Advancing Laser & Energy-Based Aesthetic Technologies Gus Rhodes of Solta Medical

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the flx is the latest and  greatest on our thermage line   uh we we i think i think we launched that uh at  the beginning of 2019 and uh it has now taken off   uh incredibly well it's really remarkable to see  the change from those early days tell us a little   bit about the thermage flx because there are a  number of people watching right now that either   have don't know about thermage or think it doesn't  work yeah and they haven't heard of flx tell us a   little bit about it first of all how big is the  spot how often does it cycle and what does it do   so um you know you're right that they think one of  those two things or that it hurts like the dickens   yes right and and because it did yeah and it did  originally that was a fair thing and you've been   through four or five at least five generations  right yeah so this is not this is not the old   thermage that you introduced many years ago now  this is a brand new device yes it's remarkable hello everyone and welcome back to the technology  of beauty where i have the opportunity to   interview the movers and the shakers of the  beauty business and today is no exception   with us today is my dear friend gus rhodes gus  is now with salta medical but he's been with a   number of companies as you're going to hear and  he's been a friend for many years welcome gus   thank you grant nice to be here it's so great  that you came in to see us and share all of your   intelligence and your background and so forth  why don't you start by telling the audience   where you came from where you went to school and  that sort of thing give us a little feel for gus   well sure yeah i grew up east coast actually which  uh most folks don't know yeah i didn't know that   yeah yeah outside of philadelphia and uh you know  went to villanova university uh back when howie   long was actually at villanova university a long  time ago yeah yeah after i graduated though um i   started heading west and uh actually had a job  in san diego and i thought this is going to be   sweet and and a great transition for me and as  i was driving through texas um stopped at her   friend's house and i wound up staying and never  left uh so we started a an antique reproduction   company isn't that right and i was we were making  roll top desks and barrister bookcases and the old   wooden ice boxes and it was it was pretty fine  what part of texas so that was in san antonio   and and so we had a wholesale business and  we were up at uh the dallas furniture show   and highlighting all of our our products  and um after a week we came back   and i i needed to see where our controller was  and they apparently thought he was with us and   that was the end of that company because he had  taken all of our money oh no so it was it was a   it was a good lesson so you pivoted so we pivoted  and uh and you know eventually got into medical   and started actually with us surgical and you  know they had the initial surgical staplers   uh to replace hand suturing of internal  anastomoses etc and then they developed   the laparoscopic products to allow us to take  gallbladders out laparoscopically and then   just kept going and going and going and and  uh that was a great career that was about nine years actually that i spent with them didn't  dennis conan work for them also so i think he did   spend some time there in his early days yeah  prior to the the laparoscopic uh approach   and so yeah so then how did you transition to  the aesthetics field and when so uh in early no   i guess it was late 2002 yeah um i started with a  company that was actually called thermage and we   launched the first radio frequency skin tightening  device that was called the tc3 and uh you remember   those days one centimeter one centimeter tips and  uh and circulated how often again was like every   10 seconds or something oh no it was forever  it did it did i think it was three seconds and one centimeter exactly exactly so  it took a while to treat a full face   uh yes um and we really didn't know uh what we  know now clearly but uh you know at that time we   were figuring out the algorithms and and uh and  making things happen but it was in in late 2004   that uh dennis condon uh reached out to me and  he was just about to launch the fraxel laser   and you know he was telling me about you know how  we're going to only treat a fraction of the skin   rather than try and resurface the entire  skin and everyone's calling him crazy right   why would you want to do that you know let's  let's just only treat a portion of the skin   right it makes no sense of course it's turned out  everything has turned fractionated now these days   and uh it was those were those were great days you  know we started with with the sr 750 remember that   and then went to the 1500 um and then we wound  up doing a series of three that we had a family   of three the the refine which was kind of the  baby then we had the restore which was the 1550   and then of course the repair right and that was  outstanding that what that was some of the most   fun that we've ever had uh did that morph into the  duel so the repair didn't so the repair was the   the fractionated co2 oh that's right yes that's  right it was yes not the 15 15 1927 that's right   right so the restorer then went to the door to  the duel that's right yeah so those the things   you stayed with dennis at then it wasn't salta  yet at that point no no so you went to reliant   so i went to reliant and and i was there for about  five years i think and and i was i was doing you   know a lot of we all wore a lot of different hats  back in those days and and so you know we were you   know between you know managing you know strategic  accounts and sales teams and and you know working   with folks like yourself you know to to see if  we could maybe get a little bit of exposure on   the podium it was it was just whatever we had to  do and and i don't know do you remember were you   at the aad in san antonio in 2008 i was and we  launched the repair that's right remember that   yes i do and we had um who was it chris  zachary had done an interview on the today show   and it was it aired the day that conference opened  and sweet he was talking about the repair because   that's when we launched it and we got so much  traffic that well also on our website and so our   website crashed three times that day because of  the volume of people who were going through our   website those are champagne problems as aaron  loves to say indeed indeed and and nothing has   ever uh topped that you know that was that  was a great launch we sold 100 at the booth   did you really 100 at the booth that what that  show it was they had a ten thousand dollar deposit   and uh it was incredible nice yeah it was a lot  of fun so in 2008 you remember what happened to   the economy in 2008 yeah totally taken yeah and so  you know people you know really didn't have a lot   of money for cosmetic procedures at that time  and companies were struggling and that was the   time that that thermage and reliance decided we  need we need to work together and merge to become   solta right so uh that's how that happened and uh  you know at that point honestly grant i i wasn't   sure where where that aesthetic business was going  to go um because the economy was tanking and and   i said you know guys i think uh if it's all right  with you uh i'm going to take a pause on this and   and so we agreed to go separate ways and they  continued obviously right but then i got into   uh the interventional spine uh market  uh with uh with implants to repair the   uh and it will stabilize the sacroiliac  joint and uh and so that's down in the hip   and a lot of like postpartum females uh  where their hips have changed and their   their sacroiliac joint gets very unstable and the  pain is excruciating uh and it was really really   interesting for me to visit different practices  and actually meet patients who would tell me   their story on on how debilitated they were and  how they could no longer work no longer be a   wife or a husband and the how this changed their  life and it really brought them their life back   it was extremely rewarding yeah a lot of fun  and the in that business you stabilize the   situation yes so we had triangular implants  and so metallic yeah so it was titanium and   um and they were fenestrated and so as we  would get them placed into the joint itself   through the ilium into the sacrum and we would  place three just like this in in a row so that we   would get full stabilization of that joint and it  was a very easy uh you know percutaneous procedure   yes yes just a small yes endoscopic just as you  would lead it with a pin place the pin first   and then you put an auger over the pin and then  just tap that implant down in place under flora   and make sure it's it's in the right spot uh it  has been it continues to work they have dominated   the market there the company is called si bone  and si bone currently is the only company that   actually has reimbursement from cms for minimally  invasive secure sacroiliac joint fixation   so you were enjoying your time there  you were changing lives of people   when did you come back to the aesthetic business  so uh it wasn't until the end of 2019 actually   so you were gone for 10 years i was gone for 10  years uh i was in interventional cardiology after   interventional spine okay and and so that was the  the remaining years uh in between so stents and   that sort of thing so um well before i was doing  plumbing with the stents and balloons but this was   actually an etherectomy device and so it would you  know we we put it in through the the groin in the   femoral artery lead it up to the heart  and it had a crown on the top of it that   would sand away the plaque from within the  arteries of the heart and open them up so   that you could actually get a stent placed in  there so with kind of a roto-rooter kind of a   roto-rooter yeah yeah pretty much except it was  eccentrically placed on the wire so as it spun   centrifugal force would have it circum circumvent  the entire artery so it's not just drilling a hole   we actually were sanding it was differential  sanding so it's like if you take a nail file   and you you rub it across the top of your finger  okay it won't hurt your skin but will definitely   file where it's resistance uh-huh and that's the  same principle of this so how it would protect the   artery itself but take the plaque out really cool  stuff that is very cool yeah yeah but anyway yeah   long story short you know um uh bill humphries our  friend bill humphries uh who uh he was a valiant   he was at valiant and then he was over at ortho  dermatologics okay at part of bausch and salta   reported up to ortho under bill and uh not  many people knew i don't know that yet yes   yeah not many people knew that and so you know  you know he you know solta had been for sale   for god knows how many years right when valiant  uh took over yeah and when a company is for sale   um how much do you invest in that company not  a whole lot not what you're trying to trim the   fat right you're trying to cut as much excess  out right you show the highest ebit you can and   and so you know as it was on sale for  sale um it was still growing but it was   pretty much stagnant and then once it became  part of orthodermatologics and bausch health   and bill was like no we're going to invest in  this and we're going to give it the attention   and and the funding that it needs to grow and  you know i'd love for you to come back and and   help with that and dave hagge our friend dave your  neighbor uh was uh just brought back himself and   so he reached out and you know dave and i were at  thermage in those early early days that's right   and had been keeping in touch ever since so you  were at the marsh then you were at fraxel yeah   yeah yeah yeah interesting and now now you're back  at salta which has both right thermage and fraxel   uh and our dear friend liz also is there indeed  yes okay so what is your position now at zolta   so so now i'm i'm over all of our strategic  accounts uh in in north america okay and uh i also   uh helped run our professional relations as as  i once did uh at reliance and and work with uh   people such as yourself and all of our friends  out there right and uh and kind of uh you know   elevating the name but you know the funny thing is  though that um you know we just we're in the we're   just getting out of this incredible pandemic  that has forever changed the way everybody does   business right and um you look back at how how we  grew and and joe papa the chairman of of bausch   had a town hall meeting and he was going through  year-over-year growth of the different divisions   uh within bausch and you know bashar and lom had  i think uh two or three percent growth here every   year um but salta had a 39 year-over-year  growth in the last 12 months is that right   i didn't it's incredible well you've launched new  products yes right yeah that certainly has helped   yes you have the flx for thermage correct the flx  is the latest and greatest on our thermage line   uh we we i think i think we launched that uh at  the beginning of 2019 and uh it has now taken off   uh incredibly well it's it's really remarkable  to see the change from those early days tell   us a little bit about the thermage flx because  there are a number of people watching right now   that either have don't know about thermage or  think it doesn't work yeah and they haven't heard   of flx tell us a little bit about it first of all  how big is the spot how often does it cycle and   what does it do so um you know you're right they  think one of those two things or that it hurts   like the dickens yes right and and because it did  yeah and it did originally that was a fair thing   and you've been through four or five at least five  generations right yeah so this is not this is not   the old thermage that you introduced many years  ago now this is a brand new device yes um it's   remarkable so it's a it's a four centimeter  square tip now so it's significantly larger   and it has this uh accupulse technology and i know  you know what this is but just for everyone else   who's watching uh we used to just get the general  impedance of a patient uh by placing the tip on   the forehead at first and just get what that  impedance was because this is radio frequency   which is really electricity going through the  body and coming out through a return pad in the   back um and that was okay it worked well but this  uses this technology where it takes the impedance   every single pulse so it optimizes the energy  depending on the thickness of the skin in that   area the amount of adipose tissue underneath the  skin so that we're making sure to heat it to that   optimum temperature to actually get the collagen  contraction and get that not only two-dimensional   tightening but three-dimensional tightening  as we contract the fiber septi uh within the   subcutaneous space all the while cooling with  cryogen before the pulse during the pulse   and after the pulse so that those two things is  the pain that minimizes the pain uh one of the   ways we minimize the pain and and and that was  a great softball by the way thank you for that   you're welcome and yeah i've had the flx yes yes  dave hagee you mentioned earlier my neighbor here   in uh hermosa beach manhattan beach uh he came  and introduced it to me and i i was afraid of   the pain because i know how much the thermage  of old used to hurt right and i had the flx   and to my amazement it didn't hurt and the  vibration did that make an impact as well yes   because using the theory the gate theory of  pain yeah yeah you know and we use that with   injectables and other things of course yeah  it's been used with anesthesia and so forth   yeah but the cooling the vibration the gate  theory and uh the impedance checking it as you go   it makes so much sense because we used to  just do it once and then assume that the   impedance which is the reciprocal of resistance  would be the same and in fact it isn't because my   cheek is not the same as my forehead indeed and  the fact that we can do it on an ongoing basis   god it sounds like i own the company i actually  have no interest in solta or the company but i   have had an flx um and i need another one think  uh you remind me you probably do need another one   okay so we have you have the new thermage  flx yes tell us a little bit about uh clear   and brilliant so if you would please no clear and  brilliant i believe was launched 10 11 years ago   and and it has been an amazing uh laser to you  know really address three things you know people   that want to prevent the signs of aging right  and so i think it's probably fair to say that   the millennial generation really kind  of started that uh that that phase in   aesthetics where they want to prevent the signs  of aging so this is a great device for that   but it's also to maintain your investment in  and maybe some other procedures that you've done   and to maintain that youthful look and  and that glow but also to improve you know   there's two different wavelengths uh one for fine  lines and wrinkles and one's more superficial   for pigment and pore size and tone and texture um  and they were usually used one or the other right   right well you either use the one for the lines  or use more superficial for pigment and tone and   texture but uh just this year we launched the  the new clear and brilliant touch and that has   been a game changer um the interest and the  demand for that device has been incredible   and and we did a number of things um you know  we certainly updated the the user interface so   that it's so much more easy to to to work with  and to be able to select what you want to do   but we also were able to now anytime within the  procedure interchange wavelengths from either   the 1440 or the 1927 with one one treatment tip  so that 1440 1927 for those of you who aren't in   the business refers to the nanometers that's the  wavelength of the laser correct uh so they can   interchange between the two wavelengths and they  do different things right guess you've got they   get it right absolutely absolutely and and as you  know you know this this thing just took off and we   we really expected that this would be something  that would expand our market and expand our reach   uh beyond those that have had our legacy device  for for many many years um but remarkably enough   uh the interest uh with current owners  has been really really high um so um we're   it's always exciting when when you launch another  generation you know it's always exciting when you   launch anything you know something is brand new  clearly has a lot of pizzazz to it but but another   generation that really makes a difference it's  been a great success so far so and that's probably   uh partly just to account for the 37 38 percent  growth right no doubt so the clear and brilliant   is new the flx is not brand new but it's  relatively sort of new to the marketplace   what's going on with fraxel and fraxel duel yeah  so so fraxel duel you know when when we designed   the fraxel this is something you may not know i'm  curious to see if you do um the engineers uh were   brilliant you know linda benedictus and his team  were stealing very well yes i mean he was on a   conference call with me just a couple weeks is  that right yeah great guy well say hi for him   i haven't talked to him for a while but you know  his team you know led by ken chan and many others   uh over engineered that device because they really  wanted to make sure that this was going to be   durable and stand the test of time and and not  be something that was going to be breaking down   often it was it was the only thing we had  going at the time at reliant technology so   we really were one trick pony but what i mean by  that is that you know the the laser source itself   is a telecom grade laser source so it's the same  source that runs the transatlantic cable uh to   transmit all of that data underneath the atlantic  ocean you know that yeah yeah there and and   did we have to do that absolutely not but len  engineered that len said we need to do this and   and so i think that has probably been  the one most important thing that has   led to the the longevity of this product line but  of course the fraxel was the first fractionated   laser you know with with that scanning technology  that really uh you know it's like you're you're   roller painting the skin as opposed to stamping  the skin and that really was a game changer and   it's pixelated yes you say fractionated so for  those of you it's pixelated if you will the laser   comes out and and they can roll across instead of  doing stamps yes right yes yes so it's a smoother   delivery basically is what that meant but um you  know right now we have the dual so we do have the   two wavelengths so it's the 1550 and the 1927.  the big difference between the one in the dual   and the one in the clear and brilliant touch  is that this is a much more powerful device   you know for the for the 1550 it's a 30 um 30  watt system uh for the 1927 i think it's a a 20   watt a system but the clearance really is  only is a single watt it's a diode it's   it's not the same source uh and it's meant to  be more superficial and and not as powerful   but those are still you know the fraxis duel  is still kicking it's you know you know there's   rumors out there that we're doing something with  it we'll have to wait and find out but uh uh i i   think it's safe to say that we would love to see  something uh uh come out in the fraxel line again   absolutely yeah i'm waiting for it i've heard  those rumors also but i have no inside information   um and then you're starting to market now the  combination therapy of thermage to tighten and   lift and create more collagen and elastin so forth  and then the fraxel dual to smooth and remove   pigment and so forth and to talk about the surface  of the skin so you've wed them together and you're   marketing them under the name thermofracs and and  we thank you very much for that uh because as many   of you may not know uh dr stevens was the one who  came up with the term uh the thermofracs back in   like 2008 in those early days wasn't it yes  it was when uh clint carnell sued me i think   uh for from foreshadowing on the terms that's how  i met clint who's my co-founder of orange twists   exactly and he brought that up on this program  yeah came into my office and said i've got to   see you for using that name for axel or thermofrax  well i'll tell you it was a brilliant move because   uh you were well ahead of the times no one  was really thinking about combination therapy   um and and many companies were really just  thinking about mono therapy right uh but   as we know when we look at any patient that  comes into your door no one technology is going   to address everything they need and so being  able to combine you know the fraxel laser with   the tightening of thermage was was a brilliant  move corporately you know with your help we have   really over the last over the last year launched  this thermofrax campaign and putting together   a lot of not only you know physician marketing  materials but direct to consumer because we   really think that this speaks so so near and dear  to people who um you know have have been on zoom   calls for the last 18 months who have been working  from home and they're looking at themselves on   the screen as we are now and saying i look  like crap and i need to do something to help   tighten and brighten uh my skin so we're going to  continue with that no no question and and look to   expand that market and you know one of the things  i i guess while we're talking about zoom yes can   i can i bring up the eyes sure absolutely because  there's not a lot to treat the eyes you know and   thrash is one of the only technologies that  you can actually treat right over the eyelid   safely to get rid of that crepiness and and  brighten those eyes up and and open them up so   that those zoom calls appear a little bit better  well in addition to that if you treat the forehead   the brow lifts up a little bit and you have more  visibility of the lid and you look less sleepy   less dreary and so forth and you mentioned titan  and brighton and you said that and that address   is really the concept that i talked about with  thermofrax years ago because the titan part is the   thermage the brighten generally is referred to the  skin which is pigment and wrinkles and so forth so   when you get tighten and brighten that's thermoph  thermofracs basically you can do both in one yes   and there are other ways to do that also but i i  happen to believe that that's a wonderful marriage   of two different technologies radio frequency  and lasers two different technologies that   come together and patients you know they don't  really care the frequency they don't really get   the energy source they just want to look  better they say hey i want to look better   i look terrible on my zoom calls all this stuff  about zoom neck and zoom eyelids and looking   down and all and i we get calls all the time  because people are looking at themselves so much   most guys look at themselves historically before  covet 10 minutes max a day in a meal is that right   generally five because they're sh they're brushing  their teeth or shaving that's generally what they   did now they're spending multiple hours a  day looking at themselves on zoom calls and   unfortunately looking down most of the time which  makes their eyes look up and makes their bags pop   out even more their double chin you know and all  the rest and then they're calling me up and saying   hey grano you're not going to believe it but i  look like crap you know you and me and all of us   that's right yeah so that sounds open the gateway  actually for a lot of males coming in frankly   because women have looked at themselves for hours  a day for years forever and we love makeup and we   love them for yes absolutely but we as guys have  traditionally and typically not been as aware   now we're painfully aware that we need some help i  think that's very fair to say so without question   titan and bright yes is a good thing and and i  think you know as we continue to expand the market   um you know depending on who the patient is maybe  we use thermage with clear and brilliant mm-hmm   you know depending on what they need to do that  same titan of brian because you just mentioned   there's many ways to get there uh so that's  something that maybe we'll be looking at too uh   in the future no reason why you can't couple those  two together if they have less needs on the skin   surface less brightening needs if you will right  okay so that opens the door to my next question   and that is about the future so i noticed you  brought your crystal ball i saw that and i'd   like you to tell me you've been in this business  for many years you left for about 10 years you   came back you've seen the development of these  various energy-based technologies all in the   non-surgical area tell me what the future looks  like let's say three five ten years from now   what are we gonna look at what's it gonna look  like three years from now five years ten years   well you know one thing we know for sure is  that technology doesn't slow down uh it's going   faster than it's ever gone in my opinion and and i  think whoever can come up with the answer to hair   loss and cellulite is probably going to have  a good run um you know there's the mechanical   hair transplant systems but to to get natural hair  growth uh prp i think is going to play a big role   in that in in some form or fashion i know there is  controversy recently uh about whether that's uh uh   appropriate or not but i think if as long as it's  autologous that you know using your own blood to   use i think that's probably is that right uh still  okay right yeah um cellulite we have you know some   some technologies out now some injectables that um  i'm looking forward to seeing how that that goes   uh i think you probably have started using that  absolutely yeah so you know those are two things   that i immediately think about that are probably  going to be interesting to see how that goes   but beyond that we talk about this pandemic and  the response that we had from industry to generate   the vaccines and you look at the the vehicles  the drug delivery systems that they're using   uh a lot of this mrna technology right and  lipid-mediated delivery of of drugs you   know obviously in the medical dermatology  side i think you know drug delivery is is   a huge opportunity but it might also come into  aesthetics at some point you know i kind of i   look at a couple companies in the bay area right  now uh one in particular that is is using mri mrna   technology uh to deliver a product that actually  restores youthfulness is this transcutaneous yes   yes so topical yes and um um i don't know  enough about it to speak intelligently uh   but i never stopped you before well you know don't  let the truth get in the way of a good story right but um but it's actually you know fascinating  to me i think that's you know drug delivery at   some form or fashion i think is as a result  of this pandemic i think might have a i mean   i agree with you i would agree we had uh ryan  beal on this program talking to us about dive   d-y-v-e that is not d-i-v-e and he has a  very interesting technology that affords uh   allows uh transcutaneous delivery of drugs into  the bloodstream actually transcutaneous topical   transcutaneous uh with measurable levels in the  blood in the urine and so forth in ways almost the   same as an injection transcutaneous it's amazing  and i i was asking about the possibility of other   uh things such as botox and other drugs that might  was tried for a while right yeah oh yeah that's   right rovance tried that for a while and and had  you know spotty results and uh uh well that would   be fantastic yeah throw away the needles yeah  uh i hadn't heard about the message rna the mrna   you may know that the person who's kind  of leading that charge uh anya cramer   oh yes yeah so uh she used to be the vp of  marketing at reliant for the fraxel that's right   and so anya is running the messenger  transcutaneously i've got to give she does but but it you know i just was talking  to her a number of weeks ago and she was telling   me you know you know the this regenerative  property that they're beginning to see um   early stage you know there's much work to be done  but fascinating stuff yeah sign me up yeah yeah   yeah well listen gus we could be talking  for uh days on this and i want to thank you   so much for coming here from texas thank you  for appearing on our program here in beautiful   manhattan beach um always always welcome and i  love working with you and can't wait to hear about   new developments at solta with fraxel and various  other exciting technologies we'll have to get   together in the mountains too sometimes absolutely  absolutely i look forward to it and hopefully i'll   be seeing you shortly at cosmetic bootcamp we'll  see you in aspen absolutely so i'd like to thank   all of you for joining us once again here at the  technology of beauty where we get to interview the   movers and the shakers of the beauty business and  today we learned all about gus rhodes and sulta   and where he came from and where we're going and  his predictions for the future with transcutaneous   topical rejuvenation of our skin and our bodies  so thank you once again gus for coming and thank   you all for joining us i'll see you each and  every tuesday on the technology of beauty you

2021-09-09

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