the they may treat  the retention the prevention pharmacologically   but they but the procedure that the procedure that  patients are really demanding and paying a lot for   ends up going somewhere else down the street so  we're really devising this hub and spoke model   you know focused on training marketing  that's where your friends that engage   i i actually brought them into a few meetings i i  can't think of a better model they they brought up   the ophthalmology technology optometry yeah they  have a hub and spoke they were on the program also   it makes so much sense right uh so um that and  then you know the select plastic surgery groups   you know as well um that are experts in facial  aesthetics that could easily be incorporating   this into their practice we just have to show them  how you know how do you incorporate a new vertical   into an existing practice and make that office  productive when you're off operating or you're   not there or you're seeing patients from room  to room so we're getting a lot of traction the   automated device the robotic device is artis which  is a form of robotics called programmed automation   so you actually program what to do and it does  it which you can imagine when you're doing 2 000   mini surgeries in a hair restoration procedure  it's a perfect place for automation and then our   manual device you may have heard of is neograft  which we brought in to the portfolio in 2017   and most customers now are bundling these  so i'd say you know what we're doing is a um   trying to recreate the landscape of hair  restoration procedures with automation   so that regardless of where you go a patient  can have a consistently good outcome number two   we're also trying to take advantage of just this  growth in robotic surgery there's seven over 75   companies developing a robot i mean it's amazing  every time i if you google robotics you'll find   five companies that are raising money or have  raised money and they're close to commercial   and some of the largest companies in healthcare  getting into that space um so that's the second   piece and then the third piece is we're  really focused on we we acquired this company   this this was dom's idea you know to restoration  robotics was an example of a great product   but the company really tried to get too broad  too quickly and so we were able to bring it on   our portfolio in november of 2019 i came on board  shortly after but what we've quickly done is is   built a programmatic approach it's you know it's  not about getting a robot or getting a neograft   it's about building a program around it and  so we're pretty excited we've gotten a lot of   traction with that on the other the other piece to  that puzzle is that you know as we look at a very   crowded call a sandbox and other in other devices  right where there's a significant commoditization   and hair removal and wrinkles and cellulite all  of which we have solutions for and we think very   good solutions under our subscription model  predominantly you know hair restoration is   sort of sitting in its own sandbox and from an  roi perspective now that the technologies are   automated predictive and so on and certainly less  stressful for the physician that they don't have   to sit in the room for eight hours to do a 2000  follicle transplant i mean the roi is 12 to 1500   an hour which is very nice compared to you know  all of the other items that originally placed   hair restoration when lasers came available in 94  95 back in the day and so it's evolved and it's   sort of coming the pendulum is sort of swinging  back as chad said you know the spoken hub model   like a lasik model and so on is really appropriate  for large chains but even the individual i'll   call it mom and pop operations now that they can  actually have a device that sort of helps walks   them through with artificial intelligence how  to do a hair restoration procedure effectively   there's a level of confidence that's being created  there and you know we've got a lot of work to do   to correct some of the errors and sins of the past  of restoration robotics we continue to do that   i mean they they chose to sell to urologists and  anybody who would cut the check which is fine if   you're reporting your numbers on a quarterly basis  as a public company but it isn't great the day   after when you actually have to teach them how  to market themselves and how to actually do the   procedure and ask for money you know because it's  a out of paper you know paper procedure so so you   know i think we we took a step back and and we  knew what we were buying and the main reason we   did this as opposed to say a conventional  ipo is because of the the depth of the ip   that restoration was able to uh create over their  10 years of existence we were quite impressed with   that and and the most important reason i think  is in order for a company to understand where the   industry's going you have to understand its past  right where it's been and you know the luxury of   gray hair and thinning hair tells us you know that  um we've seen a commonality of problems in the   industry number one the continued commoditization  as i just described it makes it very difficult   for most derms and plastics to compete you know  with the med spa down the street that's very happy   generating a hundred dollars an hour and groupon  advertising all day long and they're competing   with the same branded products regardless of which  company you know as a plastic surgeon in durham   that wants to generate and should be generating a  thousand dollars an hour of a treatment room and   would be caught dead groupon advertising their you  know their brand right and justifiably so so that   was one of the problems we identified and we think  that as time as as robots have you know evolved   we're going to be able to combine the majority of  our energy-based solutions with robotic delivery   systems with artificial intelligence and machine  learning and speed and accuracy and all the things   and that addresses i think the second problem  that the industry has had pretty much from day   one where 20 to 25 percent of patients that are  treated with non-invasive technologies don't get   the clinical outcomes that they were hoping for  or expect and when that and that usually isn't   because of the technology it doesn't matter which  company it's usually about operator experience   fatigue apathy you know multiple treatments and  so on so there are so many variables that get   thrown into a manual procedure regardless  whether it's candela cutera us whoever   that the outcomes are are you know all over the  place robots are agnostic to fatigue opinion   doesn't matter if you're doing a treatment at  nine o'clock on monday morning it's the same on a   long weekend night at five o'clock on friday right  it doesn't change and what it does for the clinic   quite frankly is it gives you as plastics and  derms and that's where we're going predominantly   with all of our robotic technologies that we start  are developing and will continue to develop it'll   give you a competitive advantage that you guys  should have quite frankly to separate yourselves   from the rest of the field because we will not  sell robots outside of the core audience that is   what that's been my mandate to the company that  this has to be exclusively available to you guys   because we think it's time that you sort of  take back the the leadership if you will on   technology of evolution and and the procedures  are properly suited for the derms and plastics   that we're working on so that makes sense and at  the clinic level last but certainly not least is   you know and you know this grant i mean  clinics you you find a good injector   you know whether it's fillers or botox and they  become a business of their own you know and the   problem is is that many times if an injector  decides to hold the clinic ransom and they   decide to go down the street because of whatever  reasons it's like a hair salon right many of those   patients follow them because they love the way  they do their lips or they do their nasolabial   folds or whatever and that's problematic for the  clinic so if we're able to provide solutions in   many different areas different procedures that  aren't dependent on the technique of the operator   but rather it's observational more than anything  else to set the algorithms at the you know the   the customized plan for that particular  patient regardless of what we're treating   we think that we're giving you guys  ultimately over the next five to ten years   you know different solutions that i think will  allow you to sort of create some daylight between   the commoditization of the industry and and what  you guys are offering that's fantastic so we've   talked a little bit about fat and skin uh as  far as tightening uh and we've talked about hair   uh what other areas are you are you chasing what  other uh problematic areas in the aesthetics yeah   so one of the one of the areas that we're really  focused on right now is a product that we are code   named robocore it sounds like a bad robocore it  sounds like a bad b movie but anyway it's robocore   but we we've treated uh 15 16 patients now 90  zones and we're focusing really on the body mostly   so what we're trying to do now is take a micro  coin capability we actually treated our first   patient with a robot a breadboard you know  obviously prototype this week and we're quite   excited in how it worked but what we're doing is  we're taking robotic technology and doing a series   of micro coring various steps various widths so  that we can actually excise this tissue okay very   cleanly and then have a directional tightening  so what does that mean what are the areas that   we're going to focus on where we did a lot of our  clinical work so far for feasibility and so on is   to potentially replace a brachial plastic so you  know a female that has bat wings does not need   to go through a surgical intervention leaving  a scar and you know the pain of recovery and   on so we think we can do that robotically in  a minimally invasive way we think that we can   do directional breast lifting um robotically okay  the same same kind of mechanism of action we think   that we can do above women's knees you know when  you get the droopiness and saggy skin so that you   can't treat it necessarily non-invasively you can  only you know minimally invasively we can treat it   and this will allow them to you know not have to  go through under anesthesia and all the stuff that   you know typically have to do with a full surgical  intervention this is an area that you know   we companies really haven't focused on as much  as they probably should because it's either full   surgical intervention you know or non-invasive  multiple treatments and the in-betweener is   where we're looking at with some of these robotic  solutions and of course face lifting brow lifting   jowls and things of that sort but we want to start  first quite frankly for for selfish reasons we   want to make sure it was safe while we go through  all of these um you know sort of iterations of the   technology and i think the big one that's why on  the back of the arm it looks very very promising   right now and who knows maybe we'll be able to  replace an abdominoplasty you know at some point   because of the speed and accuracy of the the  way the technology can sort of map out the area   hopefully measure the the thickness of the  tissue from that we're working with a third   party as well that's in the ultrasound business  and we think that we can integrate ultrasound   ultrasound technology into robotic fat reduction  devices so now before we actually treat sort of   over the entire area we will actually be  able to measure where the the thickest fat   is and the problem areas are and actually  adjust the algorithms to deliver the energy   proportionately to the areas that need the most  work versus the areas that need the least i mean   it all sounds crazy but you know we have really  strong belief that this is just a matter of time   and and we think that we're going to be able  to accelerate this process pretty quickly and   grant i'll just i'll just add to what dom said you  know about gosh was 17 years ago i was in atlanta   i met a cardiac surgeon that had the greatest  value proposition you know with technology   innovation and he said patience value is efficacy  over invasiveness squared which means if you can   develop a procedure that provides good clinical  outcomes and do it in that like in the robocore   context in a minimally invasive way with minimal  downtime minimal pain where you're out in and out   that's a really really strong outcome for the  patient and people are going to come after that   and so that's a that's a real value proposition  and you know one of the things that you know we   probably won't spend too much time on the exciting  thing is we have a lot we have a clear view of   where we want to go in the future but actually our  top selling products are the universe venus versa   which is a platform that has skin rejuvenation  hair removal uh skin tightening all in one device   it's like a build it platform for the clinics up  to ten hand pieces uh we have the venus philosophy   for hair removal the venus fever which we're get  we have a new configuration that's a higher power   it's a nano fractional resurfacing device kind of  competes with microneedling getting great outcomes   from some of the dermatology clinics we work with  and we have the venus legacy which is we've got   this resurgent demand all of a sudden i don't  know if the product's been out for seven years   i don't know if it's the clinic's reopening it's  amazing it's amazing like we're seeing tremendous   demand so it's got it's fun right now it's fun  because we have a diverse bag that we can go   off offer pretty much anything a clinic is going  to need to build the cosmetic and aesthetic part   of their business but it's fun to just go in and  meet with core doctors dermatologists plastic   surgeons and say hey what do you think about  robotics you know if you you just came out   of training or fellowship uh what do you think  10 years from now how do you think technology   is going to be deployed what's going to look  like and and that's where i think we want to go   so speaking of that what do you think it is going  to look like in five or ten years well you know   it's funny you say that because that that's always  been sort of my vision as to how do we help the   doctors quite frankly add value in their clinics i  mean at some point every doctor is going to retire   okay and one of the things that most doctors  don't think about you know because business   isn't their primary acumen right they're trained  in sciences and they're very good at what they do   and most of the stuff they do is from their hands  but how do you monetize that when you're 65 or 70   or whenever you decide to retire so we're focused  on trying to create sort of a different level of   ebitda return and value as a multiple to  the clinic that is driven by the evolution   of technology and so on so that new doctors that  are coming in have some real tangible asset value   to coming in other than the the goodwill that  the clinic may or may have not created under the   previous physician that's why you know these  durm chains and that are being created by private   equity because most of the durham's that you  know in the early days didn't really think about   that they thought about you know they're building  their product they're building a very nice living   for themselves and so on but really didn't  take into consideration the holistically   what the value of that clinic was going to be  at the point when they're saying nomas right i   want to do something else and so we we focus  a lot on that as well and we do believe that   in the next 10 years nothing will be done manually  i think every one of the procedures that's in   demand the expectation absolutely will be that  there'll be some sort of a robotic customized   treatment protocol for that patient specifically  geared to that patient and i think that   we're we're very thankful that we're sort of in  the leadership role i mean one of the main reasons   i did this very unconventional unorthodox  acquisition of restoration was because they   had over 200 patents you know that they had filed  in a variety of area areas from tattoo removal to   hair and so on and so we think that we can  leverage that ip uh with the skill sets of   the guys in silicon valley which is where we're  located for the robotic development and really   accelerate the process of developing additional  solutions and by the way at a reasonable price we   we want to we want to make sure that the  doctors understand that when we come to market   with the next generation of robotics as pricing  continues to improve and our volumes continue   to increase i mean right now globally i think we  have about 300 artists robots for hair restoration   we think that number should be 3 000 systems  as we move into skin tightening directional   lifting uh perhaps tattoo removal with with  later with the robots as well as fat reduction   and and ultimately facial structure to  do a simultaneous injection of fillers   and we've talked about this in the past where we  can map the face we can create a customized plan   for the patient and do fillers like nasolabial  folds and you know brows and whatever it might   be with botox we think that that's going to be  a huge competitive advantage again you know for   the derms and plastics because that's also an  area that's been heavily commoditized because   there are so many injectors out there and it's  price sensitive and all the things that go along   with it so we keep sort of our eye on the prize  which is ultimately providing the doctor the   best possible way to monetize their investments  and ultimately create value within their clinic   over you know the next number of years i'll add  uh one piece of that too dom and i've discussed   this and i think we discussed it with you as well  grant you know i came from the spine company the   spine industry prior to this and you know um when  you think about spine screws i mean historically   the prices have come down but i mean they all  kind of look the same and you know but for   decades it was all about the screw and how do  you put the screw in it was about the payload   but with robotics a company called mazor  robotics that was acquired by medtronic it   became about delivering the payload payload didn't  matter it was how do you deliver the payload   underneath the skin without opening the patient up  and deliver the payload with with some combination   of pre-operative scanning pre-procedural  scanning in this case facial scanning right   advanced algorithms that can be embedded into a  planning software and then mechanical automation   so a robotic arm can execute the procedure taking  out all of the variability and so you fast forward   and look at the adjacency with like fillers and  injectables a lot of it becomes about the payload   but delivering the payload right is very very  important too sure and can you assure us you know   can a clinic assure themselves that this that  this injector is as well trained and has done   as many procedures as this injector so it's it's  using robotics to take some of that guesswork out   we hope we can lead the way well it certainly  sounds like you are leading the way right now and   very creative with robotics and your financing  and we could continue this forever i'm sure   and the next time you're in l.a we'll pick up  where we're leaving off because i want to i want   to talk to you about some more the ai and robotics  as it relates to injectables uh you have i got   to see the man cave yeah that's right marina man  land where a man can feel good about looking great   exactly so i want to thank you chad and  thank you dom for sharing your time with us   and uh look forward to pleasuring  you yeah thank you very much   and we and we definitely look forward to talking  to you about the whole facial stuff because i   think that's going to be a really hot area  we'd like you to be involved we'd like you   to be involved in that because i would welcome  that opportunity yeah great you mentioned engage   and i am now the chief medical officer for engaged  technologies and uh and aesthetic innovation so uh   we definitely want to talk to you and  we definitely gotta keep promoting   we have a zoom on the calendar dom it's on your  calendar yep terrific who knows i may end up on   it you never know so again thank you very much  and i'd like to thank all of you for joining   us today on another episode of the technology of  beauty where i have the opportunity to interview   the movers and shakers of the beauty business  thank you very much and i'll see you next tuesday you

2021-08-17

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