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1 N page Neurotoxin Review Asia-Pacific Market Update ovel Hydradermabrasion System Restores Skin Health Volume 13 Circulation 20,000

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3 HydraFacial System Restores Skin Health By Jeffrey Frentzen, Executive Editor The innovative HydraFacial hydradermabrasion system from The HydraFacial Company (Signal Hill, California, U.S.) provides an advanced and effective skincare treatment that cleanses, extracts and hydrates during a single session, restoring the skin with important nutrients. Whether used as a stand-alone treatment or as an adjunct to other aesthetic procedures, this non-invasive skin wellness platform fills an unmet need in clinics across the Asia-Pacific (APAC) region. According to Hidemasa Shinohara, M.D., a plastic surgeon and director of the Skin Refine Clinic in Tokyo, Japan, There has been nothing on the market like HydraFacial. This treatment has helped my acne patients and those that want improved skin tone, a return of brightness and elasticity to the face, or have other skin-related problems. It is a medical procedure that gives patients a rejuvenated look. Hidemasa Shinohara, M.D. Plastic Surgeon Director Skin Refine Clinic Tokyo, Japan Sean Arendse, B.Sc., A.K.C., M.B.B.S. Cosmetic Physician Melbourne, Australia HydraFacial is effective for every skin type, has virtually no downtime and is suitable for patients with sensitive skin. This 30-minute treatment works on the face to help reverse environmental damage, as well as restore the skin s appearance in terms of tone, resilience and consistency. Due to the deeper exfoliation of the skin, the system s treatment protocol goes far beyond traditional dermabrasion, Dr. Shinohara noted. The benefit of HydraFacial is that it combines extractions and a light peel, and allows the operator to penetrate the skin with serums and other skincare products, such as growth factors, since a portion of the top layer has been shed. Sean Arendse, B.Sc., A.K.C., M.B.B.S., a cosmetic physician in Melbourne, Australia, heard reports of excellent results from colleagues that already had the HydraFacial system. I knew it was a modality that we needed to have at my clinic, he said. What appealed most was the fact that treatment combines a number of modalities and that it is a far superior and more comfortable procedure than traditional microdermabrasion. HydraFacial appeals to a wide-range of practitioners, from dermatologists that utilize it as a general skin health maintenance program, to plastic surgery clinics where it also works as an adjunct therapy before and/or after surgical procedures. No matter what facial treatment is performed, HydraFacial prepares the skin properly and enhances the aesthetic results, Dr. Shinohara expressed. Yu-Hao Huang, M.D., director of the International Aesthetic Medicine Center in Kaohsiung, Taiwan, concurred. We perform a lot of laser treatments and even facial cosmetic surgeries in our clinic. As skin becomes better hydrated, we will see an improved post-procedure result. Thus, we use the HydraFacial system as the final step following surgery, or as a way to repair Yu-Hao Huang, M.D. Director International Aesthetic Medicine Center Kaohsiung, Taiwan There has been nothing on the market like HydraFacial. This treatment has helped my acne patients and those that want improved skin tone, a return of brightness and elasticity to the face, or have other skin-related problems. It is a medical procedure that gives patients a rejuvenated look. THE Asian Aesthetic Guide Volume

4 2017 Volume 13 Features 36 Neurotoxin Review 60 Asia-Pacific Market Update Comparison Charts 70 Skin Rejuvenation 74 Hair Removal Vascular Technologies 78 Acne Tx Devices 80 Dermal Fillers 82 Body Shaping Technologies 84 Fractional Technologies 86 Emerging Technologies Directory Aesthetic Company Directory 4 THE Asian Aesthetic Guide Volume 13

5 Advertisers Index THE Aesthetic Industry Awards 28, 45 THE Aesthetic Show , 73 Asclepion 43 BTL Industries 2, 39 Canfield Scientific 13 DEKA 15 Eunsung 41 European Society of Aesthetic Gynecology 57 Fotona 19 Contact Information The HydraFacial Company 91 IMCAS 29 Jeisys Medical 51 Lutronic 17, 92 Michael Moretti Editor-in-Chief / Group Publisher mmoretti@miinews.com Leah Morvant Publisher lmorvant@miinews.com Medical Insight 36 Discovery, Suite 170 Irvine, CA USA MedixSysteme 53 mesoestetic 59 PerfAction Technologies 47 Sciton 55 Jeffrey Frentzen Executive Editor jeff@miinews.com Erin Velardo Senior Editor erin@miinews.com Telephone: Facsimile: Syneron Candela 21 Thermi, an Almirall Company 35 Editorial Staff Subscriptions: info@miinews.com Ulthera, a Division of Merz, Inc. 25 Niamh Cahill Contributing Editor Anthony J. Varro Contributing Editor Viveve Medical 27 William T. Kelley Senior Editor, International Kevin A. Wilson Contributing Editor Advertising Inquiries: sales@miinews.com WONIK Corporation 49 ZELTIQ Aesthetics 23 Zimmer MedizinSysteme 11 Correction of errors: Medical Insight assumes no liability for the information contained in this publication. Every effort has been taken to ensure the accuracy of this information by contacting sources believed to be reliable. Errors, when discovered, will be promptly corrected. Copyright: This publication is protected by U.S. Copyright Law; 2017 Medical Insight Unauthorized reproduction is strictly forbidden by law, the penalty for violation is $100,000 per occurance. THE Asian Aesthetic Guide is a trademark of Medical Insight THE Asian Aesthetic Guide Volume

6 and hydrate the skin between laser procedures. It is also very good for skin health. We call the HydraFacial procedure a medical facial, he stated. Unlike traditional dermabrasion devices with coarse handpiece tips made of crushed diamonds to treat the skin s surface, HydraFacial uses patented HydroPeel plastic tips with vacuum pressure to deposit medical-grade serums onto the dermis. The tips deliver even, consistent exfoliation while providing patients with a comfortable experience. Patented Vortex-Fusion technology works in sequence to cleanse and hydrate the skin, as well as extract impurities. Patients receive a thorough dermal analysis before treatment to determine what serums are appropriate to facilitate skin rejuvenation. HydraFacial comes with several specialized serums so the procedure can be customized for the individual patient. Users can find more information about all of the available serums on the HydraFacial website. Treatment begins by removing dead cells from the skin s surface using gentle exfoliation and mild resurfacing. The operator employs the Vortex-Fusion tool to open the pores and remove the topmost layer of make-up remnants and dead skin cells. One benefit of this step is the elimination of sebum, which can impede the penetration of skincare ingredients and serums. Acne patients benefit considerably from the hydradermabrasion peel, Dr. Shinohara reported. As practitioners we have a long list of options to choose from when dealing with these types of skin problems. In my opinion, one of the best options available is the HydraFacial. It can be especially helpful for individuals Before and after HydraFacial treatment Photos courtesy of The HydraFacial Company Before and after HydraFacial treatment Photos courtesy of The HydraFacial Company who have acne scars. Treatment targets hyperpigmentation, wrinkles, fine lines and congested pores. While chemical peels are effective they tend to make the patient s skin feel dry, Dr. Shinohara continued. A chemical peel by itself does not gratify patients. Conversely, a single After the skin is cleansed, a mix of salicylic and glycolic acids delivers the ben- As practitioners we have a long list of options efits of a peel without post-peel scaling. to choose from when dealing with these types This gentle treatment helps loosen pore of skin problems. In my opinion, one of the plugs that are responsible for inflammatory acne. In addition, it addresses the best options available is the HydraFacial. appearance of fine lines and wrinkles, enlarged pores and uneven skin tone. 6 THE Asian Aesthetic Guide Volume 13

7 HydraFacial treatment includes both peeling and hydration. This moisturizing procedure makes patients feel better, and works beautifully. After the peel, the system painlessly extracts impurities from the skin. The released pore plugs and dirt are removed by a combination of cleaning action by the HydraFacial applicator and suctioning of the dirt and other particles. Instead of performing manual extractions, we use the extraction nozzle, which works like a vacuum to pull out dead skin cells, dirt, grease and other substances that may be deep in your pores and deposit this debris in a receptacle at the base of the machine. You can see exactly what was removed, noted Dr. Shinohara. Following this step of the treatment, Dr. Arendse shows his patients the contents of the container. All the dead cells and effluvium that has been removed from their skin is in there, he expressed. This usually amazes them, as we all think our skin is cleaner than it is. I always see a smile on their faces at this point, because they see how well the procedure works. After the extraction stage, the operator applies antioxidant and collagen rich serums such as peptides, antioxidants and hyaluronic acid (HA) to the skin via the Vortex-Fusion tool, which also promotes elasticity and hydration. The antioxidants help repair skin damage and protect the skin, peptides help recharge the skin and minimize signs of aging, and HA can address fine lines and wrinkles by attracting moisture to the treatment site. The HydraFacial Vortex-Fusion technology will clean, purify, hydrate and enrich skin in a very quick procedure, Dr. Huang stated. As the skin becomes cleaner the absorption of active ingredients is increased. My customers come away with better quality skin, period. One of Dr. Huang s most used serums, Britenol Intensive Spot Corrector, targets and helps remedy dark spots and sun damage. It utilizes Alpha-arbutin to correct discoloration, as well as vitamin C to help create a radiant skin tone while providing antioxidant protection. In Asia, there is a big problem with brown spots and hyperpigmentation, he said. HydraFacial cleansing and infusing helps to reduce the appearance of these indications without any pain or discomfort. In Dr. Arendse s experience, Exfoliation of the skin using the Activ-4 serum and the HydraFacial blue tip produces instant results. It deeply exfoliates dead skin on the surface and prepares it for the chemical peel. The Antiox-6 solution effectively hydrates and rejuvenates the skin and the patient can really feel it working. Practitioners really don t need a separate microdermabrasion machine or THE Asian Aesthetic Guide Volume

8 multiple products to cleanse the skin, Dr. Huang noted. HydraFacial provides a distinct and unique treatment. It s not just a tool for maintaining the overall facial health of patients, but has been specifically designed for problem skin treatments. Virtually any facial skin-related indication is well served by HydraFacial, Dr. Arendse emphasized. Many of our young clients come to the clinic asking for the impossible, which is great results with little or no downtime. The Hydrafacial system is one of the few modalities we use that delivers on this request. We have seen consistently reproducible reduction in the effects of sun damage, blemishes, fine lines and improvement in overall skin texture with regular treatments. HydraFacial works as a useful alternative for more invasive treatments, as well, Dr. Arendse pointed out. It is much less aggressive than other modalities that we have for skin rejuvenation and resurfacing. The standout feature is that it is truly a lunchtime procedure where our clients can go straight back to work with glowing skin, he said. Once the patient experiences his or her first treatment, Many come back for repeat HydraFacial sessions, said Dr. Shinohara. This is a great way to bring in new customers and retain them. Since the results are immediate and look great, they naturally want to maintain that appearance over the coming years. So, who is the ideal candidate for HydraFacial? HydraFacial is safe at all ages and for all skin types, stated Dr. Arendse. Many of our clients come in for a monthly treatment, possibly in addition to more invasive modalities, but when they need a results-driven skin therapy with no downtime they often opt for the HydraFacial. According to Dr. Huang, Just about everyone is a good candidate for HydraFacial treatments, except for people who have some acute inflammation or any Before and after HydraFacial treatment Photos courtesy of The HydraFacial Company Before and after HydraFacial treatment Photos courtesy of The HydraFacial Company sort of skin infection. Almost every skin type can handle HydraFacial. It s good for so many dermal issues, but in particular I suggest that patients with acne and blackheads receive the treatment. They are amazed to see the improvement immediately after. 8 THE Asian Aesthetic Guide Volume 13

9 Dr. Arendse has received only positive feedback from patients. Immediately post-procedure patients often tell us how soft their skin feels and how radiant they look. It is very addictive; they can t just stop at one treatment, so the majority of our clients sign up for a package of sessions, he expressed. Before and after HydraFacial treatment Photos courtesy of The HydraFacial Company Before and after HydraFacial treatment Photos courtesy of The HydraFacial Company Patient satisfaction is very high, Dr. Shinohara shared. HydraFacial is efficacious for all patients. It can be used as a standalone skin wellness system, but it is ideal when used in combination with other modalities and procedures. Dr. Huang routinely combines HydraFacial treatments with other therapies to achieve certain results. We have used it with botulinum toxin and dermal filler injections, as well as other more invasive skin resurfacing modalities, such as Fraxel and the Excel V laser. Used in this way, HydraFacial can help eliminate downtime and accelerate the healing phase of these other procedures. Patients often tell us their skin has become brighter, smoother and healthier. Also, some of them tell me their skin has become more breathable. I would recommend HydraFacial to colleagues because patient satisfaction is so high and also because it works well with those other treatment modalities. The bottom line is that along with high patient satisfaction and ease of use, HydraFacial is a valuable tool for customer retention and receives excellent word-ofmouth from patients, Dr. Arendse added. It is one of the most utilized devices at my clinic. For the technicians and staff, this system is relatively easy to master, and is extremely safe on all skin types. It produces results, which in turn leads to a great return of investment (ROI) and generation of income. As a matter of fact, since acquiring the system, Dr. Huang has witnessed a very quick ROI. Given that our customer pool is quite large, the HydraFacial pays for itself in no time because I have designed it to be included in packages of combination treatments. The system is often in use and I employ three to five people to perform HydraFacial procedures every day, he said. Dr. Shinohara recommends HydraFacial as part of almost any aesthetic therapy. I also price the treatments as an adjunct to other modalities, and frequently offer it at a discount because I m using it in tandem with other procedures. That way, the ROI is reasonable, he said. I would recommend HydraFacial to colleagues because patient satisfaction is so high and also because it works well with other treatment modalities, such as intense pulsed light (IPL), CO 2, radiofrequency (RF) and laser-based devices. THE Asian Aesthetic Guide Volume

10 SCIENTIFIC ADVISORY BOARD Maurice Adatto, M.D. Medical Director Skinpulse Dermatology & Laser Center Geneva, Switzerland Daniel Cassuto, M.D. Professor of Plastic Surgery University of Catania Catania, Italy Doris J. Day, M.D. Clinical Assistant Professor of Dermatology NYU Langone Medical Center Director Day Dermatology and Aesthetics New York, NY, USA Macrene Alexiades-Armenakas, M.D., Ph.D., F.A.A.D. Assistant Clinical Professor Yale University School of Medicine New Haven, CT, USA Director Dermatology and Laser Surgery New York, NY, USA Henry Chan, M.D., Ph.D., M.B.B.S., F.R.C.P., F.H.K.C.P., F.H.K.A.M. Dermatologist Honorary Professor Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong, China Koenraad De Boulle, M.D. Director Aalst Dermatology Group Aalst, Belgium Red M. Alinsod, M.D., F.A.C.O.G., A.C.G.E. Urogynecologist and Pelvic Reconstructive Surgeon Laguna Beach, CA, USA Gregory W. Chernoff, M.D., F.R.C.S. Plastic Surgeon Medical Director Chernoff Cosmetic Surgery Indianapolis, IN and Santa Rosa, CA, USA Jason B. Diamond, M.D., F.A.C.S. Diplomate American Board of Facial Plastic and Reconstructive Surgery Los Angeles, CA, USA Tina Alster, M.D. Washington Institute of Dermatologic Laser Surgery Washington, D.C., USA Suneel Chilukuri, M.D., F.A.A.D., F.A.C.M.S. Cosmetic and Dermatologic Surgeon Houston, TX, USA Barry DiBernardo, M.D., F.A.C.S. New Jersey Plastic Surgery Montclair, NJ, USA Benjamin Ascher, M.D. Plastic Surgeon Clinique IENA Lecturer and Clinical Assistant Paris Academy Paris, France Hong-Kyu Cho, M.D. Plastic Surgeon NB Plastic Surgery Clinic Seoul, Korea Christine Dierickx, M.D. Medical Director Skinperium Boom, Belgium Peter Bjerring, M.D., Ph.D. Professor of Dermatology Aarhus University Hospital Vejle, Denmark Joon-Yong Choi, M.D. Chief Plastic Surgeon Dream Plastic Surgery Group Seoul, Korea Jason Emer, M.D., F.A.A.D. Board Certified Dermatologist Beverly Hills, CA, USA Kevin Brenner, M.D., F.A.C.S. Board Certified Plastic and Reconstructive Surgeon ROX Center Beverly Hills, CA, USA Steven R. Cohen, M.D., F.A.C.S. Medical Director FACES+ Plastic Surgery Skin and Laser Center Clinical Professor of Plastic Surgery University of California, San Diego La Jolla, CA, USA Sabrina Fabi, M.D. Board Certified Dermatologist Goldman, Butterwick, Fitzpatrick, Groff & Fabi Cosmetic Laser Dermatology San Diego, CA, USA Gregory Buford, M.D., F.A.C.S. Board Certified Plastic Surgeon Beauty by Buford Englewood, CO, USA Angelo Cuzalina, M.D., D.D.S. Past President American Academy of Cosmetic Surgery, 2011 Diplomate American Board of Cosmetic Surgery Tulsa, OK, USA Klaus Fritz, M.D. Director, Dermatology and Laser Centers Landau, Germany Associate Professor Carol Davila University of Medicine and Pharmacy Bucharest, Romania President, European Society of Laser Dermatology 10 THE Asian Aesthetic Guide Volume 13

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12 SCIENTIFIC ADVISORY BOARD Takahiro Fujimoto, M.D., Ph.D. Medical Director Clinic F Laser and Skin Centre Tokyo, Japan Pearl E. Grimes, M.D. Director Vitiligo and Pigmentation Institute VPI Cosmetic Center Los Angeles, CA, USA Chang-Hun Huh, M.D., Ph.D. Clinical Assistant Professor Department of Dermatology Seoul National University Budang Hospital Gyeonggi, Korea Ma. Teresita G. Gabriel, M.D., F.P.D.S. Chair Department of Dermatology Research Institute for Tropical Medicine Alabang, Muntinlupa City, Philippines Sanjay Grover, M.D., F.A.C.S. Diplomate American Board of Plastic Surgery Newport Beach, CA, USA Christopher Inglefield, B.Sc., M.B.B.S., F.R.C.S.(Plast) Medical Director London Bridge Plastic Surgery & Aesthetic Clinic London, UK Dore J. Gilbert, M.D. Dermatologist Newport Dermatology & Laser Associates Newport Beach, CA, USA Ka-lam Hau, M.B.Ch.B., M.R.C.P., F.H.K.A.M., F.H.K.C.P., D.C.H. Dermatology Specialist Hong Kong SAR, China Garo Kassabian, M.D., F.A.C.S. Dual Board Certified Plastic and General Surgeon Founder and Medical Director Lift MD Aesthetics Beverly Hills, CA, USA Chee-Leok Goh, M.D., M.B.B.S., M.Med., M.R.C.P., F.R.C.P.E., F.A.M.S. Clinical Professor National University of Singapore Adj. Professor Duke-NUS Graduate School Sr. Consultant Dermatologist National Skin Centre, Singapore Per Hedén, M.D., Ph.D. Associate Professor of Plastic Surgery Karolinska Institutet Founder and Chairman Akademikliniken Private Hospital Group Stockholm, Sweden Bruce Katz, M.D. Clinical Professor of Dermatology Mount Sinai School of Medicine New York, NY, USA Michael H. Gold, M.D. Gold Skin Care Ctr. Tennessee Clinical Research Ctr. Clinical Assistant Professor Vanderbilt University School of Medicine Nashville, TN, USA Gangaram Hemandas, M.B.B.S., M.R.C.P., F.R.C.P., M.Med., F.A.A.M. Head and Consultant Dermatologist Department of Dermatology Prince Court Medical Center Consultant Dermatologist Tropicana Medical Center Petaling Jaya and Kuala Lampur, Malaysia Arielle Kauvar, M.D. Clinical Associate Professor of Dermatology New York University School of Medicine New York, NY, USA David J. Goldberg, M.D. Clinical Professor of Dermatology Mount Sinai School of Medicine New York, NY, USA Alberto Goldman, M.D. Board Certified Plastic Surgeon Clinica Goldman Porto Alegre, Brazil Chanyeong Heo, M.D., Ph.D. Assistant Professor Department of Plastic Surgery School of Medicine Seoul National University Chairman and Chief of the Department of Plastic Surgery Seoul National University Budang Hospital Seoul and Gyeonggi-do, Korea Sindy Hu, M.D. Department of Dermatology Chang Gung Memorial Hospital Taipei, Taiwan Suzanne Kilmer, M.D. The Skin Surgery Center of Northern California Sacramento, CA, USA Beom-Joon Kim, M.D., Ph.D. Dermatologist Head Professor and Chairman Department of Dermatology College of Medicine, Chung-Ang University Seoul, Korea Miles Graivier, M.D., F.A.C.S. Plastic and Reconstructive Surgeon North Atlanta Plastic and Reconstructive Surgery Roswell, GA, USA Peter Huang, M.D. Plastic and Cosmetic Surgeon Director Rebecca Cosmetic Institute Taipei, Taiwan Lorrie Klein, M.D. President Lorrie Klein, M.D. - Dermatology & Laser Center Euro Day Spa, Inc. Laguna Niguel, CA, USA 12 THE Asian Aesthetic Guide Volume 13

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14 SCIENTIFIC ADVISORY BOARD Malavika Kohli, M.D., D.V.D., D.N.B. Consultant Dermatologist Aesthetic Dermatologist Jaslok Hospital and Research Centre Director Skin Secrets Mumbai, India Joyce Teng Ee Lim, M.B.B.S., F.R.C.P.I., F.A.M.S. Dermatologist Joyce Lim Skin and Laser Clinic Singapore Visiting Consultant National Skin Centre Singapore Rhoda S. Narins, M.D. Clinical Professor of Dermatology NYU Medical Center Medical Director Dermatology Surgery and Laser Center Manhattan and White Plains, NY, USA Taro Kono, M.D. Department of Plastic and Reconstructive Surgery Tokyo Women s Medical University Tokyo, Japan Corey S. Maas, M.D., F.A.C.S. The Maas Clinic for Aesthetic and Facial Plastic Surgery Associate Clinical Professor University of California, San Francisco San Francisco and Lake Tahoe, CA, USA Kei Negishi, M.D., Ph.D. Associate Professor and Chief of Aesthetic Dermatology Division Aoyama Institute of Women s Medicine Tokyo Women s Medical University Tokyo, Japan Marina Landau, M.D. Dermatology Wolfson Medical Center Holon, Israel Daniel Man, M.D. Plastic Surgeon Boca Raton, FL, USA Joseph Niamtu, III, D.M.D. Cosmetic Facial Surgeon Richmond, VA, USA Moshe Lapidoth, M.D., M.P.H. Head of the Laser Unit Rabin Medical Center Tel Aviv, Israel Woraphong Manuskiatti, M.D. Professor Department of Dermatology Siriraj Hospital, Mahidol University Siriraj Skin Laser Center Bangkok, Thailand Andrew P. Ordon, M.D., F.A.C.S. Plastic Surgeon Host CBS talk show The Doctors Beverly Hills and Rancho Mirage, CA, USA Geun-Soo Lee, M.D., Ph.D. Dermatologist Drs. Woo and Hann s Skin and Laser Center Seoul, Korea David Matlock, M.D., M.B.A., F.A.C.O.G. The Laser Vaginal Rejuvenation Institute of Los Angeles Los Angeles, CA, USA Hsien-Li Peter Peng, M.D. Director Dr. Peng s Dermatological Clinic & Cosmetic Laser Center (P-Skin Clinic) Taiwan, Republic of China Wendy W. Lee, M.D. Assistant Professor of Clinical Ophthalmology, Oculofacial Plastic and Reconstructive Surgery Bascom Palmer Eye Institute, University of Miami Miller School of Medicine Co-Director UM Cosmetic Medicine Miami, FL, USA Tess Mauricio, M.D., F.A.A.D. Founder Scripps Ranch Dermatology and Cosmetic Center San Diego, CA, USA Jorge A. Perez, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Perez Plastic Surgery Ft. Lauderdale, FL, USA Hang Li, M.D. Associate Professor Chief of the Dermatologic Surgery Division Department of Dermatology Peking University First Hospital Beijing, China David McDaniel, M.D. Laser Center of Virginia Virginia Beach, VA, USA Miriam Emily Piansay-Soriano, M.D., F.P.D.S. Davao Doctors Hospital Davao City, Philippines Yuanhong Li, M.D., Ph.D. Associate Professor of Dermatology Vice Chairman No. 1 Hospital of China Medical University Shenyang, China Ronald L. Moy, M.D. Dermatologist and Facial Cosmetic Surgeon Moy, Fincher and Chipps Facial Plastic & Dermatology UCLA Medical School Beverly Hills, CA, USA Jason Pozner, M.D., F.A.C.S. Medical Director Sanctuary Medical Aesthetic Center and Sanctuary Plastic Surgery Boca Raton, FL, USA 14 THE Asian Aesthetic Guide Volume 13

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16 SCIENTIFIC ADVISORY BOARD Nark-Kyoung Rho, M.D. Clinical Assistant Professor Department of Dermatology Samsung Medical Center Director Leaders Aesthetic Laser & Cosmetic Surgery Center Seoul, Korea Gordon H. Sasaki, M.D., F.A.C.S. Clinical Professor Department of Plastic Surgery Loma Linda Medical University Center Private Practice Pasadena, CA, USA Siak-Khim Tan, M.D., B.S. Medical Director The DRx Clinic Singapore Alexander Z. Rivkin, M.D. Facial Cosmetic Surgeon Founder Westside Aesthetics Los Angeles, CA, USA Gerhard Sattler, M.D. Founder and Medical Director Rosenpark Klinik Darmstadt, Germany Mark B. Taylor, M.D., F.A.A.D. Director Gateway Aesthetic Institute and Laser Center Salt Lake City, UT, USA Leif Rogers, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Leif Rogers, M.D. Reconstructive and Cosmetic Plastic Surgery Beverly Hills, CA, USA Kyle Koo-Il Seo, M.D., Ph.D. Clinical Associate Professor BOTOX Clinic Department of Dermatology Seoul National University Hospital Director Modelo Clinic Seoul, Korea William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S. Assistant Clinical Professor of Medicine/Dermatology University of Washington School of Medicine Seattle, WA, USA E. Victor Ross, M.D. Director Cosmetic and Laser Dermatology Unit Scripps Clinic San Diego, CA, USA Ava Shamban, M.D. Laser Institute for Dermatology Santa Monica, CA, USA Assistant Clinical Professor of Dermatology University of California, Los Angeles Los Angeles, CA, USA ChongHyun Won, M.D. Assistant Professor Department of Dermatology Ulsan University School of Medicine Seoul, Korea Mark G. Rubin, M.D. Assistant Clinical Professor of Dermatology University of California, San Diego Private Practice Beverly Hills, CA, USA W. Grant Stevens, M.D., F.A.C.S. Plastic Surgeon Marina Plastic Surgery Clinical Professor of Surgery University of Southern California Marina Del Rey, CA, USA Woffles Wu, M.B.B.S., F.R.C.S., F.A.M.S. Plastic Surgeon Woffles Wu Aesthetic Surgery & Laser Centre Singapore Neil Sadick, M.D. Clinical Professor of Dermatology Weill Cornell Medical College New York, NY, USA Insuck Suh, M.D., Ph.D. Professor Department of Plastic and Reconstructive Surgery College of Medicine, Hallym University Kangnam Sacred Heart Hospital Seoul, Korea Sabine Zenker, M.D. Dermatologist Dermatology Surgery Clinic Munich, Germany Claudine Santos-Roura, M.D., F.P.D.S. Dermatologist and Cosmetic Surgeon Contours Advanced Face and Body Sculpting Institute Manila, Philippines Nantapat Supapannachart, M.D. Dermatologist Clinical Professor Ramathibodi Hospital, Mahidol University Medical School Clinical Staff Bumrungrad Hospital Bangkok, Thailand Guoyu Zhou, M.D. Oral and Maxillofacial Surgeon Deputy Director Medical Laser Centre of Shanghai Jiaotong University Medical College, Ninth People s Hospital Shanghai, China Deborah S. Sarnoff, M.D., F.A.A.D., F.A.C.P. Clinical Professor of Dermatology NYU Langone Medical Center New York, NY, USA Atchima Suwanchinda, M.D., M.S. Consultant Laser and Dermatologic Surgery Unit Ramathibodi Hospital, Mahidol University Director Medisci Biointegrative and Anti-Aging Center Bangkok, Thailand Craig L. Ziering, D.O., F.A.O.C.D. CEO and Medical Director Ziering Medical Worldwide West Hollywood, CA, USA 16 THE Asian Aesthetic Guide Volume 13

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18 SP Dynamis Joins Er:YAG and Nd:YAG Lasers to Optimize Periorbital Rejuvenation to 65 C to stimulate collagen contraction, Dr. Yanli explained. In the second step, Application of the exclusive Fotona 1064 nm ultra-long pulse laser enables the target sites to be treated with deep heating to form thermal condensation in the redundant fat layer, promoting the metabolism and constriction of the expanded fat mass in the eyelids. By Anthony J. Varro, Contributing Editor Dr. Yanli adjusts her protocol to individual patients problems. For example, if a patient has heavy, dark under-eye circles, I will choose to do more in step three FRAC3, she shared. This mode uses microsecond Nd:YAG pulses to gently heat skin and break up excess pigment while promoting periorbital microcirculation to metabolize and remove the pigment. Lastly, the procedure s fourth step, uses the Er:YAG laser to perform superficial micron erugation, which smooths superficial wrinkles. deliver gentle coagulative heating without significant epidermal ablation. Tian Yanli, M.D. Dermatologist Beijing, China When it comes to the complex demands of periorbital rejuvenation, the SP Dynamis from Fotona (Ljubljana, Slovenia and Dallas, Texas, U.S.) provides several unique modes of action that are well-suited to the task. Tian Yanli, M.D., a dermatologist in Beijing, China, selected the SP Dynamis for the special capabilities of its Smooth mode. This Er:YAG (2940 nm) modality delivers a fast sequence of low-fluence pulses within an overall super-long 200 ms to 350 ms pulse. Exceeding the epidermal thermal relaxation time, these pulses Dr. Yanli also likes the SP Dynamis Variable Square Pulse (VSP) technology, an Er:YAG capability that generates square pulses (0.1 to 1.5 ms) for controlled energy absorption while minimizing laser impact on surrounding tissues. For her objectives, Dr. Yanli added, The laser s main mechanism of action is the heat delivered to the skin by the TwinLight fractional rejuvenation modality, which creates a suitable temperature for the process of shortening the collagen fibers and stimulating neocollagenesis. These changes improve tightness and elasticity in treated tissues. TwinLight fractional rejuvenation capitalizes on the deep penetration of the Nd:YAG laser and the superficial efficiency of the Er:YAG laser. The 2940 nm wavelength provides very precise ablation, which means shorter downtime. Using the proper dosage of Smooth mode, the temperature in the mucosa reaches 60 C Before and after two SP Dynamis TwinLight periorbital treatments Photos courtesy of Tian Yanli, M.D. In a recent clinical study, Dr. Yanli and colleagues treated 100 patients for undereye puffiness using the SP Dynamis 4D capability. As the only laser system enabling non-invasive removal of under-eye puffiness, Fotona 4D facilitates the Charm Eye procedure, she pointed out. This treatment employs Smooth mode to control the heating of tissues, as well as stimulate collagen remodeling and regeneration with an effective depth of 200 to 500 µm. Study patients underwent three to five sessions over a two-month period. Using a 5-point scale (1 = exceptional improvement; 5 = worsening), three independent physicians rated mean improvement levels in the palpebral frontalis, under-eye puffiness and dark circles at 2.6, 2.29 and 1.9, respectively, one year post-treatment. Patients evaluated their own results and found the most striking improvement in dark under-eye circles (3.5). They also noted clear improvement in under-eye puffiness, and satisfactory compaction of the palpebral frontalis. Furthermore, based on a 10-point scale, the mean patient-assigned procedural pain score was less than 3. Some patients even fell asleep during treatment, Dr. Yanli reported. The laser s main mechanism of action is the heat delivered to the skin by the TwinLight fractional rejuvenation modality, which creates a suitable temperature for the process of shortening the collagen fibers and stimulating neocollagenesis. 18 THE Asian Aesthetic Guide Volume 13

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20 PicoWay Non-Invasively Revitalizes Skin By Kevin A. Wilson, Contributing Editor Wichai Hongcharu, M.D. Chief of the Dermatology Unit Saint Louis Hospital Bangkok, Thailand Carl K.L. Cheng, M.D. Director Haute Beaute Skin & Vein Clinic Founder The Bundles Skin Clinic Taipei, Taiwan PicoWay from Syneron Candela (Irvine, California, U.S.) not only shatters pigment particles with picosecond power, it may also be employed for a more superficial skin revitalization treatment using the same basic principles of non-invasive photomechanical action, rather than photothermal. Featuring wavelengths of 1064 nm, frequency doubled 532 nm and 785 nm, this device is more versatile than ever, as physicians further explore its myriad capabilities. According to Wichai Hongcharu, M.D., chief of the dermatology unit at Saint Louis Hospital (Bangkok, Thailand), the key is using PicoWay s high energy, rapid pulse duration to achieve laser induced optical breakdown (LIOB). LIOB is a photomechanical (photoacoustic) effect that occurs when this method of energy delivery induces plasma formation in the dermis, which rapidly expands, thus also creating a micro-shockwave that affects the surrounding tissue as far as 0.2 mm from the cavitation zone. Additional laser energy is absorbed by the generated plasma cloud. This pigment-shattering effect causes indirect induction of the cytokine cascade, but photothermal damage is minimal and the skin barrier is maintained, so treatment is more comfortable, with very little downtime. The trick to a less aggressive superficial rejuvenation therapy is to reduce intensity one step below the LIOB threshold, focusing energy at a depth of about 500μ, Dr. Hongcharu continued. At this level energy is still intense enough to cause photomechanical stress and a cavitation effect but not LIOB in the dermis while maintaining an intact strateum corneum, he reported. We observed better clinical improvement with this approach due to the direct photoacoustic injury to the dermis. This less intense effect is called laser induced cavitation, or LIC. 20 THE Asian Aesthetic Guide Volume 13 First, we use the standard Zoom handpiece to induce LIOB and treat pigment, then we use the Resolve handpieces to induce cavitation and stimulate cytokine production and neocollagenesis, simultaneously reducing pigment and inducing the healing cascade to revitalize skin. PicoWay features two handpieces, Zoom and Resolve, both of which can use each wavelength. The standard Zoom handpiece has spot sizes of 2 mm to 10 mm, and the Resolve fractional handpiece has a 6 mm x 6 mm spot with a 10 x 10 microbeam array, and is used for more superficial treatment. The Resolve handpieces were designed specifically to create gentle photomechanical injury, said Carl K.L. Cheng, M.D., director of Haute Beaute Skin & Vein Clinic, and founder of The Bundles Skin Clinic (Taipei, Taiwan). The key to achieving the photomechanical effect is plasma formation, Dr. Cheng further explained. Initiation of breakdown can occur either through multiphoton absorption, as in the case of LIOB, or through the thermal initiation pathway as in the case of laser induced thermal breakdown (LITB). The PicoWay 532 nm standard Zoom and Resolve fractional handpiece technology is highly absorbed by melanin, thus it can be easily applied to produce a photomechanical effect purely with a low fluence LITB mechanism. In contrast, 1064 nm standard Zoom and Resolve fractional handpieces may achieve macrotissue effects through LIOB and subsequent cavitation bubbling. Combining the effects of both photodisruption (focal plasma effect) and photoremodeling (shockwave emission and cavitation bubbling) is called PicoTuning, a two-phase treatment process. First, we use the standard Zoom handpiece to induce LIOB and treat pigment, then we use the Resolve handpieces to induce cavitation and stimulate cytokine production and neocollagenesis, simultaneously reducing pigment and inducing the healing cascade to revitalize skin, Dr. Cheng concluded.

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22 Versatile New Applicator Increases CoolSculpting Efficacy and Patient Comfort By Jeffrey Frentzen, Executive Editor Benoit Chardon Vice President of International Marketing ZELTIQ London, UK Henry Hin Lee Chan, M.D., Ph.D., M.Sc., M.B.B.S. Dermatologist Honorary Clinical Professor University of Hong Kong Hong Kong The latest CoolSculpting applicator, the CoolAdvantage Petite from ZELTIQ Aesthetics (Pleasanton, California, U.S.), is designed to deliver cryolipolysis treatments for fat reduction to the upper arms and other small pockets of fat. Arms can be one of the most challenging areas to treat, stated Henry Hin Lee Chan, M.D., Ph.D., M.Sc., M.B.B.S., a dermatologist and honorary clinical professor at the University of Hong Kong. The good news is this device is highly effective. Dr. Chan recently completed an investigator-initiated study (IIS) that evaluated the safety and efficacy of the CoolAdvantage Petite on the upper arms, as well as on the abdomen and flanks of the Asian petite patient. While we have not looked at all the data we generated when comparing the CoolAdvantage Petite to other CoolSculpting applicators, we did look at the efficacious therapeutic effects that we were achieving, he said. Our impression is that CoolAdvantage Petite offers a faster treatment that cools body areas much better. The unit is also very easy to use, and the design is also to be congratulated because it allows us to expose enough volume to the cold. The smaller form factor is ideal for treating Asian patients, Dr. Chan added. The fat level in Asians is much different from that of Caucasians. In the past, we looked at some of the other CoolSculpting applicators and felt they were too big for our clients. CoolAdvantage Petite is perfect for my petite patients. Successful outcomes will depend upon good patient selection and managing expectations. The ideal candidate should understand that CoolSculpting is not a weight reduction mechanism, Dr. Chan expressed. It s for body contouring. Patients must be able to maintain a proper weight after treatment, as well, and sustain the necessary lifestyle changes including exercise and diet. CoolAdvantage Petite patients have been very satisfied with their results, Dr. Chan reported. We re not seeing any side effects, such as pain. In addition, the suction on this applicator is much better tolerated by patients. Dr. Chan intends to rely on the CoolAdvantage Petite for much of his CoolSculpting work, going forward. We have decided to change many of our applicators to the CoolAdvantage Petite simply because of the speed of treatment, as well as the overall efficacy. We will continue to use the submental and flat applicators. In addition, Dr. Chan said return on investment has been good. Patient turnaround has increased, as well, because the treatment is quick for us and our patients. High efficacy and low time exposure is important; therefore, the CoolAdvantage Petite is a good investment, he concluded. According to 2016 market research, arm fat ranks in the top seven areas of concern for 30.7 million people in the Asia-Pacific region, stated Benoit Chardon, vice president of international marketing at ZELTIQ in London, U.K. The CoolAdvantage Petite is a U.S. FDA cleared, non-invasive fat reduction treatment for the upper arms that works by cooling targeted fat cells, thus inducing a controlled elimination of fat without affecting surrounding tissue. This new applicator comes with two interchangeable contours tailored to treat the distinctive shape of the upper arm area, allowing practitioners more flexibility in fine tuning treatments. Before and ten weeks after one CoolAdvantage Petite session Photos courtesy of Jeffrey C. Dawes, M.D., F.R.C.S.C. Before and 12 weeks after one CoolAdvantage Petite session Photos courtesy of Jean Carruthers, M.D. and Shannon Humphrey, M.D. 22 THE Asian Aesthetic Guide Volume 13

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24 Ultrasound Visualization Creates Unrivaled Precision for Ultherapy By Kevin A. Wilson, Contributing Editor Ultherapy transducer depth can be set at 1.5 mm (superficial dermis), 3.0 mm (deep dermis) and 4.5 mm (SMAS/platysma), depending on the needs of the patient, and what the user learns using DeepSEE imaging plays a major role in how transducer depth is modulated. For example, since the introduction of Ultherapy Amplify software-optimization of treatment parameters, Ultherapy is more efficient and tolerable, but you want to avoid the bone. Treating on or below the bone surface is painful, and DeepSEE helps us avoid that as we choose which transducer to use, Dr. Bucay explained. There are other nearby tissue structures where the application of energy may cause unnecessary damage or at least provide no therapeutic benefit. The goal of any therapy is to target tissue or tissue structures that will lead to a therapeutic benefit, and avoid anything else. The better one can do that, the better any therapy will be. Vivian Bucay, M.D. Medical Director Bucay Center for Dermatology and Aesthetics San Antonio, TX, USA The use of ultrasound to visualize organs and tissue structures non-invasively has been a boon to medicine for decades. The Ulthera System from Merz Aesthetics (Frankfurt, Germany) utilizes that same energy as a therapeutic modality for noninvasive facial tightening, but still incorporates a real-time ultrasound visualization component known as DeepSEE imaging into the platform to provide unparalleled precision in treatment, a feature that sets Ultherapy apart. Ultherapy targets as deep as the superficial muscular aponeurotic system (SMAS layer), the same facial anatomy tightened during surgical face-lifting to combat tissue redundancy due to aging, in a single 30 to 90 minute treatment with no downtime. The capability to visualize subsurface tissue stratification is what makes truly effective non-invasive tightening of the SMAS possible. There is no substitute for having real-time visualization when performing a treatment of this type, said Vivian Bucay, M.D., medical director of the Bucay Center for Dermatology and Aesthetics (San Antonio, Texas, U.S.). We know exactly where we re supposed to be treating. We know where our target should be and can see where it is, exactly. You can know facial anatomy in and out and have years of experience, but until you see it you don t know where that individual patient needs to be treated. Everyone is different, so it s a great advantage that we re not treating blindly. We can see where we re supposed to treat, as well as structures we want to avoid. I don t know of any company that spends as much time and money on their presence at conferences around the world, regularly bringing in expert physicians to share with users at all levels of experience. Add to that the safety and efficacy, real-time imaging, and what I believe to be the best ROI of any treatment I offer, and you have a proven winner in Ultherapy. Using intensive, up-to-date training programs and regular forums promoting the free exchange of information, Merz keeps its physician partner base informed and performing so that the patient gets the best outcomes Ultherapy has to offer. I don t know of any company that spends as much time and money on their presence at conferences around the world, regularly bringing in expert physicians to share with users at all levels of experience, said Dr. Bucay, who herself has often been called upon in that capacity. Add to that the safety and efficacy, realtime imaging, and what I believe to be the best ROI of any treatment I offer, and you have a proven winner in Ultherapy. 24 THE Asian Aesthetic Guide Volume 13

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26 Viveve Achieves Efficacious, No Downtime Feminine Rejuvenation Procedures By Jeffrey Frentzen, Executive Editor Jennifer Harrington, M.D. Board Certified Plastic and Reconstructive Surgeon Plymouth, MN, USA Increasingly, practitioners in the Asia- Pacific region are offering non-surgical options for treating introital vaginal laxity. Of the energy-based systems on the market, only the Viveve System from Viveve Medical, Inc. (Englewood, Colorado, U.S.) employs proprietary, cryogenically cooled monopolar radiofrequency (CMRF)-based energy to restore vaginal collagen at a deep level and provide optimal structural support. Vaginal laxity and associated tissue damage may adversely impact a woman s sexual health. Viveve s Geneveve procedure can tighten vaginal tissue without incisions, tissue ablation or anesthesia by utilizing a single treatment model that reaches deeper into the submucosa. Hyejin Cho, M.D. Aesthetic Physician Owner Honest Clinic Seoul, Korea Maggie Zhang, M.D. Plastic Surgeon Chongqing, China pleasure, vaginal laxity problems due to childbirth or age-related collagen degeneration. Since vaginal laxity can be a very subjective matter, most women can be the right candidate for Geneveve if you set the patient expectation levels properly. Managing patient expectations is critical to success, Dr. Cho continued. It is important to compare Geneveve with other vaginal laxity procedures so that people understand the beauty of this treatment. It is a painless, quick procedure without downtime and results almost as good as surgical techniques. Showing published clinical articles to prospective patients is another effective way to convince them to receive Geneveve treatment. The Viveve System is the only medical device in its category that is backed by peer-reviewed clinical studies, explained Maggie Zhang, M.D., a plastic surgeon in Chongqing, China, and senior consultant, Asia for Viveve Medical. Because of the strong studies, Viveve has gained government regulatory approval in many Asian countries for the treatment of vaginal laxity, she said. Combination therapies that include Geneveve are becoming more common, noted Dr. Cho. Patients prefer procedures with less pain and faster recovery. For those reasons, vaginal fillers and Geneveve are preferred. Sometimes it is advisable to combine the Geneveve treatment with platelet-rich plasma (PRP) or stem cell therapies. This increases the efficacy of the procedure. Many physicians understand the need to enter into the feminine rejuvenation space, but few have thought through how best to tap into this hidden but large potential patient base, Dr. Zhang indicated. Viveve offers an international level certificate program for physicians that are not very familiar with this space. It covers marketing, patient consultation, basic anatomy, examination procedures and treatment. The bottom line, according to Dr. Harrington, Is that Geneveve really works. And it is catching on like wild fire with patients around the world. Manufacturer s note: The Viveve System is indicated for use in general surgical procedures for electrocoagulation and hemostasis in Thailand. Unlike other energy-based systems that only penetrate the skin to around 1.5 mm deep, the Geneveve procedure can reach 5 mm and even deeper, according to Jennifer Harrington, M.D., a board certified plastic and reconstructive surgeon in Plymouth, Minnesota, U.S. This is achieved by combining the RF heat energy with cryotherapy cooling. Treatment is less labor intensive than previous modalities I ve used, and the results are amazing. It is kind of Nirvana, she said. Geneveve can be a good way for clinics to provide additional female wellness services, stated Hyejin Cho, M.D., owner of Honest Clinic (Seoul, Korea). Before receiving Geneveve, patients often endured symptoms like reduced sexual While many devices penetrate the skin up to 1.5 mm deep, the Geneveve procedure can reach 5 mm and even deeper. Photo courtesy of Viveve Medical, Inc. 26 THE Asian Aesthetic Guide Volume 13

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30 Feminine Rejuvenation Device Impacts Clinics Across APAC Region By Jeffrey Frentzen, Executive Editor Fiona Wei-Ling Chang, M.D. Anti-Aging Specialist Beijing, China Non-surgical vaginal rejuvenation procedures continue to grow in popularity worldwide, enabling practitioners to offer pain free, no downtime procedures to patients that do not require surgery. Increasingly, physicians in the Asia- Pacific (APAC) region have answered this call by adopting an advanced, energybased procedure that effectively addresses a range of women s health concerns. Vulvovaginal changes may happen through all stages of life and can affect the way women feel about themselves and their confidence. The radiofrequency (RF)-based ThermiVa device from Thermi, an Almirall Company (Irving, Sejal Desai, M.D., D.N.B. Gynoplasty Surgeon and Gynecologist Mumbai, India Oscar Horky, M.B.B.S. Cosmetic Gynecologist Sydney, Australia Texas, U.S.) fills a need for non-surgical, transcutaneous temperature-controlled therapy in the vulvovaginal region, using controlled RF to gently heat vulvovaginal tissue at the patient s comfort level. The ThermiVa handpiece works with the company s ThermiRF aesthetic platform, which features unique technology that combines precision temperature control with advanced real-time temperature monitoring when treating both the internal and external anatomical features of the vagina. For instance, ThermiVa works to tighten labial tissues to reduce sag and the visible outline of the labia majora in tight or formfitting clothing; improve atrophic vulvovaginitis; increase vaginal comfort (before, during and after sexual intercourse) without the use of hormones; shrink vaginal tissues to help improve muscular coordination and strength; reduce labial irritation; improve stress urinary incontinence; and help resolve pelvic prolapse, as well. In addition to tightening vulvovaginal tissues and increasing blood flow, ThermiVa treatments improve the sensitivity of the vulvar structures, clitoral region and internal vagina. Treatment results in collagen regeneration, which is necessary for thickening of the vaginal lining. It also works to solve the problem of painful intercourse. As a whole, the number of feminine medical, aesthetic and sexual issues that can be addressed by ThermiVa is impressive, stated Fiona Wei-Ling Chang, M.D., an anti-aging specialist in Beijing, China. Vaginal rejuvenation procedures using energy-based devices are very popular. My experience utilizing RF-based energy to treat chronic diseases led me to offer ThermiVa to female customers that desire vaginal youth. Specifically, in China s top tier cities, feminine rejuvenation My experience utilizing RF-based energy to treat chronic diseases led me to offer ThermiVa to female customers that desire vaginal youth. Specifically in China s top tier cities, feminine rejuvenation procedures of this sort are a huge growing market. 30 THE Asian Aesthetic Guide Volume 13

31 procedures of this sort are a huge growing market, she said. What is driving the exploding popularity of non-surgical vaginal rejuvenation? It is likely due to the increased awareness men and women have of their genital appearance, said Sejal Desai, M.D., D.N.B., M.I.C.O.G., D.G.O., F.C.P.S., D.F.P., a gynoplasty surgeon and gynecologist in Mumbai, India. Female sexual dysfunction and incontinence are more discussed today, as is genital hair removal. This may also be attributed partly to the proliferation of sexually explicit material in digital print formats, she stated. While many Western societies reflect liberal attitudes about vaginal rejuvenation therapies, acceptance can be slow in the more conservative APAC societies, noted Dr. Desai. Talk of related topics is still taboo. Women often feel that they are resigned to their fate, and don t approach a physician easily even if they have urinary incontinence issues, let alone sexual problems and desires. However, despite some cultural pushback women in these conservative countries still seek out non-surgical feminine rejuvenation. One reason is that ThermiVa is a valuable tool for helping to improve a couple s sex life, noted Dr. Desai. Apart from diet, exercise and sleep, a very important aspect of a so-called healthy lifestyle is sexual intimacy, Dr. Desai added. Many studies have shown that couples that are happily intimate into their older ages have less chance of hypertension, cardiac problems, diabetes, depression and maybe even Alzheimer s disease. However, these issues are largely Vaginal stroma before and after ThermiVa treatment. Results show increased fibroblasts and collagen. Courtesy of Gustavo H. Leibaschoff, M.D. ignored by patients and physicians. Hence, the demand for procedures like ThermiVa is on the rise. ThermiVa fills an obvious gap in the practitioner s armamentarium, expressed Oscar Horky, M.B.B.S., F.R.C.O.G., D.G.O., F.R.A.N.Z.C.O.G., a cosmetic gynecologist in Sydney, Australia. Incontinence and vaginal surgery can be very successful, but not everyone s symptoms are bad enough to warrant the risks and costs of surgery, he said. I have been doing cosmetic gynecology for over 20 years and have learned that many women are fearful of surgery so I searched for other options. My initial interest was in Erbium:YAG and CO 2 - based solutions, which worked well, but the bulky equipment and need for a laser license, eye protection and dedicated laser room were disadvantages. An exchange of ideas with experts at a conference in Istanbul led to an invitation for Dr. Horky to learn how to use ThermiVa in California. It did not take long to convince me that ThermiVa was a winner, he shared. The treatment is effective, comfortable and there is no downtime. Over 90% of my patients like it. At progressive clinics throughout the APAC region, ThermiVa now plays a larger part in gynecological aesthetics and function, noted Dr. Desai, who had also used laser-based devices prior to adopting ThermiVa. I often think of ThermiVa as my magic wand, she said. I m very impressed with this patient-friendly, painless procedure. It requires no medications and has no side-effects. All of our patients say that they would do it again. Whether ThermiVa is used for vaginal rejuvenation, improving vaginal lubrication or addressing wrinkled skin, It is a life changer, Dr. Desai added. I m most impressed by its ability to work on urinary incontinence in patients of all ages. Prior to ThermiVa we had nothing to offer except surgery or recommend a live with it approach. Now, we have such a simple solution. My oldest patient is 80 years old, and she has become diaper free and regained her quality of life. At Dr. Horky s clinic, ThermiVa is often employed to address mild to moderate voiding dysfunction stress and urge incontinence. In addition, old looking and saggy labia are filled out and made to look plump and young, he stated. The THE Asian Aesthetic Guide Volume

32 New ThermiVa disposable handpiece Photo courtesy of Thermi best results are seen in the treatment of the distended vagina where it is tightened, as well as made moister and more sensitive for intercourse. Sensitivity is further enhanced if work is done on the G spot and clitoris. Post-menopausal atrophy and lichen sclerosus also respond very well to treatment. At Dr. Chang s clinic, ThermiVa is a valuable addition to long-term individual wellness programs. It can be part of an integrated anti-aging management system and aesthetic solution, with personalized programs to address and resolve the pain and discomfort experienced by some female patients without surgery. Dr. Chang utilizes a variety of aesthetic solutions when treating women s health concerns. I have often used Erbium and carbon dioxide lasers, ultrasound and other approaches. RF-based energy is only one of the treatments that I offer, but the women that have experienced ThermiVa are very satisfied, she said. This device can help to resolve a lot of embarrassment and discomfort for patients, Dr. Chang added. In addition to restoring the full shape of the vulva, increasing sexual desire and satisfaction. In general, patients experience a high degree of comfort during treatment and retain a positive attitude towards follow-up sessions. Patients experience a wow moment with the ThermiVa procedure, confirmed Dr. Desai. It is a walk-in, walk-out treatment that can be done in a comfortable We recently conducted a study at the Indian Academy of Vaginal Aesthetics using ThermiVa. Some of the statistics showed the FSFI score for vaginal rejuvenation improved from 15.3 to 24.6, and for urinary leakage the ICIQ-UI scores improved from 11.7 to in-office setting. Even after a single application for the vulva, when the patient views her before and immediate after pictures I see she is immensely satisfied. We recently conducted a study at the Indian Academy of Vaginal Aesthetics using ThermiVa. Some of the statistics showed the FSFI score for vaginal rejuvenation improved from 15.3 to 24.6, and for urinary leakage the ICIQ-UI scores improved from 11.7 to It has made patients very happy with their quality of life. According to Dr. Desai, My ideal patient understands her problems, knows the treatment options available and selects this procedure with full, informed knowledge and consent. It should be clearly understood by her that ThermiVa will take care of certain aspects from her wish list, but will not work for all of the indications on her list, for which other procedures or surgeries may be required. Her expectations should be realistic. While outcomes can often be explained in terms of statistics, patients should be fully aware of the frequency of treatments and that collagen remodeling results can be varied. Another selling point for ThermiVa is its safety profile, stated Dr. Chang. Patient safety is assured because the temperature conduction can be regulated. The operator controls the handle 32 THE Asian Aesthetic Guide Volume 13

33 movement frequency and path, which is a skill set that must be learned. Complications like overheating, burns and other injuries are minimized, Dr. Desai reported, Due to the system s builtin settings and cut-offs. The ergonomic handpiece features a sensor that knows the actual working temperature and can compare that with the desired temperature. Dr. Horky agreed. It has an excellent safety profile, he said. Burns have not occurred. Some patients are more sensitive to temperature than others and may complain of excess warmth during application, but this is momentary and stops as soon as the ThermiVa handpiece is moved. There is no downtime or unpleasant post-procedure effects. Normal activities and even intercourse can be immediately resumed. According to Dr. Desai, the additional clinical training that aesthetic physicians require in order to successfully perform feminine rejuvenation include, A good understanding of the anatomy and physiology of the vulvovaginal area, as well as how the device works, and how to enhance and work with the same system to address different patient concerns, she noted. Preferably, a course in vulvovaginal aesthetic surgery would be equally important. A one procedure fits all attitude is not realistic in this area. Luckily, the ThermiVa training program does not have a long learning curve. In addition to high patient satisfaction, the market potential for ThermiVa appears to be tremendous, as well, Dr. Desai opined. Apart from showing excellent results for vaginal rejuvenation, incontinence, lubrication and skin changes, it is also showing great promise Labia majora vulva epithelium before and after ThermiVa treatment. Results show increased activity in the basal layer, further maturation of the epithelium and an increased presence of glycogen and collagen. Courtesy of Gustavo H. Leibaschoff, M.D. for anti-aging, prevention and maybe the reduction of prolapse. My belief is that it will become something that all women will want to do. On a business level, The economics of ThermiVa are excellent, expressed Dr. Horky. The initial costs and service fees are considerably less than those involved in purchasing and maintaining most aesthetic lasers. A busy practice should see a return on investment (ROI) in six months or even less. While feminine rejuvenation procedures have been slower to take off in India, Dr. Desai still sees ThermiVa as a profitable addition to her practice. I think times are changing. If we can elicit more awareness and patient education, then I see no reason why the ROI should take long, she said. As physicians we may not always consider ROI and the bottom line first, but the ability to offer such simple solutions that are preventing surgeries and changing lives that is invaluable. Dr. Chang echoed these sentiments. It is a question of the profit model. Anti-aging patients show concern that the cost is too high. It is a common refrain, but I don t let that stop me from utilizing modern, comprehensive medical technology to meet customer needs, she said. Asian women will continue to grow more aware of how vaginal rejuvenation therapies can lead to significant quality of life improvements, Dr. Chang continued. I expect to see more energy-based solutions for women s health concerns, including advanced procedures for the breast and other intimate areas. As stated by Dr. Horky, RF and other energy-based technologies are here to stay and have changed the landscape in medical aesthetics. RF is a very valuable tool in cosmetic medicine, and over time modifications will continue to be made to enhance results and improve the patient and physician experience. ThermiVa assists the practitioner in easily and effectively rejuvenating the post-natal and age affected vulva and vagina. My patients and I are great fans of this procedure and I would encourage women to consider it. THE Asian Aesthetic Guide Volume

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37 lobalization of Neurotoxins for Facial Aesthetics Attracts New Players GBy Andy Pickett, B.Sc., Ph.D., Toxin Science Limited For nearly 30 years, the use of botulinum toxin (BoNT) for aesthetic treatments has continually grown year over year. Actual hard data on usage does not exist outside of the companies supplying these products; therefore, only estimates relating to individual companies and/or products have been possible. THE Asian Aesthetic Guide Volume

38 Globalization of Neurotoxins for Facial Aesthetics Attracts New Players Data collected from the members of specific national and international clinical associations vary widely and simply do not agree. However, there are two things everyone can agree on; only a small fraction of the target demographic for such treatments is being reached, and women are still far more likely to be treated than men. One indication of this increase in use is a similar growth in the number of BoNT products that have become available recently. For many years the availability of different products to expand both clinicians and customers options was restricted. However, the largest families of products, owned by Allergan (Ireland), Ipsen (France) / Galderma (Switzerland) and Merz (Germany), now have serious competition both around the world and within specific countries. The Big Three Since the products from Allergan, Galderma (manufactured and also distributed in some countries by Ipsen) and Merz were first introduced for treatment of therapeutic conditions with subsequent arrival of the aesthetic versions some years later there has been no change in the type or availability of the BoNT products from these major suppliers (Table 1). These products have steadily become registered in more countries and the vial size range of each product has TABLE 1: Three Main Families of Botulinum Toxin Producers in the World, 2017 Manufacturer Product U/vial [Product specific] Ipsen/Galderma Allergan Merz Source: Toxin Science 2017 Dysport/Dyslor 300/500 Azzalure 125 BOTOX/BOTOX Cosmetic 50/100/200 Vistabel/Vistabex 50 Xeomin/Xeomin Cosmetic 50/100/200 Bocouture 50 Excipients (in vial) HSA: 125 ug Lactose: 2.5 mg HSA: 125 ug Lactose: 2.5 mg HSA: 500 ug NaCl: 0.9 mg HSA: 500 ug NaCl: 0.9 mg HSA: 1 mg Sucrose: 5 mg HSA: 1 mg Sucrose: 5 mg increased, but no new versions (product formats or formulations) have appeared on the market from these suppliers. This is perhaps remarkable given that the original products were first licensed many years ago and, by now, different formats or formulations should have been expected. There is one exception to this, a new liquid version of Dysport (Ipsen/Galderma), discussed later. All of the Big Three products are serotype A1 BoNT. Notably, there is still one product (Neurobloc /Myobloc from Elan Pharmaceuticals) that is an alternative serotype B1. Testing of this product for aesthetic treatments was carried out over 15 years ago 1, but the product has found no place in routine use. The issue of antibodies and resistance to the product 2, particularly after therapeutic use, has been a permanent problem, severely restricting the product as a real alternative. Korean Toxins Although, BTXA, a Chinese toxin product from Hughs, has been available in a few countries in Asia and Latin America since 1997, the first real alternative toxin to the major brands arrived on the Korean market in 2006 from Medytox. This product, named Meditoxin in Korea and Neuronox, Siax, Cunox and Botulift elsewhere, was developed as a BOTOX (Allergan) look-alike in formulation and is prepared from the same original bacterial strain, sourced from Edward Schantz and Eric Johnson s laboratory at the University of Wisconsin. Meditoxin rapidly gained market share in Korea, mainly due to the severe price reduction in comparison to the other Western products (Figure 1) and is now the market leader in that country. With these significant gains in market share experienced by Medytox from a ground zero starting point, two other companies initiated activities to produce alternative products. Hugel Pharma, a division of Hugel, Inc. founded in 2009, launched Botulax in June 2010 and overseas export began in August Like Meditoxin, Botulax was intended to essentially be a copy of BOTOX. In 2015, the company claimed they have 34% of the Korean market for toxin, worth approximately 80 billion (about $69 million). 3 Current export markets include Vietnam, Thailand and the Philippines, as well as Latin American countries such as Peru, Colombia and Chile. Daewoong Pharmaceutical Co. Ltd. was the third company to introduce a new toxin product onto the Korean market. 38 THE Asian Aesthetic Guide Volume 13

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40 Globalization of Neurotoxins for Facial Aesthetics Attracts New Players Percent Market Share Figure 1: The Rise of Meditoxin in Korea (based on publicly available data) FY04 FY05 FY06 FY07 FY08 FY09 (Q1) Source: Toxin Science Established in 1945, Daewoong has the largest prescription product sales in the country, with overall sales in the region of 675 billion ($500 million+). Their product, Nabota, was launched in Korea in 2014, but the company had already signed distribution agreements for many other countries by then, including the U.S. via Evolus and Latin America via Pharmvital. Through the Evolus arrangement, the product has now virtually completed Phase 2 and 3 clinical trials in the U.S. and is slated for marketing approval by the FDA in With the competition increasing in Korea, Medytox has clearly taken steps to provide additional, innovative products for the clinical community (Table 2). In 2013, the first liquid product available anywhere was introduced, and more recently Coretox, a purified neurotoxin product, has also been approved. The form of this product is believed to be similar to Xeomin (Merz Pharmaceuticals), but most likely with a different formulation. Recent information from Korea indicates there are five new BoNT products currently in development by different companies. For most of these new products there is no information available. Although, Protoxin from Protox, is described on its website as non-diffusible or ultra-low diffusibility (quite different properties), and three times the efficacy of BOTOX 4. However, early videos demonstrating how the product works in an animal model have now been removed from the website and how the company is achieving such claims cannot be speculated. Conversely, Huons received approval from the Korean Ministry of Food and Drug Safety to start clinical trials in August 2016 and in October 2016 the company announced that the Korean government had permitted export of their product, but whether this is for clinical trials or commercialization is not known. Considering all of these developments, there is little doubt that Korea is and will remain the key country for introduction of new toxin products in the foreseeable future. How this will affect the world market is, as yet, undetermined, but certainly one key aspect, perhaps the most important to many aesthetic practitioners, will be the selling prices of the products. Regional Toxin Products In addition to the three major neurotoxin products and those from Korea, a number of regional products have emerged onto the market (Table 3) as well. Currently these products have limited clinical information publicly available. While the main clinical trial registries do not contain information on trials carried out with these products, occasionally local databases will have information, such as in the case of Masport. 5 This trend of local, home-based products is driven by both the need to be more self-sufficient in pharmaceutical products, including toxin, but also to reduce foreign spending, thus investing the money back into the home country. Provided these products meet the minimum standards for safety and efficacy required by the local regulatory authorities, there is no reason why they should not be accepted for patient treatment. Nonetheless, the likelihood that they will emerge into North American, European Table 2: The Medytox Botulinum Toxin Portfolio, 2017 Product Meditoxin/ Neuronox/Siax/ Botulift/Cunox INNOTOX/MT10109L (December 2013) CORETOX (June 2016) Production strain Process u/vial Excipients (in vial) Hall [Unknown] 50/100/200 µ 0.5 mg HSA 0.9 gm NaCI Hall [Unknown] 25/50 µ Polysorbate 20 Methionine Hall Source: Toxin Science 2017 [Unknown no complex protens] 100 µ? 40 THE Asian Aesthetic Guide Volume 13

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42 Globalization of Neurotoxins for Facial Aesthetics Attracts New Players or even Latin American markets seems low, given the level of marketing resources and effort that would be required. Liquid Formulations A Viable Alternative? One of the most obvious innovations in the toxin world would be a product already diluted and ready to use. Currently the main neurotoxin products are all powders in vials (Table 1) with a post dilution shelf life that is limited by the regulatory authorities to 24 hours maximum. Clinicians often ask, How long can I keep the product after reconstitution? and much work has been published on this subject. 6 A ready-to-use product would avoid this issue entirely. There is already a liquid toxin product on the market in some Asian countries. Innotox, made and distributed by Medytox, has been licensed since December Originally only available as a 25 unit vial, restricting its use in aesthetics, a 50 unit vial is also now available. Inexplicably, over the last three years there seems to be no obvious move to register the product in new countries. This may be due to the licensing agreement concluded in January 2014, between Allergan and Medytox which gave the former access and exclusive rights to Medytox liquid technology outside Korea and coexclusively in Japan. To date, there has been no indication of Allergan performing clinical trials with this product in the U.S. or elsewhere. In fact, according to recent indications from Allergan, Medytox will be responsible for the U.S. trials. Additionally, there are two other liquid toxin products currently in development. The first is from Ipsen, designated Table 3: Regional Botulinum Toxin Products Worldwide, 2017 Product Country (producer) Formulation Relatox Masport Boto Genie Source: Toxin Science 2017 Russia (NPA Microgen) Iran (Masoondarou Biopharmaceuticals) India (Bio-Med Private Limited) 6 mg gelatin 12 mg maltose 50 & 100 units [formulation unknown] 500 units 5 mg Lactose 50 & 100 units Dysport NG (Next Generation). Though the exact details about the product are not known at present, clinical trials in both therapeutic and aesthetic applications have been carried out. 7 A Phase II dose-ranging study in glabellar lines was reported at the Toxins 2015 meeting in Lisbon (January 2015) and at the IMCAS World 2015 congress shortly after. Phase III aesthetic studies have been started in Europe. The second liquid product in development comes from Galderma. To date, only two announcements have been issued by the company about the product status 8,9 and a Phase II clinical study has been carried out in the U.S. No data has been announced yet, but the product has been described as ultrapure and obtained from a proprietary bacterial strain. Topical Toxin The idea that a topical neurotoxin would revolutionize the current market has been discussed endlessly for many years. Having invested heavily in this type of product, Revance, a California, U.S.-based company is the leader in this field. For many years, numerous physicians would present at international congresses around the world, asserting that the Revance product would be arriving in one to two years, but this has turned out not to be the case. In reality, Revance has endured a long and complicated development cycle for topical toxin. The company was told by the FDA to develop a device to administer their product in order to prevent any misuse or mishandling by physicians or patients, thereby consigning the product to an in-office procedure and nullifying it as a home-use product. As well, the doses required were very high many multiples of those for an injectable, 10,11 and special assessment scales had to be developed to evaluate product benefits. 12 Unfortunately, after all of that, the topical product was shown to only work on the crow s feet area at rest, where the musculature responsible for wrinkles is much more superficial. Minimal or no effects were found for the glabellar. The product was, therefore, restricted in potential uses, despite Revance often reporting that there were many patients who were needle-averse and who could benefit from topical toxin treatments. In June 2016, Revance announced that their latest Phase III trials (REALISE 1) of the topical gel product RT001 for treatment of glabellar lines had unambiguously failed to achieve the co-primary and other endpoints and they were stopping 42 THE Asian Aesthetic Guide Volume 13

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44 Globalization of Neurotoxins for Facial Aesthetics Attracts New Players development activities on topical toxin. 13 The possibility of a useful topical toxin all but ended. Some commentators believe that Revance will continue to work on such products in the future, but the timeline is now open-ended. Besides Revance, there are three other companies working on topical toxin: Malvern Cosmeceutics, Ltd. (U.K.), Transdermal Corp. (Canada), and Anterios (U.S.). In a display to the aesthetic community that there is still some belief in topical technology, Allergan purchased Anterios in January 2016 for $90 million 14 and currently show their development product ANT-1207 in their portfolio. Prior to the deal, Anterios also spun-out a new private company, Eirion Therapeutics which retains some non-exclusive rights to ANT Conversely, nothing is known about the Malvern gel product MCL005-2, but both pain relief and wrinkle reduction are the targeted indications. Similarly, Transdermal Corp. founded in 2008, has published only limited information relating to use of their Ionic Nano Particle Technology (INParT ) for treatment of wrinkles, but they are known to be targeting hyperhidrosis as well. 15 On the Horizon With the imminent arrival of the Korean toxins in the West, the picture of botulinum toxin use in aesthetics is likely to change. This will continue in flux until the exact proportion of the market that these new offerings will take is identified, which will take years to determine. Price is undoubtedly going to be a key driver for their acceptance, given that their license standing will be the same as the major products. In the near term, most patients will still request the Big Three branded products, which they know are safe and provide the results expected time and again, until there is much clearer clinical experience with the newcomers. That experience will build with time, but what is clear now is that the future of botulinum toxins is starting a new chapter! Dr. Pickett is director and founder of Toxin Science Limited (U.K.); adjunct professor at the Botulinum Research Center, IAS (U.S.); and senior program leader and scientific expert, neurotoxins in the Galderma Aesthetic and Corrective Global Business Unit. The opinions and views expressed are those of the author and Toxin Science Limited only. This article is for scientific information purposes only and is not intended to promote the use of any botulinum toxin product in any way that is not currently authorized by regulatory authorities. References 1. Ramirez AL, Reeck J, Maas CS. Botulinum toxin type B (MyoBloc) in the management of hyperkinetic facial lines. Otolaryngology head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2002;126(5): Dressler D, Bigalke H. Botulinum toxin type B de novo therapy of cervical dystonia: frequency of antibody induced therapy failure. Journal of neurology. 2005;252(8): accessed 13 January accessed 13 January accessed 13 January Liu A, Carruthers A, Cohen JL, et al. Recommendations and current practices for the reconstitution and storage of botulinum toxin type A. J Am Acad Dermatol. 2012;67(3): accessed 13 January accessed 13 Janaury Dermatology-and-Cosmetic-Surgery accessed 13 January Brandt F, O Connell C, Cazzaniga A, Waugh JM. Efficacy and safety evaluation of a novel botulinum toxin topical gel for the treatment of moderate to severe lateral canthal lines. Dermatol Surg. 2010;36 Suppl 4: Glogau R, Blitzer A, Brandt F, Kane M, Monheit GD, Waugh JM. Results of a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of a botulinum toxin type A topical gel for the treatment of moderate-to-severe lateral canthal lines. J Drugs Dermatol. 2012;11(1): Kane MA, Blitzer A, Brandt FS, et al. Development and validation of a new clinically-meaningful rating scale for measuring lateral canthal line severity. Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery. 2012;32(3): accessed 13 January accessed 13 January accessed 13 January THE Asian Aesthetic Guide Volume 13

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46 JVR-Powered EnerJet2.0 Delivers Promising Results for Lineae Albicantes By Kevin A. Wilson, Contributing Editor Daniel Cassuto, M.D. Plastic Surgeon Professor of Plastic Surgery University of Catania Milan and Catania, Italy Stretch marks, or striae, are an aesthetic nuisance for those who have experienced rapid weight changes or any other condition in which skin is stretched, causing reddish or purple lesions which, over time, turn white as the tissue atrophies and loses pigmentation. The appearance of stretch marks diminishes over time, but they do not disappear completely, and as with any mature scar, they can be difficult to resolve. Utilizing the unique synergy between needleless microtrauma and implantation of a therapeutic compound, JVR (jet volumetric remodeling) Powered Enerjet2.0 from PerfAction Technologies (Rehovot, Israel) provides an effective and valuable treatment option for striae, specifically for lineae albicantes or white stretch marks. The proprietary needle-free technology of EnerJet2.0 simultaneously delivers kinetic energy and a hyaluronic acid (HA) based healing compound via a tiny entry point in the epidermis (up to 200 microns). The molecular mass of the compound is accelerated by pneumatic jet stream breaking through the fibrotic tissue of the scar. Acting as nano-bullets, the particles create a microtrauma during implantation, which stimulates the wound healing cascade with virtually no visible sign of damage, covering an area more than 2,500 times the size of the entry point, and gentle enough for even the most delicate areas of skin tissue. This combination of controlled microtrauma and implantation of healing compounds for each indication induces neocollagenesis and dermal remodeling, creating thicker dermal tissue and correcting skin imperfections for long lasting, healthy aesthetic improvement via a gentler, more natural pathway. For stretch marks, EnerJet rebuilds healthy dermal tissue while simultaneously supplying it with HA, a building block of the dermal extracellular matrix, for a more natural color and texture that diminishes stretch mark appearance. This lowdowntime treatment is applicable to many scar subtypes and is safe for all skin types. With JVR technology, the specific scar area is treated, in contrast to other modalities such as laser skin resurfacing where a significantly larger area outside the scar is subject to treatment. EnerJet2.0 challenges the limits of non-surgical therapies for deep remodeling and long lasting skin treatments, incorporating a new dosing system, stronger jet, new lighter and more ergonomic applicator, and intuitive and modern user interface. The outcomes for stretch marks are the best I have seen in years, stated Prof. Cassuto. Controlled, uniform delivery of compounds plus kinetic energy, with high versatility in terms of areas that can be treated and different implanted formulas that can be used, make this a great non-surgical solution. This device is without a doubt, the best option for stretch marks on the market today, said Daniel Cassuto, M.D., a plastic surgeon in Milan, Italy and professor of plastic surgery at the University of Catania (Catania, Italy). Depending on the patient, it will take between one and three treatments to see results. More are needed in rare cases. Outcomes are outstanding, even three years after treatment. Prof. Cassuto mainly uses JVR Powered EnerJet for treatment of scarring and stretch marks, but sees its versatility as a key advantage. The fact that it can be used for a wide variety of indications is an important benefit we hope for in any device, he said. The ability to control depth of delivery of healing compounds is also a great advantage that no other solution offers. Stretch marks before and eight months after one EnerJet treatment Photos courtesy of Daniel Cassuto, M.D. This device is without a doubt, the best option for stretch marks on the market today. Outcomes are outstanding, even three years after treatment. 46 THE Asian Aesthetic Guide Volume 13

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48 INNOJECTOR Micro Vortex Technology Achieves Needleless Skin Remodeling that penetration depth is different depending on pressure and injected solution. 2 Prof. Kim also researched the histological analysis of INNOJECTOR in a mouse model. 3 Skin thickness and collagen fibers of the dermis were significantly increased after treatment. In addition, these effects lasted longer than conventional injections. After injection we observed activation of vimentin protein, thus we can suggest that INNOJECTOR effectively induced collagen synthesis via activation of vimentin in fibroblasts and myofibroblasts. All of these processes can reduce wrinkles. In comparison with other treatments, INNOJECTOR has the added advantage of being less invasive and less time-consuming than other therapies. Additionally, its speedy recovery time allows patients to return to their daily lives in a short period of time. Beom Joon Kim, M.D. Head Professor Department of Dermatology Chung-Ang Unversity Seoul, Korea INNOJECTOR from WONIK Corporation (Gyeonggi-do, Korea) features unique vortex technology, which delivers millions of micro jet bubbles to the active target. These micro bubbles stimulate fibroblasts, as well as promote collagen and elastin regeneration and remodeling. Upon initiation of this powerful, yet gentle modality, the propulsive micro jet stream travels through the epidermal layer to penetrate the dermis where the active target lies or even deeper. No injectable anesthesia is required. INNOJECTOR is unique in employing the smallest 100 µm spot size, resulting in less pain and shorter downtime as well. According to Beom Joon Kim, M.D., head professor in the department of dermatology at Chung-Ang University Hospital in Seoul, Korea, the effectiveness of INNOJECTOR treatment for scars has been proven by publications and clinical studies. Using pressurized air, the INNOJECTOR delivers medicinal fluid beneath the skin layer at a high speed of up to 180 m per second. This fluid is dispersed laterally into the skin in a near-spherical shape due to the inertia of the jet stream, he explained. Using this vortex technology, INNOJECTOR provides mechanical stimulation and drug delivery simultaneously. Treatment also targets the papillary layer, which is the most effective area for mechanotransduction therapy. During the wound healing process, growth factors are stimulated and formation of new collagen fibers are promoted. We have observed great improvement in patients with depressed, hypertrophic and/ or keloid scars. According to a cadaveric study of INNOJECTOR published in Lasers in Surgery and Medicine 1, various solutions such as saline, hyaluronic acid (HA) and placental extract that were introduced into the dermis evenly during treatment, resulted in an increased rejuvenation effect of skin. This study has histologically identified the mechanism and effect of INNOJECTOR, and proved References: Penetration depth and shape of INNOJECTOR micro jet stream depends on delivery pressure of the vortex technology and the solution used. Photos courtesy of Professor Beom Joon Kim, M.D. Scar before treatment Two months after INNOJECTOR treatment Photos courtesy of Professor Beom Joon Kim, M.D. 1. Investigating Skin Penetration Depth and Shape Following Needle- Free Injection at Different Pressures: A Cadaveric Study. Lasers Surg Med Aug;48(6): The NEEDLELESS MICROJET: a novel device for hypertrophic scar remodeling on the forehead. J Eur Acad Dermatol Venereol Nov;30(11):e145-e Needle-free jet injection of hyaluronic acid improves skin remodeling in a mouse model. Eur J Pharm Biopharm Aug;105: THE Asian Aesthetic Guide Volume 13

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50 Case Study Proves Efficacy and Safety of LIPOcel for Flanks and Thighs By Ungku Shahrin, M.D. In our study, we carefully assessed and marked the eight treatment sites before the procedure. Based on our findings we believe that selection of the target site definitely plays an important role in the success of outcomes. A physician can perform a pinch test in order to identify the appropriate fat thickness as some folds around the flank could be due to reduced skin laxity rather than a subcutaneous fat layer. The efficacy and safety of high-intensity focused ultrasound (HIFU) to reduce abdominal fat has been established through many clinical papers published worldwide. Jeisys Medical, Inc. (Seoul, South Korea) has launched an improved HIFU-based system with contact cooling and newly released 8 mm and 11 mm cartridges, enabling higher energy delivery without damaging the surrounding tissue, thus achieving a pain-free, non-invasive fat reduction procedure. We recently conducted a case study to examine fat removal on the flanks and thighs using a shorter treatment time by lowering the number of shots delivered. In addition, a shorter depth HIFU probe was used for the thighs. A total of five patients were selected based on the inclusion and exclusion criteria set before the study. HIFU treatment using the LIPOcel was administered on the flanks and thighs. Each side of the flank received four shots at 13 mm penetration depth, and each thigh received 15 shots at 11 mm penetration depth. Results from treatment of the thighs showed that after four weeks two of the study subjects observed a 2 cm reduction in their right thigh and one subject did not record any changes on their right thigh. GAIS scores for the thigh treatment measured 3 and above (3 = no improvement). Before and four weeks after LIPOcel treatment Photos courtesy of Ungku Shahrin, M.D. Overall our results show that HIFU treatment via the LIPOcel device is effective, with minimal adverse events, and can be done in a shorter time provided there is a standardized protocol. Hands-on training is also very beneficial for new users in order to achieve the desired result. Throughout the study, the patients weight was measured for any observable changes. After all measurements were taken, we noticed changes in the waist line / flanks for all subjects after four weeks. Of the five patients, two saw reductions of 3.5 cm, two experienced a 2.5 cm decrease and one patient observed a 2 cm reduction, with the average change equaling -2.8 cm. Global Aesthetic Improvement Scale (GAIS) scores assigned for each subject showed all scores above 4 (improved), and there were no adverse events noted in any subject after the treatment. Before and four weeks after LIPOcel treatment Photos courtesy of Ungku Shahrin, M.D. Ungku Shahrin, M.D. Dr. Shahrin is the group managing director for Esthetic Medical Solution Company and member of the National Committee of Aesthetic Medical Practice, Ministry of Health, Malaysia. 50 THE Asian Aesthetic Guide Volume 13

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52 SygmaLift Defines Jawlines and Diminishes the Double Chin for Asian Patients By Kevin A. Wilson, Contributing Editor Ryan Tan, M.D. TCS Aesthetics Central Singapore Reshaping of the jawline and reduction of a double chin are key aesthetic indications among the Asian population. SygmaLift from MedixSysteme (Ruggell, Liechtenstein) addresses those conditions in a painless, non-invasive manner using a unique combination of high-intensity focused ultrasound (HIFU) and 635 nm cold laser light. SygmaLift is a great leap in the evolution of how HIFU should be performed, stated Ryan Tan, M.D. of TCS Aesthetics Central in Singapore. It s painless, accessible, reproducible and provides results that are observable. A far cry from uncomfortable first-generation devices, SygmaLift can be used to perform stacked passes for better results without messy numbing creams or nerve blocks. The outcomes include patient comfort, confidence and compliance, which also positively impact the physician-patient relationship for the future. Lam Bee Lan, M.D. Medical Director Ageless Medial Centre Singapore Monica Jacob, M.D. Aesthetic Physician and Cosmetic Surgeon Bodyz Wellness Mumbai, India above competitors, according to aesthetic physician and cosmetic surgeon Monica Jacob, M.D., of Bodyz Wellness in Mumbai, India. Patients seek to eliminate pockets of fat that have been resistant to diet and exercise without additional impact on their busy lifestyle, she expressed. A double chin is especially difficult to change through diet and exercise alone, and many Asian patients have a square shaped jaw. SygmaLift helps them achieve the V-shaped face by fat ablation and skin revitalization, targeting the dermis and superficial aponeurotic system (SMAS). The biological thermal effect of HIFU on this tissue creates a lifting effect, collagen contraction and increased production of collagen and elastin. Patient versatility also makes SygmaLift attractive to Dr. Lam. This can be used on older patients who have sagging skin and are considering a non-surgical facelift, or younger patients looking to lift their cheeks and jawline, resulting in a sharper and more defined lower face, she said. Facial remodeling, skin rejuvenation and wrinkle reduction can be performed. According to Dr. Tan, success with SygmaLift is about addressing each patient s unique needs. We need to cater to each patient s facial morphotype, take their expressed desires into consideration and formulate a treatment plan, he said. The number of sessions required may vary, depending on the patient s age and needs, and the patient quickly notices results with each additional session. In the treatment phase we recommend one-week intervals, but results can last beyond 18 months so yearly maintenance is usually enough to hold back the appearance of aging. Dr. Lam agreed. This is a true lunchtime procedure, with one treatment per week for three to six weeks, depending on the patient s age and skin condition. From my experience, patients can see immediate visible skin tightening and lifting after just one application and progressively as the skin continues to generate collagen. Results are remarkable, Dr. Jacob said. In just a few sessions SygmaLift helps reshape the face and revitalize skin so that it is firm with a radiant glow. While HIFU is the centerpiece technology, the addition of laser therapy provides the finishing touch. SygmaLift features three handpieces, the HIFU for remodeling and lifting, the Tri-Focal for smaller scale HIFU on the forehead or around the mouth and eyes (or for noninvasive stimulation of bioactivity), and the 635 nm cold laser for biostimulation and enhancing skin glow, explained Lam Bee Lan, M.D., medical director of Ageless Medical Centre in Singapore. The safety, comfort and efficacy of SygmaLift are what elevate this device 66 year old patient before and after one SygmaLift treatment Photos courtesy of Laser-Clinic Radom 53 year old patient before and after one SygmaLift treatment Photos courtesy of Andrea Kubatova, M.D. 52 THE Asian Aesthetic Guide Volume 13

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54 Forever Young BBL Slows Aging of Asian Skin By Kevin A. Wilson, Contributing Editor Patrick Bitter Jr., M.D. Advanced Aesthetic Dermatology Los Gatos and Santa Monica, CA, USA When it comes to Asian skin types, it s about more than the treatment of common skin problems with non-invasive broadband light (BBL). Forever Young BBL from Sciton (Palo Alto, California, U.S.) is a skincare solution that slows the appearance of aging, keeps skin healthy, and staves off future procedures for years. This powerful broadband light device is available as a standalone system or as a module for the company s versatile JOULE platform. treatment. Smart Filters available in seven wavelengths (420, 515, 560, 590, 640, 695, and 800 nm) are quick and easy to change so only a single handpiece is needed. Sciton BBL also features one of the largest spot sizes available at 15 mm by 45 mm, with Finesse Adapters in three sizes for treating hard-to-reach or otherwise challenging anatomy. Sapphire crystal cooling allows users to precisely control temperature in increments of 1 C. Adjustable fluence and repetition rate promote comfort and efficacy. Using the proper techniques, with different filters and adapters, you can safely treat most skin types including Type V, Dr. Bitter explained. Sciton BBL lends itself to treatment of ears, lips and the periocular region; anatomical areas often overlooked by other laser and light-based devices, which are not designed to address these easily. You can treat skin anywhere on the body as well, which is a major benefit. It is designed so that you can do multiple passes at less aggressive settings, which is a key to success of Forever Young BBL therapy. Most complications, in darker skin especially, occur when using a single pass at higher settings. Many body parts, including the face, may be treated in less than ten minutes. I can do a face, neck and chest in about 20 minutes, whereas it used to take well over an hour with older IPL systems, Dr. Bitter added. And with multiple passes we get better collagen response and a uniform appearance to the skin, as well as a safer, more comfortable treatment experience. According to the manufacturer, 95% of all Sciton systems sold in the last decade are still in service today. The best things you can do for your skin are stay out of the sun, and use Forever Young BBL, Dr. Bitter said. According to FotoFacial pioneer Patrick Bitter Jr., M.D., of Advanced Aesthetic Dermatology (Los Gatos and Santa Monica, California, U.S.), We start with a focus on correction, treating signs of photodamage, pigmentation, vascular lesions, acne and texture. We can combine BBL with other procedures such as laser resurfacing to enhance the overall result, but there are two other main benefits to broadband light and they re encompassed by the term Forever Young BBL, he stated. One important benefit of regular BBL treatments is maintenance of skin health; this is especially appealing to my Asian patients. The other benefit is delaying skin aging. Forever Young BBL is a protocol using a multiple pass technique with the right choice of parameters to maximize skin health and slow the aging process easily and without downtime. This appeals to patients of any age. Many features make Sciton BBL stand out for its efficacy, safety and affordability. There are no consumables. Duralamp technology extends handpiece life and reduces maintenance costs. Carefully crafted optics create a uniform beam for consistent Before and after Forever Young BBL treatment Photos courtesy of Jacque P. LeBeau, M.D. Before and after Forever Young BBL treatment Photos courtesy of AesthetiCare MedSpa 54 THE Asian Aesthetic Guide Volume 13

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56 ESAG Launches First-Ever Chinese Master Class on Aesthetic Feminine Rejuvenation TThe European Society of Aesthetic Gynecology (ESAG) is a leading organization specializing in cosmetic and aesthetic gynecology. Operating worldwide, ESAG is dedicated to promoting innovation within this specialty by connecting and educating skilled medical physicians around the globe. In 2018 ESAG will offer its first-ever Chinese Master Class on Aesthetic and Reconstructive Female Genitalia. Designed by ESAG in collaboration with Groupe de Recherche et Innovations en Restauration Génitale (GRIRG), and supported by leading companies specializing in female genital rejuvenation technologies, this one day event will take place in Paris, France on January 31. This workshop will offer intensive sessions encompassing theoretical and live demonstration cases, providing attendees with a thorough and in-depth understanding of the different therapies being used to treat the female intimate area. Participants will discover the full range of laser and radiofrequency (RF)-based modalities, as well as platelet-rich plasma (PRP) treatments. In addition, all participants attending this Chinese Master Class will receive the following exclusive benefits: One free registration to ESAG s third World Congress, which will be held April 28-29, 2018 in London, U.K.; and one complimentary invitation to attend the accompanying Gala Dinner & Awards event on the evening of April 28. This Congress features the largest specialized group in the field, comprised of gynecologists, plastic surgeons, dermatologists, GPs, family physicians, sexual medicine professionals, anti-aging medical professionals, aestheticians, nurses, midwives, and all others interested in women s health, beauty and well-being. Attendees have the unique opportunity to interact with the fathers of cosmetic and aesthetic gynecology. More than 35 speakers will share their deep knowledge, personal cases, scientifically approved research and clinical studies within this field, all under one roof. Those interested in staying updated on the latest developments in the field of cosmetic and aesthetic gynecology are invited to join ESAG s third World Congress, educational courses and hands-on workshops to receive full training in all aspects of surgical and non-surgical cosmetic and aesthetic gynecology procedures. ESAG has delivered comprehensive live surgery training courses on invasive and non-invasive female genital cosmetic and aesthetic procedures at the Bader Medical Institute of London since Attend the most comprehensive and complete international meeting in this field to further expand your knowledge by learning advanced techniques and becoming proficient in the latest technological devices and products used within this field. ESAG congresses are not only about cosmetic gynecology; they are all about modern women s well-being, beauty and quality of life. To learn more about ESAG s professional network and the benefits of becoming a senior member visit To register for, or learn more about the 2018 ESAG congresses, visit or 56 THE Asian Aesthetic Guide Volume 13

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58 mesoestetic Offers Effective Solution to Eliminate Pigmentation In the 1980s, specialists in the emerging aesthetic medicine industry did not feel their needs were being met. Grasping this reality, Joan Carles Font, a pharmacist in Barcelona, began creating compounded formulations and preparations to produce more effective, safer, customized treatments for these professionals. Over the years, that specialized pharmacy became mesoestetic Pharma Group (Barcelona, Spain), a global leader in the aesthetic medicine sector, and through it all the company s values remain the same a commitment to the development and marketing of top-quality products right from the start, with scientifically proven results. One of mesoestetic s most renowned solutions is cosmelan, an aesthetic depigmentation treatment for professional use, which over one million patients and aesthetic specialists trust worldwide. Pigmentation concerns are a growing, global issue; they affect more than 90% of adults over the age of 50. Regardless of skin color or type, hyperpigmentation is a significant issue because of its unattractive appearance and negative psychological and emotional impact, affecting a person s quality of life. There are numerous external and internal factors that can cause hyperpigmentation: genetic tendency, sun exposure, inflammation, hormonal changes, aging, exposure to chemicals and photosensitizing medication. Their consequences include a variety of pathologies such as melasma, which presents as an uneven and irregular shape with undefined edges that are often symmetrical; post-inflammatory hyperpigmentation; solar and senile lentigines, appearing in the form of uniform, lentil-shaped oval or round spots; and ephelides (freckles). Conscious of the necessity to provide a solution to people concerned about their pigmentation problems, We developed a professional method formulated with an exclusive combination of active ingredients with proven efficacy, which act on all stages of the hyperpigmentation process to completely eliminate existing pigmented lesions, preventing both their reappearance and the appearance of new dark spots, Mr. Font explained. The duality of corrective and regulating action make cosmelan a unique, all-round treatment. Before and after using cosmelan Photos courtesy of mesoestetic Pharma Group Before and after using cosmelan Photos courtesy of mesoestetic Pharma Group who, strictly following the protocol, applies the degreasing solution and the cosmelan 1 face mask. Once the mask has been applied the patient can return home and proceed according to the professional s instructions. The second phase takes place at home, 48 hours after removing the mask. The patient must then follow the steps indicated at each stage to ensure the desired result. They will use the cosmelan 2 face cream, hydra-vital factor k moisturizing cream and moisturizing sun protection. The complete home treatment lasts for seven months and consistency and diligence are essential to ensure the guaranteed results. It is a pleasure to see the improvements on my patients and their satisfaction, Dr. Torres emphasized. In addition, recommending a highly-efficient and medically-proven treatment like cosmelan is a paradigm for me. Results obtained with cosmelan are incredibly significant and long lasting, says Nestor Torres, M.D., a cosmetic surgeon based in Toronto, Canada. Perseverance with at-home treatment and the continued use of sun protection are key to maximizing the effects of this method. One of the features that make cosmelan a preferred treatment for hyperpigmentation globally is its ease of use. The method comprises two phases. Phase one begins at the hands of a professional 58 THE Asian Aesthetic Guide Volume 13 Joan Carles Font, founder of mesoestetic Pharma Group

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60 APAC s Medical Aesthetic Market Experiences Phenomenal Growth By Michael Moretti, Editor-in-Chief S imilar to other regions of the world, the Asia-Pacific (APAC) medical aesthetic market has consistently expanded in recent years. With more consumers seeking cosmetic treatments the range of products and technologies available to practitioners continues to increase to encompass more advanced, less invasive solutions. Additionally, more countries than ever across Southeast Asia are entering into the business of aesthetics, purchasing equipment and opening spas and clinics. 60 THE Asian Aesthetic Guide Volume 13

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62 APAC s Medical Aesthetic Market Experiences Phenomenal Growth Robert Ruck Executive Vice Presient, Asia Pacific Syneron Candela Hong Kong Michael Gold, M.D., F.A.A.D. Dermatologist Founding Member The Dermatologic and Aesthetic Surgery Leagues Nashville, TN, USA Bill Kelley Global Consultant Coto de Caza, CA, USA Barry Rigby Vice President of International Sales Thermi Singapore Throughout APAC, practitioners have grown more interested in the many minimally or non-invasive energy-based (laser, light, radiofrequency, cryolipolysis, radial shockwaves, CO 2, ultrasound, etc.) platforms that effectively treat a range of applications and multiple indications non-surgically with no pain or downtime. Practice economics have also matured around the region, with social media and the Internet enabling easy access to information about current procedures. According to Medical Insight s (Irvine, California, U.S.) Global Aesthetic Market XV market study, sales of all aesthetic products and devices in the APAC region reached close to $1.6 billion in 2016, with anticipated growth of 12.9% per year through Of this, sales of all energy-based devices totaled $570 million, neurotoxin sales reached $446 million and sales of dermal fillers equaled $333 million. The APAC market is very healthy, stated Robert Ruck, executive vice president, Asia Pacific at Syneron Candela in Hong Kong. Some areas grow faster than others, but overall we re seeing development activity across the board. According to Bill Kelley, a global consultant and former Cynosure executive, Some of the smaller markets have started to pick up steam, such as the Philippines, Indonesia, Vietnam, even Myanmar. These are countries that only recently scratched the surface with aesthetic procedures, but are now coming alive in terms of buying equipment and opening clinics. Taro Kono, M.D. Plastic Surgeon Associate Professor Department of Plastic Surgery Tokai University Tokyo, Japan Some of the smaller markets have started to pick up steam, such as the Philippines, Indonesia, Vietnam, even Myanmar. These are countries that only recently scratched the surface with aesthetic procedures, but are now coming alive in terms of buying equipment and opening clinics. As stated by Michael Gold, M.D., F.A.A.D., a dermatologist in Nashville, Tennessee, U.S., and founding member of The Dermatologic and Aesthetic Surgery Leagues (DASIL), In Vietnam alone, the number of aesthetic devices has probably quadrupled in the last few years. Indonesia has actually been ahead of the game in the liposuction world for a long time. Indonesian physicians learned it early and they do a lot of teaching. Thailand is also seeing exponential growth in lasers. It is amazing to watch, he said. By far, China is the largest market, stated Mr. Ruck. If you look back a couple of years, Japan was the leading market for aesthetic devices. However, China and Korea have grown very quickly in a short time, so we estimate that China is most likely double the size of Japan in terms of adoption of energy-based systems, he said. As the next largest region, Korea continues to lead in implementing new technologies faster than anywhere else, Mr. Kelley expressed. Taiwan is a growing market in what I call the second tier countries, which includes Thailand and Singapore. Australia has a booming aesthetic industry, Mr. Kelley added. While it is a part of APAC, it very much follows U.S. trends, whereas New Zealand is slower to respond and emulates more of what you would 62 THE Asian Aesthetic Guide Volume 13

63 find across Europe. There are a few top clinics in Auckland, but overall it is a small market that is conservative when it comes to embracing aesthetic technologies. Even with these thriving markets, product manufacturers face unique challenges and competitive pressures in the APAC region. For a while, the biggest burden these companies faced was related to price, Mr. Kelley noted. Many Asian manufacturers offered systems that they claimed were equivalent to U.S. products, but at a much lower cost. For instance, as Mr. Ruck pointed out, when picosecond lasers came out a few years ago, it set off a cascade of innovation in the APAC region, with local firms trying to duplicate technologies first seen in the Western countries. While the challenge of shady manufacturers offering counterfeit medical devices is still a chronic issue in the APAC region, Practitioners are becoming increasingly aware of the differences between legitimate products and knock-offs, and more manufacturing companies are going direct in Asia, partnering with local distributors, which has been very successful, Mr. Kelley shared. Mr. Ruck concurred. Leading clinics in the region still look to Western devices as the gold standard and what they would aspire to purchase. Some lower end clinics may purchase an authentic, branded model in addition to counterfeit systems, Mr. Ruck continued. The patient receives their first treatment on the real device and subsequent treatments on a copycat device. We also see a lot of hacking of consumables, in order to give an energy-based system more pulses or more lifetime. According to Barry Rigby, vice president of international sales at Thermi in Singapore, Most copycat products are now from Korea, not China. Chinese physicians prefer the actual branded product. In Korea, locally made counterfeits are more popular than the real products. The major reason for this is that most are one-third of the price of the authentic systems, and Korea has become extremely cost conscious in the midst of a struggling economy. It is becoming more difficult to obtain regulatory approval throughout Asia. This works against the counterfeiters. While there are a few Third World countries where bootlegging occurs, in the more sophisticated markets governments are increasingly policing, and cracking down on counterfeiters. Aside from the counterfeiting of medical devices, the pharmaceutical manufacturing segment in APAC is a much different story, Mr. Kelley advised. In India, for instance, local companies manufacture a great deal of generic drugs and they compete quite well within the Western markets. Notably, the regulatory process in most Asian countries is maturing, as well. It is becoming more difficult to obtain regulatory approval throughout Asia, Mr. Rigby pointed out. This works against the counterfeiters. While there are a few Third World countries where bootlegging THE Asian Aesthetic Guide Volume

64 APAC s Medical Aesthetic Market Experiences Phenomenal Growth occurs, in the more sophisticated markets governments are increasingly policing, and cracking down on counterfeiters, Mr. Rigby stated. Considering the overall strength of the industry, Mr. Ruck says the health of aesthetic clinics throughout the region is good and getting better. What drives the overall industry is the development of new clinics, he indicated. This trend is particularly strong in China, which now allows physicians to set up their own private practices. Previously they had to work in state-run hospitals. Even in slower growing regions like Japan we continue to see new offices opening, and existing ones adding products and technologies. There is also a good flow of patients. What drives the overall market is the development of new clinics. This trend is particularly strong in China, which now allows physicians to set up their own private practices. Even in slower growing markets like Japan we continue to see new offices opening, and existing ones adding products and technologies. Mr. Kelley agreed. Regarding patient growth, China is leading the charge. The evolution has been astounding, he advised. You still see some government hospitals that are 40 to 50 years old, but the clinics that are popping up are brand new, beautifully outfitted and are as nice and well supplied as the best U.S. practices. Capital funding of new clinics is also on the rise, Mr. Kelley continued. I have seen more entrepreneurs becoming involved in establishing practices and clinic groups, or expanding the businesses of physicians who want to gain prominence as aesthetic practitioners, dermatologists, etc. When asked which nations consumers are most receptive to aesthetic procedures, Taro Kono, M.D., a plastic surgeon and associate professor in the department of Plastic Surgery at Tokai University in Tokyo, Japan said, Korean and Chinese people are very open. They want dramatic changes. Other cultures, including the Japanese opt to maintain their health and appearance naturally without drugs or surgery. An important driver for patient growth is beauty standards. In the past, beauty standards in Asia were reflective of aesthetic ideals in the West, Dr. Gold expressed. But this is changing. People are not as fixated on Western ideals. In Asia, the focus is on the eyes and contour of the jaw. And they look up to their celebrities, which are the models they wish to emulate. Many want to look like baby dolls in real life. And some of them actually do. While rounding the eyes is still a popular procedure, In many ways pigment is the first and foremost condition people want to treat, said Mr. Ruck. In Asia skin is everything. More and more, I see the Asian beauty ideal as a strong influence. As stated by Dr. Gold, In Asia, treating pigmentary problems is a big deal. Asian practitioners spend a lot of time trying to figure out how to use skin lightening / whitening agents, and how to combine these with lasers and chemical peels. 64 THE Asian Aesthetic Guide Volume 13

65 Dr. Kono concurred. We also treat many people that present with enlarged pores, wrinkles and sagging fat. Popular approaches to many of these indications include non-surgical modalities, such as energybased devices and injectables. In Japan, new facial contouring and body shaping procedures are of great interest, as is picosecond laser technology, he said. Emerging regenerative and anti-aging treatment approaches are also catching on in places, but it is still too early to gauge this market s strength. Stem cells, platelet-rich plasma (PRP) and other anti-aging therapies are being adopted for use in some of the more liberal countries, noted Dr. Gold. It is fascinating to watch how researchers and scientists are figuring out effective ways to use these approaches. For instance, a lot of the clinical studies that are coming out now on PRP are from Korea. As reported by Dr. Kono, In Japan, V-line jaw shaping, contouring the body using CoolSculpting and other novel technologies, such as feminine rejuvenation, are popular. The use of stem cells and PRP is strictly controlled here. Vaginal rejuvenation remains a very strong segment throughout the APAC region, Mr. Rigby added. It is still growing, with more and more competitors entering into the fray. As the leading U.S. and European companies continue to move into Asia, the standard of care continues to improve while more APAC physicians increase their medical training. Some of the energy-based device manufacturers have direct sales in the region, and they bring in top aesthetic specialists from all over the world to teach and train, stated Dr. Gold. In addition, physicians and scientists from many Asian countries publish a lot of scientific papers. The APAC market will remain very dynamic as medical aesthetics continues to develop in the region. We re still in the early stages of adoption, so it is really an exciting market to be in right now. The younger generation of Asian physicians are also a different breed, Dr. Gold added. Many of them come to the U.S. and Europe to train, so they have modern skills. They return home and are able to introduce the high grade technologies and clinical methods, with superior results. In Mr. Ruck s opinion, the APAC market will remain very dynamic as medical aesthetics continues to develop in the region. We re still in the early stages of adoption, so it is really an exciting market to be in right now, he said. As Mr. Kelley concluded, APAC s aesthetic industry is going to be good for many years to come because it has only just recently taken off, so there is considerable room to grow. THE Asian Aesthetic Guide Volume

66 Allergan 1st Floor, Marlow International Parkway Marlow, Bucks SL7 1YL, UK telephone facsimile Allergan is a multi-specialty healthcare company focused on discovering, developing and commercializing innovative pharmaceuticals, biologics and medical devices that enable people to live life to its greatest potential to see more clearly, move more freely and express themselves more fully. With patient satisfaction at the heart of research and development, Allergan has the treatments, devices and professional support to help you offer patients the natural look they want. Asclepion Laser Technologies GmbH Brüsseler Str. 10 Jena, Germany (0) telephone +49 (0) facsimile Asclepion Laser Technologies has been operating within the medical laser market since Its success has been proven by thousands of customers worldwide and the Top 100 award for the most innovative medium-sized company in Germany. Today, more than 60 countries trust in Asclepion s made in Germany technology. BTL Industries, Ltd. Unit 5 High Carr Network Center High Carr Business Park Millenium Way Newcastle under Lyme Staffordshire ST5 7XE, UK telephone There may not be one device to meet all of your clinical needs, but there is one company. This has been the mantra of BTL Industries, Ltd. ever since the company established itself as a leader in the aesthetic industry, providing scientifically proven devices for body shaping, skin tightening and facial treatments. With direct offices in all major Asian markets, BTL guarantees an unrivalled level of service support and customer care. Canfield Scientific 4 Wood Hollow Rd. Parsippany, NJ USA / telephone Canfield Scientific is a leading supplier and developer of medical and aesthetic imaging products, including VECTRA 3D imaging and aesthetic simulation systems, VISIA Complexion Analysis Systems, Reveal facial imagers, VEOS dermatoscopes, IntelliStudio full body photography systems, Mirror medical imaging software and other practice specific imaging products. Contura International A/S Sydmarken 23 Soeborg 2860, Denmark telephone facsimile / Contura develops and markets the Aquamid product line of injectable volumizers for long lasting augmentation and restoration of facial and body features. Manufactured in Denmark using Contura s patented polyacrylamide hydrogel technology, Aquamid is sold in more than 30 countries. Aquamid has ten years of efficacy and safety data published, with numerous clinical trials involving more than 5,000 patients. Cutera 3240 Bayshore Blvd. Brisbane, CA USA telephone facsimile Cutera is a trusted authority in energy-based medical aesthetic technologies for face and body, that practitioners turn to for innovation, sophistication and performance. Cutera s premium portfolio of products include xeo, trusculpt 3D, excel V, excel HR and enlighten. DEKA M.E.L.A. s.r.l. Via Baldanzese, 17 Calenzano, Firenze Italy telephone facsimile DEKA designs, manufactures and markets medical lasers and pulsed light equipment for specialized medical requirements in over 83 countries worldwide. DEKA produces laser and light systems like the revolutionary MonaLisa Touch for gynecology; ear, nose and throat; surgery; aesthetic medicine; and dentistry. DEKA develops systems with innovative technologies such as, CO 2, Nd:YAG, Nd:YAP, Er:YAG, Er:Glass, Ho:YAG, Dye, KTP and Alexandrite lasers, Flash Lamp and CW IR lamp systems. Eunsung Global Corp. 120 Gieopdosi-ro, Jijeong-myeon Wonju-si, Gangwon-do, Republic of Korea telephone facsimile Founded in 1995, Eunsung Global provides a full range of medical laser devices for skin treatments and body contouring. Eunsung Global products include Cool Shaping, 3-Max, Magicpot, PowerShape, Megason, Spring and Jet Clear, which are marketed in more than 50 countries. Eunsung Global also provides innovative products and services to over 100 partners worldwide. Through our expansive international network we are able to offer our clients more convenient access to our products, solutions and services. 66 THE Asian Aesthetic Guide Volume 13

67 European Society of Aesthetic Gynecology (ESAG) 33 Cavendish Square Marylebone W1G 0PW London, UK +44 (0) / telephone The European Society of Aesthetic Gynecology (ESAG) is a leading organization specializing in cosmetic and aesthetic gynecology operating worldwide. ESAG constantly contributes to the promotion of innovation within the field of cosmetic and aesthetic gynecology by connecting and educating skilled medical physicians from around the world. To learn more about the European Society of Aesthetic Gynecology and its professional network, or to enjoy the benefits of a senior member, subscribe for an annual senior membership today. Fotona d.d. Stegne 7 Ljubljana 1000 Slovenia telephone facsimile Fotona develops and manufactures high performance, quality made laser devices. Our wide-range of systems purvey quality, reliability, safety and cutting edge innovation in treatment speed and efficiency. Our global network of representatives and reference medical centers guarantee exceptional customer support, as well as technical and clinical training. GALDERMA International Tour Europlaza - La Défense 4 20 avenue André Prothin La Défense Cedex, France +33 (0) telephone +33 (0) facsimile Galderma is a leading global pharmaceutical company specializing in the research, development and marketing of therapeutic, corrective and aesthetic solutions in dermatology. With products sold in more than 65 countries, Galderma provides a wide-range of innovative medical solutions which meet the highest standards of safety and efficacy. HIRONIC 19F U-Tower, 767, Sinsu-ro, Suji-gu, Yongin-si Gyeonggi-do, 16827, South Korea telephone facsimile Established in 2006, Hironic is a KOSDAQ-listed company that manufactures innovative medical aesthetic laser and energy-based devices for dermatology and plastic surgery clinics. Committed to creating value for beauty and health, Hironic provides a diverse range of products including Doublo, a skin lifting device utilizing high intensity focused ultrasound (HIFU) technology for skin rejuvenation, MICOOL, which permanently destroys fat cells using cryo fat reduction technology for body shaping, MIRACLEAR and A-Fit for acne treatment, VeraSHAPE for obesity care, ByeLIPO for fat reduction and cellulite removal, Q-Fit for pigmented lesion treatment and EASYMO GRAFT, a non-invasive hair transplant device. The Hironic brand continues to be recognized, valued and trusted globally because of its beautifully designed, innovative and reliable technology. The HydraFacial Company 2277 Redondo Avenue Signal Hill, CA USA telephone Established in 1997, The HydraFacial Company designs award-winning, patented skincare technologies and solutions. This Southern Californiabased company pioneered hydradermabrasion and now HydraFacial and Perk products are popular in over 75 countries around the world. Ilooda Co., Ltd. 120 Jangan-ro 458 beon-gil Jangan-gu Suwon-si, Gyeonggi-do, Korea telephone facsimile Ilooda Co., Ltd. is a professional manufacturer of laser and other energybased systems for the dermatological and aesthetic markets. Its major product lines include a diode hair removal laser, CO 2 fractional laser and vascular laser systems, etc. The VIKINI diode hair removal laser system is one of the most well-known brands in the market, with more than 400 units sold worldwide since early Made at Ilooda technology guarantees the highest quality and world class service. Jeisys Medical, Inc. 307, Daeryung Techno Town 8-cha Gasan-dong, Geumcheon-gu Seoul, South Korea telephone facsimile Jeisys Medical, Inc. produces medical devices featuring IPL / RF microneedling, HIFU, fractional CO 2 / Q-switched Nd:YAG laser, diode laser, etc., that are reliable and better quality for dermatologists, plastic surgeons and other aesthetic physicians, based on large investment in research & development and valuable experience. Lumenis Unit 2602, Miramar Tower, 132 Nathan Road TST, Kowloon, Hong Kong telephone facsimile Lumenis, one of the world s largest medical laser companies, is a global developer, manufacturer and distributor of laser and light-based devices for surgical, ophthalmic and aesthetic applications, with more than 800 employees worldwide. Lumenis has 270 registered patents, over 260 FDA clearances, an installed base of over 30,000 systems and a presence in over 100 countries. Lumenis endeavors to bring the finest state-of-the-art technology products to the market, fulfilling the highest standards of excellence, quality and reliability, delivering premium value and service to its customers. THE Asian Aesthetic Guide Volume

68 Lutronic 219 Sowon-ro, Deogyang-gu Goyang-si, Gyeonggi-do, Republic of Korea telephone facsimile At Lutronic our passion is to improve the lives of physicians and their patients by developing innovative solutions that are intuitive, versatile, efficacious and beneficial to society. We are committed to investing in R&D to ensure our systems remain innovative, while maintaining reasonable pricing. MedixSysteme Industriestrasse 56 Ruggell, Liechtenstein telephone MedixSysteme is a leading European manufacturer of medical equipment, ISO certified. Based in a high technology park, we offer products and services to the medical aesthetic field for non-invasive application. MedixSysteme is one of the first to introduce fractional focal ultrasound, HIFUs emitted in lines, as well intensive cold laser 635 nm for fat treatment and rejuvenation. Merz Asia Pacific, Pte., Ltd. 21 Biopolis #06-03 North Tower Nucleos Singapore telephone facsimile Merz Aesthetics brings a century of healthcare expertise, cutting edge products and unparalleled service to the field of aesthetic dermatology. Merz has a long history in skincare treatment. Company founder Friedrich Merz researched the effects of revitalizing skincare products, and the company introduced the world s first anti-wrinkle treatment in Today, familyowned Merz created Merz Aesthetics to meet the growing needs of patients and physicians through state-of-the-art science. mesoestetic Pharma Group C/ Tecnologia, 25 Viladecans, Barcelona telephone facsimile Specializing in dermatology and cosmetic medicine, mesoestetic Pharma Group offers leading anti-aging and depigmenting treatments. With a production plant, logistics platform, as well as Biotechnology, Medical Monitoring and Follow-up Units, the company can carry out the entire production cycle, including in vitro and in vivo studies to develop, manufacture and market products under its brand name mesoestetic, including cosmeceutics, nutraceutics, class III intradermal administration medical devices with CE marking, topical medication and electro-medical equipment available in over 80 markets. All products are supported by clinical research guaranteeing their safety, quality and excellent therapeutic results. PerfAction Technologies, Ltd. 10 Plaut St. Rehovot, Israel telephone facsimile PerfAction Technologies is a medical technology company pioneering new treatment modalities for aesthetic and dermatological applications. The Enerjet platforms bring together the company s proprietary Jet Volumetric Remodeling (JVR) technology, which simultaneously delivers kinetic energy and a healing compound to create a unique micro-trauma profile, enabling a controlled deep injury effect for scar repair and dermal remodeling. Sciton, Inc. 925 Commercial Street Palo Alto, CA USA telephone facsimile Sciton is committed to providing best-in-class laser and light solutions for medical professionals who want superior durability, performance and value. Sciton offers superior medical devices for laser-assisted lipolysis, fractional and full-coverage skin resurfacing, hair removal, phototherapy, wrinkle reduction, treatment of vascular and pigmented lesions, scar reduction and laser vaginal therapy, all on an expandable platform. The new Halo laser is a hybrid fractional laser, combining ablative and non-ablative wavelengths for epidermal renewal and deep dermal rejuvenation with non-ablative downtime. Sinclair Pharma PLC 1st Floor Whitfield Court 30-32, Whitfield Street London W1T 2RQ UK telephone Sinclair is a pharmaceutical company with a renowned strong skin expertise providing best in class treatments for different skin pathologies. The company recently widened its portfolio to aesthetics to further support physicians in their practice thanks to unique treatments that answer all patients needs at all ages through minimally invasive procedures. Syneron Candela Room , 25/F Hopewell Center 183 Queen s Road East Wan Chai, Hong Kong telephone facsimile Syneron manufactures and sells non-ablative to ablative medical aesthetic devices that use a wide variety of energies including Syneron s signature elōs technology a combined energy platform that effectively treats dermatological conditions including wrinkles, pigmentation, skin laxity, acne, rosacea, hair removal, vascular lesions, cellulite and circumferential reduction. 68 THE Asian Aesthetic Guide Volume 13

69 Thermi, LLC 3131 West Royal Lane Irving, TX USA telephone facsimile Thermi, an Almirall company, is a leading global manufacturer of temperature controlled radiofrequency technology. The company s flagship product is ThermiRF, a platform technology that uses temperature as a clinical endpoint for various non and minimally invasive applications. Thermi also offers the Thermi250 device as the newest innovative RF for the body and is the distributor of Silhouette InstaLift (lifting to redefine mid-facial contours). Ulthera, Inc., a Division of Merz, Inc S. Stapley Drive, Suite 200 Mesa, AZ USA telephone facsimile Ulthera, Inc. is a global, high-growth medical device innovation center pioneering aesthetic and medical applications using therapeutic ultrasound platform technology. The Ulthera System is CE Marked for non-invasive dermatological sculpting and lifting of the dermis of the upper face, lower face, neck and décollete. Venus Concept, Ltd. 255 Consumers Road, Suite 100 Toronto, ON, M2J 1R4 Canada telephone facsimile Venus Concept is a global aesthetic device manufacturer that develops effective, pain free technologies for the body and face, and offers them through our industry changing, low risk, subscription-based business model. Our brands include the top rated Venus Freeze, Venus Legacy featuring two 4D applicators and Venus Viva, the latest nanofractional RF technology with SmartScan. Venus Versa provides a complete package of aesthetic solutions to address the most in-demand aesthetic treatments. WONIK Corporation 7th Floor Wonik Building, 20 Pangyo-ro, 255 beon-gil Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea telephone facsimile WONIK Corporation specializes in providing innovative treatment solutions in medical and aesthetic applications. We combine our expertise in marketing world-class products and satisfying customers for over 30 years to enhance the patient experience and clinical results. We re offering our flagship product, INNOJECTOR, which provides a clinically-proven, new treatment option for aesthetic and dermatological applications. ZELTIQ, Ltd. First Point Buckingham Gate London Gatwick RH6 ONT telephone intlsupport@zeltiq.com ZELTIQ is a science-based medical device company committed to continuing the scientific exploration and innovations in the use of cryolipolysis for nonsurgical aesthetic procedures and treatments based on clinical data, physician input and market demand. The cryolipolysis technology behind CoolSculpting is exclusively licensed from Massachusetts General Hospital. Zimmer MedizinSysteme GmbH Junkersstraße 9 Neu-Ulm, Germany telephone facsimile Based on hyaluronic acid, the brand new ZFill product line is suitable for all established indications of wrinkle injections. In 2016 ZLipo, a brand new system for CryoContouring was launched. By combining ZLipo and ZWavePRO (radial shockwaves) Zimmer MedizinSysteme offers the perfect combination treatment for significantly improved fat reduction. Viveve Medical, Inc. 345 Inverness Drive South, Bldg. B, Suite 250 Englewood, CO USA telephone The Viveve System is a non-surgical device that remodels vaginal tissue in a single, 30-minute, procedure; satisfying patient demand for a painless solution to vaginal laxity. Vaginal laxity is associated with decreased sexual sensation and urinary incontinence. The system uses cryogen-cooled, monopolar radiofrequency (CMRF) technology to renew the collagen scaffolding. THE Asian Aesthetic Guide Volume

70 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Asclepion Laser Technologies MCL31 Dermablate MultiPulse TattooStar Effect COMBO TattooStar Effect R TattooStar R Er:YAG CO 2 Q-Switched Nd:YAG / Ruby Q-Switched Ruby Q-Switched Ruby 2940 nm 10,600 nm 532 nm, 585 nm, 694 nm, 1064 nm 694 nm 694 nm 2.5 J 30 W max. 1.5 J / 1.2 J 1.2 J 1.2 J 100 1,000 μs Pulsed, Superpulse, CW and max. 2,000 μs with scanner 8 ns / 40 ns 40 ns 40 ns VarioSpot handpiece with 1 6 mm spot; VarioSpot XL handpiece with 8 12 mm spot; MicroSpot handpiece with microlens array and variable skin coverage. Smoke evacuation system integrated. Fixed Focus handpiece with 0.4 mm spot; Zoom handpiece with mm spot; Scanner MicroPulse with pitch of 200 2,000 μm. Fractional handpiece (Ruby), Dye handpiece (Nd:YAG). Fractional handpiece. Fractional handpiece. Cutera enlighten xeo excel V Laser Laser Laser 532 nm, 670 nm, 1064 nm 1064 nm 532 nm, 1064 nm Up to 300 J/cm 2 Up to 300 J/cm ps + 2 ns Up to 300 ms Up to 60 ms Optional IPL handpieces. DEKA SmartXide DOT SmartXide 2 DOT/RF SmartXide Touch Synchro HP Excellium MiniSilk FT Synchro FT Synchro REPLA:Y Fractional CO 2 Fractional CO 2 plus RF Fractional CO 2 plus RF Multi-Functional Platform Pulsed Light System Multi-Functional Platform Multi-Functional Platform 10.6 µm 10.6 µm 10.6 µm 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 500 nm, 520 nm, 550 nm, 600 nm, 650 nm 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 50 W max. 80 W max. 60 W max. LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse J/cm J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse 63.5 J (max.) 125 W (max.) / 120 J 180 W (max.) LP; 120 J (max.) SP / 160 J (max.) energy per pulse µs µs µs From 2 50 ms SP, from ms LP / from 3 8 ms 2 85 ms (1-3 pulses) ms SP; 2 30 ms LP (1 3 pulses) / 3 8 ms 2 50 ms (single pulse); 2 40 ms (double pulse) / 2 50 ms SP; ms LP / 3 8 ms DOT scanner and freehand handpiece; touchscreen monitor; Stack feature; Smart Track delivery mode; Smart Pulse; patient database; CW, PW, traditional and fractional scanning modes available. PSD technology with selectable pulse shape (SP, DP, UP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand, TFT touchscreen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos; patient database with videos and photos. Store user protocols. Optional diode laser module. PSD technology with selectable pulse shape (SP, DP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand, TFT touchscreen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos; patient database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Interchangeable snap-on filters, integrated contact cooling; lamp water cooling; transportable. 3.1 cm 2 or 6.2 cm 2 spot area available. IR filter available for greater skin tightening. Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. 5 Hz and high power (125 W) on Alexandrite emission; 180 W Nd:YAG laser module with up to 27,000 W pulse peak power. Three delivery pulse designs and adjustment feature for Alexandrite and Nd:YAG. Twelve application handpieces to 24 mm. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connection; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Eunsung Global Corp. Duet RF Fraction CO 2 Comfort Dual Microson Focus Dual Bipolar / Monopolar RF CO 2 Bipolar RF High Intensity Focused Ultrasound HIFU + RF Needle 10,600 nm 7 50 W mj 25 W J/cm J/cm ,600 ms ms Partical handpiece with easy tip replacement; NS, NC, NCE; 64 pin, 100 pin, 196 pin. Specialized handpiece for optimum functionality; micro spot beam size; more than 70 μm. Shot mode: treatment selection per body area. Motion mode: two pre-set programs per body area and respective energy density. Five cartridges: SM 4-4.5, DD 7-3.0; SD 7-1.5, SD 7-1.5N, SC 4-13; three dot density levels; 25 mm max. length. Five cartridges: SM 4-4.5, DD 7-3.0; SD 7-1.5, SD 7-1.5N, SC 4-13; 25 pin needle. Fotona d.d. SP Dynamis XS Dynamis XP MAX QX MAX Nd:YAG / Er:YAG Er:YAG Nd:YAG Nd:YAG Q-Switched / Long Pulse 1064 nm / 2940 nm 2940 nm 1064 nm 1064 nm, 532 nm, 585 nm, 650 nm Up to 600 J/cm 2 (pulse), up to 80 W (QCW) / up to 500 J/cm 2 Up to 500 J/cm 2 Up to 600 J/cm 2 Up to 160 J/cm ms ms ms 5 20 ms; 250 µs F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Handpieces: 2-8 mm spot sizes. Note: Data subject to change; please refer to Company Directory for supplier contact information. 70 THE Asian Aesthetic Guide Volume 13

71 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories HIRONIC New MIDAS MIXEL Doublo-S MIRACLEAR Doublo Gold Q-Fit RF / IR CO 2 Fractional High Intensity Focused Ultrasound Blue Light, Vacuum, IPL High Intensity Focused Ultrasound Q-switched Nd:YAG Bipolar: 1 MHz / 700 2,000 nm, monopolar: MHz 10,600 nm nm 1064 nm / 532 nm 360 W / 75 W 60 mj J/cm J/cm J/cm J / 0.5 J Continuous Up to 5,000 µs 3 27 ms 5 10 ns No consumables; real-time cooling system (up to -5 C). Metal tube; scanner type, scan size 2 x 2 mm to 20 x 20 mm. Beam size: µm. Maximum spot quantity: 40,000. Three types of cartridges: M7, D4, D7, available to 10,000 shots; mm space between dots, length 5-25 mm. Small tip: 14.5 x 12.5 mm; normal tip: 26.5 x 14.5 mm. Three types of cartridges: M7, D4, D7 available to 10,000 shots mm space between dots; length 5 25 mm. 532 Fractional, 1064 Fractional, Fixed Collimated handpieces. Ilooda Co., Ltd. Secret RF Fraxis Fraxis DUO Multiple IRIS CuRAS RF microneedle CO 2 Fractional CO 2 Fractional; RF microneedle OPS Diode Laser Q-Switched Nd:YAG 10,600 nm 10,600 nm 532 nm (Fractional); 532 nm (Normal) 1064 nm; 532 nm 25 W 30 W 30 W; 20 W 70.7 J/cm 2 ; 832 J/cm J/cm ms ms ms; ms 100 ms; 400 ms 5 20 ns; 100 ns; 300 µs 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas such as around the eyes; optional smart pen handpiece for acne and thread vein. CO 2 fractional handpiece; optional surgical handpiece. RF fractional needle handpiece; CO 2 fractional handpiece; optional surgical handpiece. 532 nm Fractional, 532 nm Normal; available to treat vascular lesions in the epidermis. Energy meter including Zoom handpiece; collimated handpiece; optional fractional handpiece. Jeisys cellec v TRI-BEAM SmoothCool Edge Fractional INTRAcel INTRAcel PRO IntraGen ULTRAcel IPL QS Nd:YAG Intense Pulsed Light Fractional CO 2 Laser Fractional RF Microneedling Fractional RF Microneedling Grid Fractional RF Multi-Functional Platform (HIFU / Fractional RF Microneedling / Grid Fractional RF) nm 1064 nm / 532 nm / 585 nm / 650 nm nm / nm 10,600 nm Up to 60 J/cm J (1064 nm PTP) / 500 mj (532 nm) Up to 65 J/cm mj Up to 50 W Up to 50 W Up to 200 W Up to 3 J / up to W / up to 200 W 1 60 ms 5 10 ns (QS) / 300 µs (Quasi-Long) 1 60 ms ms 5 1,000 ms 10 ms 5 sec 0 2 sec ms / 60 2,000 ms / 0 2 sec Nine interchangeable filters: 420S ( nm), 500S ( nm), 530S ( nm), 550S ( nm), 530D ( nm and nm), 560 nm, 640 nm, 700 nm. Spot size: 40 x 10 mm; contact cooling. Zoom, collimated and fractional handpieces; Dye handpieces: 585 and 650 nm. 560 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Spot size: 120, 350, 800 µm, surgical tip; surgical handpieces (50 and 100 mm). Invasive tip (FRM) and non-invasive tip (SRR); bipolar and monopolar available. Insulated except for 0.3 mm at end of the tips where it emits the RF energy. 49 tip (insulated). Insulated (except 0.3 mm) at end of tips where RF is emitted. SRR Tip / 16 Tip (non-insulated). Bipolar and monopolar available. Full tip (15 x 15 mm) and small tip (7 x 7 mm). Platform device features HIFU, RF microneedling and noninvasive RF technology. HIFU: B cartridge (depth: 3.0 mm); C cartridge (depth: 4.5 mm). FRM: FRM tip; SRR tip. GFR: large (15 x 15); small (7 x 7) tip. Lutronic SPECTRA SOLARI HEALITE eco2 INFINI MOSAIC HP CLARITY ACTION II Lasemd SPECTRA XT Lasemd Pico + 4 PICOPLUS Q-switched Nd:YAG IPL LED CO 2 Fractional Bi-Polar Fractional RF Er:Glass Fractional Long Pulsed Alexandrite / Nd:YAG Fractional Er:YAG Laser Thulium Fractional Laser Nd:YAG based Multi-Platform Thulium Laser Picosecond Nd:YAG Q-Switched Nd:YAG 532 nm, 585 nm, 650 nm, 1064 nm nm 830 nm (with 590 nm); 633 nm; 415 nm available (single wavelength per head) 10,600 mm 1550 nm 755 nm / 1064 nm 2950 nm 1927 nm 1064 nm, 532 nm, 585 nm, 595 nm, 650 nm, 660 nm 1927 nm 1064 nm, 532 nm, 595 nm and 660 nm 1064 nm, 532 nm, 595 nm, 660 nm Up to 1.5 J 35 J/cm 2 (with 510 nm filter) Focused: up to 150 mw/cm 2 ; up to 80 mw/cm 2 ; up to 50 mw/cm mj 50 W mj Up to 600 J/cm 2 50 J, Long pulse: 180 J Up to 20 mj 1064: 1.2 J at ns max., 4.5 J at quasi-long max.; 532: 0.4 J max., 585 and 595: 0.25 J max., 650 and 660: 0.15 J max. Up to 20 mj 750 ps, 2 ns Up to 800 mj 5 7 ns / 300 µs, (Spectra Mode) ms Ultra Pulse: 40 1,000 µs; Super Pulse: 1 5 ms 10 1,000 ms ms 250 µs, Long Pulse: 1,000 ms 5 10 ns, 300 ms 600 mj max. at 750 ps, 800 mj max. at 2 ns 450 ps/2ns Variety of handpieces: 3-8 mm Zoom Collimated; 1-7 mm Zoom; 7 mm Fixed Collimated; 585 nm and 650 nm Dye. Cut-off filters. Variety of heads and configurations available: single and dual wavelength heads. Planar and Focused (max. intensity) delivery options. Fractional or Insicional handpieces. Variety of Fractional handpiece tips available: 120, 300, 500 micron tip. Variety of handpieces and tips available. MFR handpiece: 49 tip (7 x 7 needles, scan size: 10 x 10 mm); Comfort / 16 tip (4 x 4 needles, scan size: 5 x 5 mm); SFR handpiece: 144L tip (12 x 12 electrodes, Dual Channels, scan size: 20 x 20 mm); 64S tip (8 x 8 electrodes, Single Channel, scan size: 10 x 10 mm). Skin and hair tips. Nine adjustable spot sizes, ICD cryogen or air cooling. Fractional, Zoom, Shining Peel and Petit Lady handpieces. Variety of ampoules for cosmeceutical delivery: Vitamin C, Vitamin A, Tranexamic Acid, CK (human blood cell conditioned media + KGF) and RS (Resveratrol). Zoom HP, Collimated, Dye, Gold Toning, RuVY Touch, Fractional. Roller set. comb tip set, square tip set, Lasemd ampoules and cosmetics. Five handpieces. Five diffrent handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 and 5mm Gold Toning+, 2 and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

72 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Sciton JOULE Halo ClearScan YAG Contour TRL ProFractional ThermaScan BBLs BBL Nd:YAG / Er:YAG / BroadBand Light / Alexandrite Hybrid Fractional Laser (ablative and non-ablative) Nd:YAG Tunable Resurfacing Laser (TRL) Er:YAG Nd:YAG BroadBand Light BroadBand Light Various 1470 nm / 2940 nm 1064 nm 2940 nm 2940 nm 1319 nm nm nm Up to 400 J/cm mj/mtz, 50 mj/mtz Up to 400 J/cm 2 Up to 40 W Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 5 ms Up to 200 ms Up to 50 ms Variable Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Delivery of ablative and non-ablative wavelengths in single pass. Dynamic Thermal Optimization (DTO) for precise energy delivery. Roller tip adaptors; optical navigation; integrated Zimmer cooling advanced mode for precise and independent control of depth and density. Pre-programmed modes and integrated smoke evacuation system. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Computerized scanner, smart user interface, MicroLaserPeel, Tunable Resurfacing Laser. Expandable module / density 1.5% 26%. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Table top system, SkinTyte II, 420, 515, , 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters. 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron Candela Profound emax/elight SR emax/elight SRA emax/elaser ST etwo elōs Plus with SR/SRA/SR Plus/SRA Plus/SRA Mini/ST Alex TriVantage with Laser-Pumped Laser Handpieces Vbeam Perfecta GentleMAX Pro GentleLase Pro-U GentleYAG Pro-U Bi-Polar RF 460, 5 khz Optical Energy / RF Electrical Energy Optical Energy / RF Electrical Energy IR / RF Electrical Energy Fractionated Bi-Polar RF Optical Energy / Bi-Polar RF Microsecond Pulse and Q-switched Alexandrite / Nd:YAG / KTP Nd:YAG Pulsed Dye Laser Long Pulse Alexandrite / Nd:YAG Long Pulse Alexandrite (upgradable to GentleMAX Pro) Long Pulse Nd:YAG (upgradable to GentleMAX Pro) nm nm 700 nm 2000 nm nm 755 nm / 1064 nm / 532 nm 595 nm 755 nm / 1964 nm 755 nm 1064 nm Max. output voltage 84 VRMS Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 45 J/cm 2 / up to 25 J/cm 3 6 W/cm 2, up to 120 J/cm 3 Up to 100 mj / pin Up to 45 J/cm 2 ; up to 25 J/cm 2 ; up to 200 J/cm 3 Up to 18 J/cm 2 Q-switched; up to 70 J/cm 2 long pulse Up to 40 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 50 ns (all wavelengths); 100 μs at 755 nm ms ms ms ms RF microneedling device for mandibular and submandibular contouring and wrinkles. 12 x 25 mm spot size. Same as above. 12 x 8 mm spot size. Standard 64 pin tip with 12 x 12 mm spot and focal 44 pin tip with 11 x 3 mm spot. SR/SRA: 25 x 12 mm; SR/SRA Plus: 35 x 14 mm; SRA Mini 15 x 14 mm. 2 mm, 3 mm and 4 mm spots at 755 nm. 2 mm, 3 mm and 5 mm spots at 1064 and 532 nm. Eight spot sizes up to 12 mm, including 3 x 10 elliptical and pigmented lesion handpieces. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy mm spot sizes. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Air cooling compatible delivery systems available. Same as above. Same as above. Venus Concept, Ltd. Venus Swan Venus Freeze Venus Legacy Venus Viva NanoFractional RF with SmartScan Venus Versa Multi-Polar RF and Pulsed Magnetic Fields Multi-Polar RF and Pulsed Magnetic Fields Multi-Polar RF and Pulsed Magnetic Fields NanoFractional RF with scanner mode IPL SR515: nm, SR580: nm Up to 120 W Up to 150 W Up to 150 W RF: 1 MHz, 460 khz; 160 pins with 62 mj/pin 5 25 J/cm ns OctiPolar and DiamondPolar HP. OctiPolar and DiamondPolar HP. Two 4D applicators; OctiPolar and DiamondPolar HP. Venus Viva HP comes with multi Tx, single patient tips; DiamondPolar HP also comes standard. 10 x 30 mm spot size. Note: Data subject to change; please refer to Company Directory for supplier contact information. 72 THE Asian Aesthetic Guide Volume 13

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74 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Asclepion Laser Technologies MeDioStar NeXT PRO XL MeDioStar NeXT PRO ALeX MeDioStar NeXT PRO High Power Diode High Power Diode High Power Diode nm nm nm 20 J/cm 2 max. (XL-L); 60 J/cm 2 max. (XL-S); 35 J/cm 2 max. (ALX); 47 J/cm 2 max. (STANDARD); 90 J/cm 2 max. (HIGH POWER) 20 J/cm 2 max. (XL-L); 60 J/cm 2 max. (XL-S); 35 J/cm 2 max. (ALX); 47 J/cm 2 max. (STANDARD); 90 J/cm 2 max. (HIGH POWER) 20 J/cm 2 max. (XL-L); 60 J/cm 2 max. (XL-S); 35 J/cm 2 max. (ALX); 47 J/cm 2 max. (STANDARD); 90 J/cm 2 max. (HIGH POWER) ms ms ms Optional handpieces: ST handpiece with 14 x 10 mm 2 spot; ALX handpiece with 14 x 10 mm 2 spot; HP handpiece with 8 x 6 mm 2 spot; VAS handpiece with 4 x 3 mm 2 spot. Standard handpieces: XL handpiece (XLL laser tip) with 38 x 24 mm 2 spot and XL handpiece (XLS laser tip) with 30 x 10 mm 2 spot. Standard handpiece: ALX handpiece with 14 x 10 mm 2 spot. Optional handpieces: ST handpiece with 14 x 10 mm 2 spot; HP handpiece with 8 x 6 mm 2 spot; VAS handpiece with 4 x 3 mm 2 spot; XL handpiece (XLL laser tip) with 38 x 24 mm 2 spot and XL handpiece (XLS laser tip) with 30 x 10 mm 2 spot. Standard handpiece: ST handpiece with 14 x 10 mm 2 spot. Optional handpieces: ALX handpiece with 14 x 10 mm 2 spot; HP handpiece with 8 x 6 mm 2 spot; VAS handpiece with 4 x 3 mm 2 spot; XL handpiece (XLL laser tip) with 38 x 24 mm 2 spot and XL handpiece (XLS laser tip) with 30 x 10 mm 2 spot. BTL Industries BTL Exilite IPL 480 nm, 530 nm, 560 nm, Up to 40 J/cm 2 for 640 nm, 690 nm filters, up to 1200 nm 4.4 cm² spot size, 176 J/pulse (max.) Up to 250 ms; intelligent multipulse mode Five high precision filters determine light spectrum required to treat wide-range of aesthetic indications. Advanced thermoelectric cooling of sapphire spot makes therapy gentle. Post-light LED non-thermal Tx reduces erythema, improves skin regeneration and stimulates production of collagen after IPL Tx. Cutera xeo + prowave excel HR Laser / IPL Laser 1064 nm / nm 755 nm, 1064 nm 300 J/cm 2 / up to 35 J/cm 2 Up to 300 J/cm 2 Up to 300 ms / up to 90 ms Up to 300 ms DEKA Synchro HP Excellium MiniSilk FT Synchro REPLA:Y Synchro FT Motus LD Motus AX Multi-Functional Platform Pulsed Light System Multi-Functional Platform Multi-Functional Platform High Power Diode Laser High Frequency Alex Laser 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IR filter 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 810 nm ± 10 nm 755 nm LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse J/cm J (max.) 125 W (max.) / 120 J 180 W (max.) LP, 120 J (max.) SP / 160 J (max.) energy per pulse 700 J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse Up to 60 J Up to 30 J From 2 50 ms SP, from ms LP / from 3 8 ms 2 85 ms (1-3 pulses) 2 50 ms (single pulse), 2 40 ms (double pulse) / 2 50 ms SP, ms LP / 3 8 ms ms SP, 2 30 ms LP (1 3 pulses) / 3 8 ms Up to 46 ms 2 50 ms (single pulse), from 4 80 ms (Twin pulse) 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Interchangeable snap-on filters; integrated contact cooling; lamp water cooling; transportable. 3.1 cm 2 or 6.2 cm 2 spot areas available. IR Filter available for greater skin tightening. 5 Hz and high power (125 W) on Alexandrite emission. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power. Three delivery pulses and adjustment feature for Alexandrite and Nd:YAG. Twelve application handpieces to 24 mm. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connections; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. Transportable device with optional chart; intergrated skin contact cooling; 10 x 10 mm 2 spot area available with up to 15 Hz repetition rate. Motion functionality for painless Tx. Transportable device, integrated Peltier skin contact cooling; 20 mm spot area available with up to 10 Hz repetition rate. Proprietary new Mòvèo Technology functionality for painless and smokeless hair removal. Eunsung Global Corp. Clearlight LD808 Clearlight Diode Intense Pulsed Light 808 nm nm J/cm J/cm ms 5 25 ms 808 nm diode laser and large, 14 x 14 mm spot size. Differentiated handpiece with 15 x 40 mm wide spot size. Fotona d.d. SP Dynamis XP MAX QX MAX Nd:YAG Nd:YAG QS Nd:YAG Q-Switched / Long Pulse 1064 nm 1064 nm 1064 nm Up to 600 J/cm 2 Up to 600 J/cm 2 1,600 mj/pulse ms ms 250 µs S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Same as above. Handpieces: 2-8 mm spot sizes. Note: Data subject to change; please refer to Company Directory for supplier contact information. 74 THE Asian Aesthetic Guide Volume 13

75 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Ilooda Co., Ltd. VIKINI Epilia RF VeLux Diode Diode / RF Diode 808 nm 808 nm 755 nm Up to 120 J/cm 2 Up to 60 J/cm 2 5,000 W ms ms / ms ms Supports various range of pulses with 600 W. Powerful extra cooling handle; 12 x 11 spot sized sapphire tip contact cooling and new optional cooling adaptor. Safe and effective for most skin types; sapphire tip contact cooling. Supports various line scanning types. 50 x 15 mm (10 x 15 mm) spot sized sapphire tip contact cooling with powerful extra air cooling adaptor. Jeisys cellec SmoothCool IPL IPL nm nm / nm Up to 60 J/cm 2 Up to 65 J/cm ms 1 60 ms Eight interchangeable filters: 420S ( nm), 530S ( nm), 420 nm, 530 nm, 560 nm, 640 nm, 700 nm, 800 nm. Spot size: 40 x 10 mm; contact cooling. 560 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Lumenis LightSheer Duet with LightSheer ET and LightSheer HS LightSheer ET LightSheer XC IPL Quantum SR or DL with HR upgrade Lumenis One Elora M22 Diode Diode Diode Intense Pulsed Light Intense Pulsed Light / Nd:YAG / LightSheer Diode IPL Modular / Plug and Play / IPL 800 nm 800 nm 800 nm nm nm / 1064 nm / 800 nm nm nm LightSheer ET: J/cm 2 LightSheer HS: J/cm J/cm J/cm J/cm J/cm 2 / J/cm 2 / J/cm 2 Up to 22 J/cm J/cm 2 LightSheer ET: ms LightSheer HS: ms ms ms 6 18 ms ms / 2 20 ms / ms 4 20 ms High speed LightSheer HS handpiece: 22 x 35 mm spot with vacuum assist technology, field replaceable handpiece combined with LightSheer ET: 9 x 9 mm spot with ChillTip, field replaceable handpiece. ChillTip handpiece. 9 x 9 mm spot. ChillTip handpiece. 12 x 12 mm spot. Upgrade for IPL Quantum DL or SR, spot size 34 x 8 mm, optional mm head. Multi-technology, multi-application platform. Optimized presets and comprehensive patient database. Spot sizes IPL: 15 x 35 mm and 8 x 15 mm, Nd:YAG: 3, 6, 9 mm, LightSheer: 9 x 9 mm. Spot size of 20 x 30 mm crystal, 33 Hz. Optimum Pulse Technology (OPT), multiple sequential pulsing, continuous contact cooling with SapphireCool light guides: 15 x 35 mm, 8 x 15 mm. ExpertFilters: 515, 560, 590, 615, 640 and 695 nm. Lutronic SOLARI ADVANTAGE Advantage Power+ CLARITY IPL Diode Diode Long Pulsed Alexandrite / Nd:YAG Laser nm 805 nm 805 nm 755 nm / 1064 nm 35 J/cm² (at 510 nm filter) J/cm² J/cm 2 Up to 600 J/cm ms ms ms ms Cut-off filters. Field replaceable handpieces with chilled compression tip: D1-800 (10 x 10 mm); D3-800 (10 x 30 mm). Cart. Field replaceable handpieces with chilled compression tip: D1-800 (10 x 10 mm); D3-800 (10 x 30 mm). D (10 x 10mm). Cart. Nine spot sizes including 2, 3, 5, 8, 10, 12, 15, 18, 20 mm. Sciton JOULE ClearScan YAG ClearScan ALX BBLs BBL Forever Bare BBL Laser and Light Platform Nd:YAG Alexandrite BroadBand Light BroadBand Light BroadBand Light Various 1064 nm 755 nm nm nm nm Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Same as above. Table top system, SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. FB BBL technology is in motion. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron Candela emax/elaser DSL emax/elight DS elōs Plus with Motif LHR/DSL elōs Plus with Motif HR/DS and Motif HR Plus GentleMAX Pro GentleLase Pro-U GentleYAG Pro-U Diode / RF Electrical Energy Optical Energy / RF Electrical Energy Optical Energy / Bi-Polar RF Optical Energy / Bi-Polar RF Long Pulse Alexandrite / Nd:YAG Long Pulse Alexandrite (upgradable to GentleMAX Pro) Long Pulse Nd:YAG (upgradable to GentleMAX Pro) 810 nm nm 810 nm nm 755 nm / 1964 nm 755 nm 1064 nm Up to 50 J/cm 2 / up to 50 J/cm 3 Up to 45 J/cm 2 / up to 25 J/cm 2 Up to 50 J/cm 2 / up to 50 J/cm 2 Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm ms ms ms 15 x 12 mm spot size. 25 x 12 mm spot size. 15 x 12 mm spot size. 35 x 14 mm and 25 x 14 mm spot sizes mm spot sizes. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Air Cooling Compatible delivery systems available. Same as above. Same as above. Venus Concept, Ltd. Venus Versa IPL nm, HR690(XL): 5 20 J/cm ms 10 x 30 mm spot size; XL: 20 x 30 mm spot size nm Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

76 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Asclepion Laser Technologies QuadroStarPRO YELLOW QuadroStarPRO GREEN QuadroStarPRO 940 MeDioStar NeXT PRO XL with Vascular Handpiece MeDioStar NeXT PRO ALeX with Vascular Handpiece MeDioStar NeXT PRO with Vascular Handpiece High-Power Optically Pumped Semiconductor Laser (HOPSL) HOPSL Diode High Power Diode High Power Diode High Power Diode 577 nm 532 nm 940 nm 940 nm 940 nm 940 nm 5 W max. 8 W max. 30 W max. Up to 210 J/cm 2 Up to 210 J/cm² Up to 210 J/cm 2 1 ms 95 s; CW 1 ms 95 s; CW 1 ms 95 s; CW Up to 200 ms Up to 200 ms Up to 200 ms Scanner; handpiece with different spot sizes: 0.5 mm; 1.0 mm; 1.5 mm; 2.8 mm. Same as above. Bare fibers for Endovascular Laser Therapy (EVLT). Handpieces for hair removal (Alexandrite, High-Power, Standard). Handpieces for hair removal (XL, High-Power, Standard). Handpieces for hair removal (XL, Alexandrite, High-Power). Cutera excel V xeo Laser Laser / Limelight 532 nm, 1064 nm Up to 300 J/cm 2 Up to 60 ms 1064 nm / nm 300 J/cm 2 / 30 J/cm 2 Up to 300 ms / Automatic DEKA Synchro VAS-Q Synchro HP Excellium Synchro FT MiniSilk FT Synchro REPLA:Y Multi-Functional Platform Multi-Functional Platform Multi-Functional Platform Pulsed Light System Multi-Functional Platform 595 nm PDL / RightLight Technology 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 1064 nm Nd:YAG / 700 J/cm 2 (max.) 500 nm, 520 nm, 550 nm, SP and LP / 160 J 600 nm, 650 nm IPL (max.) energy per pulse 500 nm, 520 nm, 550 nm, 600 nm, 650 nm, IR Filter 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 8 J / 33 J/cm 2 LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse J/cm J (max.) 125 W (max.) / 120 J 180 W (max.) LP; 120 J (max.) SP / 160 J (max.) energy per pulse From ms 2 50 ms SP, ms LP / 3 8 ms ms SP; 2 30 ms LP (1 3 pulses) / 3 8 ms 2 85 ms (1 3 pulses) 2 50 ms (single pulse); 2 40 ms (double pulse) / 2 50 ms SP; ms LP / 3 8 ms Powerful PDL with RightLight Technology. Eliminates all vascular anomalies, malformations and superficial erythrosis. Four handpieces (5, 7, 10 and 12 mm) with Auto Spot Size Recognition. Top Hat technology and high energy modality up to 7 J; delivery pulse settings available. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. Interchangeable snap-on filters; integrated contact cooling; lamp water cooling. Transportable; 3.1 cm 2 or 6.2 cm 2 spot area available. IR Filter for greater skin tightening. 5 Hz and high power (125 W) on Alexandrite emission. 180 W Nd:YAG module with up to 27,000 W pulse peak power. Three delivery pulse designs and adjustment feature for Alexandrite and Nd:YAG. Twelve application handpieces up to 24 mm. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connections; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Eunsung Global Corp. Clearlight Intense Pulsed Light nm 3 35 J/cm ms Differentiated handpiece of 15 x 40 mm wide spot size. Fotona d.d. SP Dynamis XP-2 Focus XP MAX QX MAX Nd:YAG Nd:YAG Nd:YAG Nd:YAG Q-Switched / Long Pulse 1064 nm 1064 nm 1064 nm 1064 nm Up to 600 J/cm 2 Up to 300 J/cm 2 Up to 600 J/cm 2 Up to 160 J/cm ms ms ms 250 µs S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Nd:YAG handpieces: 2-10 mm spot sizes. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. Handpieces: 2-8 mm spot sizes. Ilooda Co., Ltd. Multiple IRIS Secret RF OPS Diode Laser RF Microneedle 532 nm (Fractional); 532 nm (Normal) 70.7 J/cm 2 ; 832 J/cm 2 25 W 100 ms; 400 ms ms 532 nm Fractional, 532 nm Normal; available to treat vascular lesions in the epidermis. 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas, such as around the eyes; optional smart pen handpiece for acne and thread vein. Note: Data subject to change; please refer to Company Directory for supplier contact information. 76 THE Asian Aesthetic Guide Volume 13

77 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Jeisys cellec v SmoothCool IPL IPL nm nm / nm Up to 60 J/cm 2 Up to 65 J/cm ms 1 60 ms Nine interchangeable filters: 420S ( nm), 500S ( nm), 530S ( nm), 550S ( nm), 530D ( nm and nm), 560 nm, 640 nm, 700 nm. Spot size: 40 x 10 mm; contact cooling. 560 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Lumenis IPL Quantum DL IPL Quantum SR Lumenis One M22 Nd:YAG Intense Pulsed Light Intense Pulsed Light / Nd:YAG / LightSheer Diode Modular / Plug and Play / Intense Pulsed Light 1064 nm nm nm / 1064 nm / 800 nm nm J/cm J/cm J/cm 2 / J/cm 2 / J/cm ms 6 26 ms ms / 2 20 ms / ms 4 20 ms Upgradable to hair removal, rejuvenation and tattoo removal. Spot size 6 mm. Upgradable to hair removal, deep vascular lesions and leg veins and tattoo removal. Spot size 34 x 8 mm, optional 590 nm and 640 nm heads for rejuvenation. Multi-technology, multi-application platform. Upgradable, expandable, seven IPL filters, novel Optimal Pulse Technology for multiple sequential pulsing, optimized presets and patient database, spot sizes: 15 x 35 mm and 8 x 15 mm (IPL); 2 x 4, 6, 9 mm (Nd:YAG), LightSheer: 9 x 9 mm. Optimum Pulse Technology (OPT), multiple sequential pulsing, continuous contact cooling with SapphireCool light guides: 15 x 35 mm, 8 x 15 mm. ExpertFilters: 515, 560, 590, 615, 640 and 695 nm. Lutronic SOLARI CLARITY PICOPLUS IPL Long Pulsed Alexandrite / Nd:YAG Laser Q-switched Nd:YAG nm 755 nm / 1064 nm 1064 nm, 532 nm, 595 nm, 660 nm 35 J/cm² (at 510 nm filter) Up to 600 J/cm 2 Up to 800 mj ms ms 450 ps / 2ns Cut-off filters. Nine spot sizes including 2, 3, 5, 8, 10, 12, 15, 18, 20 mm. ICD Cryogen or air cooling available. Five different handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 and 5 mm Gold Toning+, 2 and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. Sciton JOULE ClearScan YAG ClearScan ALX Pro-V BBLs BBL Laser and Light Platform Nd:YAG Alexandrite Nd:YAG BroadBand Light BroadBand Light Various 1064 nm 755 nm 1319 nm nm nm Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 50 Watts Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Same as above. Endovenous and transcutaneous laser Tx of varicose and other veins. Uses non-proprietary fibers. Table top system, SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron Candela elōs Plus / emax/elight SR elōs Plus / emax/elight SRA elōs Plus / emax/elaser LV elōs Plus / emax/elaser LVA Vbeam Perfecta GentleMAX Pro GentleLase Pro-U GentleYAG Pro-U Optical Energy / RF Electrical Energy Optical Energy / RF Electrical Energy Diode / RF Electrical Energy Diode / RF Electrical Energy Pulsed Dye Laser Long Pulse Alexandrite / Nd:YAG Long Pulse Alexandrite (upgradable to GentleMAX Pro) Long Pulse Nd:YAG (upgradable to GentleMAX Pro) nm nm 900 nm 900 nm 595 nm 755 nm / 1964 nm 755 nm 1064 nm Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 140 J/cm 2 / up to 100 J/cm to 350 J/cm 2 / 10 to 100 J/cm 3 Up to 40 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm ms ms ms ms 25 x 12 mm spot size. Same as above. 8 x 5 mm spot size. 8 x 2 mm spot size. Eight spot sizes up to 12 mm, including 3 x 10 elliptical and pigmented lesion handpieces. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy mm spot sizes. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Air Cooling Compatible delivery systems available. Same as above. Same as above. Venus Concept, Ltd. Venus Versa IPL SR515: nm, SR580: nm 5 25 J/cm ns 10 x 30 mm spot. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

78 Acne Tx Device Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Asclepion Laser Technologies MCL31 Dermablate MultiPulse MeDioStar NeXT PRO XL MeDioStar NeXT PRO ALeX High Power Diode MeDioStar NeXT PRO Er:YAG CO 2 High Power Diode High Power Diode 2940 nm 10,600 nm nm nm nm 2.5 J 100 1,000 μs 30 W max. Pulsed, Superpulse, CW, 2,000 μs max. with scanner 47 J/cm 2 max ms (STANDARD), 90 J/cm 2 max. (HIGH POWER) 47 J/cm 2 max ms (STANDARD), 90 J/cm 2 max. (HIGH POWER) 47 J/cm 2 max ms (STANDARD), 90 J/cm 2 max. (HIGH POWER) VarioSpot handpiece with 1 6 mm spot; VarioSpot XL handpiece with 8 12 mm spot; MicroSpot handpiece with microlens array and variable skin coverage. Smoke evacuation system integrated. Fixed Focus handpiece with 0.4 mm spot; Zoom handpiece with mm spot. Scanner MicroPulse with pitch of 200 2,000 μm. Alexandrite, High-Power, Standard, Vascular handpieces. XL, High-Power, Standard, Vascular handpieces. XL, Alexandrite, High-Power, Vascular handpieces. Cutera excel V Laser 532 nm / 1064 nm Up to 300 J/cm 2 Up to 60 ms Cynosure Medley Multifunction laser and IPL Pulsed Light nm Up to 35 J/cm 2 Four IPL filters (450, 510, 540, 650 nm) and a full powered laser with Er:YAG, QS Nd:YAG and 810 nm diode handpieces. One year warranty included. DEKA SmartXide DOT SmartXide2 DOT/RF SmartXide Touch Synchro HP Excellium Synchro FT Synchro REPLA:Y Fractional CO 2 Fractional CO 2 plus RF Fractional CO 2 plus RF Multi-Functional Platform Multi-Functional Platform Multi-Functional Platform 10.6 µm 10.6 µm 10.6 µm 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 IPL 50 W max. 80 W max. 60 W max. LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse 700 J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse µs µs µs 2 50 ms SP, ms LP / 3 8 ms ms SP; 2 30 ms LP (1 3 pulses) / 3 8 ms 63.5 J (max.) 125 W 2 50 ms (single (max.) / 120 J 180 W pulse), 2 40 ms (max.) LP; 120 J (double pulse) / (max.) SP / 160 J 2 50 ms SP, 0.2 (max.) energy per 12 ms LP / 3 8 ms pulse DOT Scanner and freehand handpiece; touchscreen monitor; Stack feature; Smart Track delivery mode; Smart Pulse; patient database; CW, PW, traditional and fractional scanning modes available. PSD technology with selectable pulse shape (SP, DP, UP, HP, PW, CW, traditional and fractional scanning modes available); DOT/ RF scanner with RF feature; freehand; TFT touchscreen monitor; Stack and Smart Track delivery modes, multimedia built-in training videos; patient database with videos and photos. Store user protocols. Optional diode laser module. PSD technology with selectable pulse shape (SP, DP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand; TFT touchscreen monitor; Stack and Smart Track delivery modes, multimedia built-in training videos; patient database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. 5 Hz and high power (125 W) on Alexandrite emission; 180 W Nd:YAG laser module with up to 27,000 W pulse peak power. Three delivery pulse designs and adjustment feature for Alexandrite and Nd:YAG. Twelve application handpieces up to 24 mm. Auto Spot Size recognition. Top Hat technology; contact or optional external cooling connection; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Eunsung Global Corp. Clearlight Intense Pulsed Light nm 3 35 J/cm ms Differentiated handpiece of 15 x 40 mm wide spot size. Fotona d.d. SP Dynamis XS Dynamis QX MAX Nd:YAG / Er:YAG Er:YAG Nd:YAG Q-Switched 1064 nm / 2940 nm 2940 nm 1064 nm Up to 600 J/cm 2, (pulse) 80 W (QCW) / up to 500 J/cm 2 Up to 500 J/cm 2 Up to 160 J/cm ms ms 250 µs Accelera pulse F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Handpieces: 2-8 mm spot sizes. HIRONIC MIRACLEAR A-Fit Blue Light, Vacuum, IPL Diode / RF nm 1450 nm / 0.5, 0.7, 1.0 MHz 2 11 J/cm 2 Max. 13 J/cm ms 250 ms Small tip: 14.5 x 12.3 mm; normal tip: 26.5 x 14.5 mm. RF needle. Note: Data subject to change; please refer to Company Directory for supplier contact information. 78 THE Asian Aesthetic Guide Volume 13

79 Acne Tx Device Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Ilooda Co., Ltd. Secret RF Fraxis DUO Fraxis RF Microneedle CO 2 Fractional / RF Microneedle CO 2 Fractional 10,600 nm 10,600 nm 25 W 30 W / 20 W 30 W ms ms / ms ms 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas such as around the eyes; optional smart pen handpiece for acne and thread vein. RF fractional needle handpiece; CO 2 fractional handpiece; optional surgical handpiece. CO 2 fractional handpiece; optional surgical handpiece. Jeisys Medical AcGen 1 Needle RF / Grid Fractional RF Up to 15 W / up to 200 W 0 2 sec 1 needle tip (0.8, 1.2, 1.5 mm): insulated for 0.3 mm at top of tips where RF energy is emitted. Grid RF (7 x 7 and 15 x 5 mm) tips. cellec v SmoothCool INTRAcel ULTRAcel IPL IPL Fractional RF Microneedling Multi-Functional Platform (HIFU / Fractional RF Microneedling / Grid Fractional RF) nm nm / nm Up to 60 J/cm² Up to 65 J/cm² Up to 78.4 J/cm² Up to 3 J / up to W / up to 200 W 1 60 ms 1 60 ms 5 1,000 ms ms / 60 2,000 ms / 0 2 sec Nine interchangeable filters: 420S ( nm), 500S ( nm), 530S ( nm), 550S ( nm), 530D ( nm and nm), 560 nm, 640 nm, 700 nm. Spot size: 40 x 10 mm; contact cooling. 530 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Invasive tip (FRM) and non-invasive tip (SRR). Bipolar and monopolar available. HIFU: B cartridge (depth: 3.0 mm); C cartridge (depth: 4.5 mm). FRM: FRM tip; SRR tip. GFR: large (15 x 15), small (7 x 7) tip. Lutronic, Inc. SPECTRA SOLARI HEALITE HEALITE II PICOPLUS INFINI eco2 MOSAIC H SPECTRA XT Lasemd Q-switched Nd:YAG IPL LED LED Q-switched Nd:YAG Bipolar Fractional RF CO 2 Fractional Laser Er:Glass Nd:YAG based Multi-Platform Thulium Fractional Laser 532 nm, 585 nm, 650 nm, 1064 nm nm 830 nm (with 590 nm); 633 nm; 415 nm available (single wavelength per head) 830 nm (with 590 nm), 633 nm, 415 nm 1064 nm, 532 nm, 595 nm, 660 nm 10,600 nm 1550 nm 1064 nm, 532 nm, 585 nm, 595 nm, 650 nm, 660 nm 1927 nm Up to 1.5 J 35 J/cm² (at 510 nm filter) Focused: Up to 150 mw/cm 2 ; up to 80 mw/cm 2 ; up to 50 mw/cm W, W Up to 800 mj 50 W 5 7 ns / 300 µs (Spectra Mode) ms 450 ps/2ns 10 1,000 ms Up to 240 mj Ultra Pulse: 40 1,000 µs; Super Pulse: 1 5 ms mj 1064: 1.2 J at ns max., 5-10 ns, 300 ms 4.5 J at quasi-long max.; 532: 0.4 J max., 585 and 595: 0.25 J max., 650 and 660: 0.15 J max. Up to 20 mj Variety of handpieces: 3-8 mm Zoom Collimated; 1-7 mm Zoom; 7 mm Fixed Collimated; 585 nm and 650 nm Dye. Cut-off filters. Variety of heads and configurations available: single and dual wavelength heads. Planar and Focused (max. intensity) delivery options. Multiple wavelenghs available: 830 nm (with 590 nm) and 633 nm, 633 nm and 415 nm, 415 nm and 830 nm (with 590 nm). Five different handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 and 5mm Gold Toning+, 2 and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. MFR handpiece with a variety of tips available: 49 tip (7 x 7 needles, scan size: 10 x 10 mm), Comfort / 16 tip (4 x 4 needles, scan size: 5 x 5 mm) Fractional or Insicional handpieces. Variety of fractional handpiece tips available: 120, 300, 500 micron tip. Skin tips, hair tips. Zoom HP, Collimated, Dye, Gold Toning, RuVY Touch, Fractional. Variety of ampoules for cosmeceutical delivery: Vitamin C, Vitamin A, Tranexamic Acid, CK (human blood cell conditioned media + KGF) and RS (Resveratrol). Sciton JOULE ThermaScan BBLs BBL Contour TRL Laser and Light Platform Nd:YAG BroadBand Light BroadBand Light Tunable Resurfacing Laser (TRL) Various 1319 nm nm nm 2940 nm Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 40 W ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 50 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Table top system. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Computerized scanner, smart user interface, MicroLaserPeel, Tunable Resurfacing Laser. Syneron Candela emax/elight AC elōs Plus Vbeam Perfecta Optical Energy / RF Electrical Energy Optical Energy / Bi-polar RF Pulsed Dye Laser nm nm 595 nm Up to 18 J/cm 2 / up to 25 J/cm 3 Up to 18 J/cm 2 Up to 40 J/cm ms 25 x 12 mm spot size. 25 x 12 mm spot size. Eight spot sizes up to 12 mm, including 3 x 10 elliptical and pigmented lesion handpieces. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Venus Concept, Ltd. Venus Versa Venus Viva IPL Nanofractional RF with Smart Scan Scanner Mode nm, nm 5 25 J/cm 2 1 MHz, 460 KHz; 160 pins with 62 mj/pin; 5 25 J/cm ms 10 x 30 mm spot size. Venus Viva HP comes with multi-treatment single patient tips; DiamondPolar HP also comes standard. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

80 Dermal Filler Product Comparison Chart Manufacturer Product(s) Key Component Description Regulatory Status Allergan CosmoDerm CosmoPlast HydraFill Softline HydraFill Softline Max Surgiderm 18 Surgiderm 30 Surgiderm 24XP Surgiderm 30XP Juvéderm Ultra Smile Juvéderm ULTRA 2 Juvéderm ULTRA 3 Juvéderm ULTRA 4 Juvéderm VOLUMA Juvéderm HYDRATE Purified Human-based Collagen plus Lidocaine Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid plus lidocaine Non-Animal Hyaluronic Acid plus Lidocaine Non-Animal Hyaluronic Acid Non-Animal Hyaluronic Acid Purified human-based collagen 35 mg/ml. Purified human-based collagen 35 mg/ml, cross-linked with glutaraldehyde. *All collagen products contain 0.3% lidocaine. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 18 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. CE marked. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. *All Juvéderm ULTRA products contain 0.3% lidocaine. Non-animal, cross-linked cohesive hyaluronic acid 20 mg/g mg/g plus mannitol 0.9%; 1 x 1 ml syringe. Worldwide. Worldwide. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. Anteis S.A. (part of Merz Pharma GmbH & Co. KGaA) Belotero Hydro 18 mg/ml* Belotero Soft 20 mg/ml Belotero Balance 22.5 mg/ml Belotero Intense 25.5 mg/ml Belotero Volume 26 mg/ml *not cross-linked Hyaluronic Acid Monophasic hyaluronic acid (non-animal origin) with CPM (Cohesive Polydensified Matrix) manufactured using a patented dynamic cross-linking technology (DCLT). CE marked. U.S. approval pending. CE marked. U.S. approval pending. CE marked. FDA approved. CE marked. U.S. approval pending. CE marked. U.S. approval pending. Contura International A/S Aquamid Aquamid Reconstruction Polyacrylamide Gel (PAAG) 2.5% cross-linked hydrophilic PAAG and 97.5% non-pyrogenic water. Homogenous gel without particles for long lasting results in aesthetic and reconstructive indications. 1 x 1 ml syringe. CE-marked, sold in more than 30 countries worldwide. Galderma EMERVEL Restylane Restylane Touch Restylane Perlane Restylane Sub-Q Restylane Lipp Restylane Vital Macrolane VRF30 Macrolane VRF20 Hyaluronic Acid NASHA Non-Animal Hyaluronic Acid 20 mg/ml. NASHA gel a non-animal hyaluronic acid, stabilized with BDDE. The differentiation is in the size of the NASHA particles, to assure a tissue-tailored range of products. Restylane 100,000 particles per ml. Restylane Touch 500,000 particles per ml. Restylane Perlane 10,000 particles per ml. Restylane Sub-Q 1,000 particles per ml. Concentration 20 mg/ml. CE medical marked Restylane is approved worldwide with the exception of Japan. Restylane Perlane, Restylane Sub-Q and Restylane Touch are approved worldwide with the exception of Japan and U.S. U.S. approval in progress. Restylane Lipp approved in Europe. HIRONIC JUVINA Light JUVINA Moderate JUVINA Deep JUVINA Deep Plus JUVINA Light Comfort JUVINA Moderate Comfort JUVINA Deep Comfort JUVINA Deep Plus Comfort Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine 20 mg/ml for superficial lines, worry lines, crows feet and neck wrinkles. 20 mg/ml for deep nasolabial folds, facial contouring and augmentation. 20 mg/ml for severely deep lines, facial contouring and augmentation, and chin. 20 mg/ml for forehead, chin and nose. 20 mg/ml plus 0.3% lidocaine for superficial lines, worry lines, crows feet and neck wrinkles. 20 mg/ml plus 0.3% lidocaine for deep nasolabial folds, facial contouring and augmentation. 20 mg/ml plus 0.3% lidocaine for severely deep lines, facial contouring and augmentation, and chin. 20 mg/ml plus 0.3% lidocaine for forehead, chin and nose. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. Medytox, Inc. Neuramis Deep Non-Animal Hyaluronic Acid Non-animal, cross-linked cohesive hyaluronic acid, stabilized with BDDE. Concentration 20 mg/ml. CE marked. Merz North America, Inc. (part of Merz Pharma GmbH & Co. KGaA) Radiesse Radiesse Lidocaine CaHA CMC The principal component is synthetic calcium hydroxylapatite (CaHA) suspended in an aqueous sodium carboxymeth- FDA approved. CE marked. FDA approved. CE marked. ylcellulose gel matrix consisting primarily of water (sterile water for injection) and glycerin. Radiesse Lidocaine is enhanced with 0.3% integral lidocaine hydrochloride. mesoestetic mesohyal X-DNA mesohyal NCTC mesohyal HYALURONIC mesohyal VITAMIN C mesohyal ORGANIC SILICON Non-cross linked Cell membrane protection. hyaluronic acid + Sodium deoxyribonucleotide Non-cross linked Intensive cell biorevitalization. hyaluronic acid + Biorevitalizing cocktail Non-cross linked Moisturizing and rejuvenation of the skin. hyaluronic acid Non-cross linked hyaluronic acid + vitamin C Antioxidant and brightening effects. Non-crosslinked hyaluronic acid + Skin tissue regeneration and restructuring. silicon CE marked. CE marked. CE marked. CE marked. CE marked. Note: Data subject to change; please refer to Company Directory for supplier contact information. 80 THE Asian Aesthetic Guide Volume 13

81 Dermal Filler Product Comparison Chart Manufacturer Product(s) Key Component Description Regulatory Status Prollenium Medical Technologies, Inc. Revanesse Pure Revanesse Revanesse Ultra Revanesse Kiss Revanesse Contour ReDexis Revanesse, Revanesse Ultra, Revanesse Kiss and Revanesse Contour with Lidocaine Non-cross linked, nonanimal Hyaluronic Acid Non-Animal Hyaluronic Acid High-viscosity, non-animal Hyaluronic Acid Non-Animal Hyaluronic Acid High-viscosity, nonanimal Hyaluronic Acid Non-Animal Hyaluronic Acid, Dextranomer Beads Non-Animal Hyaluronic Acid plus Lidocaine 14 mg/ml hyaluronic acid for bio-revitalization. 25 mg/ml stabilized hyaluronic acid. 25 mg/ml stabilized hyaluronic acid. 25 mg/ml stabilized hyaluronic acid. 25 mg/ml stabilized hyaluronic acid. 25 mg/ml stabilized hyaluronic acid, 25 mg/ml dextranomer beads. 25 mg/ml stabilized hyaluronic acid, 0.3% lidocaine. CE marked, Health Canada. CE marked, Health Canada. CE marked, Health Canada. CE marked, Health Canada. Health Canada. Health Canada. Health Canada. S & V Technologies AG amalian balance amalian smoothline amalian LT I active amalian LT II intense amalian expert III amalian SF fine amalian SF medium amalian SF advanced Non-Animal Hyaluronic Acid 12 mg/ml HA, non cross-linked hyaluronic acid gel for skin rejuvenation. 8 mg/ml HA, cross-linked monophasic gel for orbital frame rejuvenation and smoothing of fine lines. 16 mg/ml HA, cross-linked monophasic gel for smoothing fine to moderate wrinkles. 24 mg/ml HA, cross-linked monophasic gel for filling moderate to deep wrinkles and folds. 24 mg/ml HA, cross-linked bi-phasic gel HA for restoring facial volume and contours. 16 mg/ml HA, cross-linked soft monophasic gel for smoothing of fine lines. 20 mg/ml HA, cross-linked soft monophasic gel for smoothing of fine to moderate wrinkles. 24 mg/ml HA, cross-linked soft monophasic gel for filling moderate to deep wrinkles and folds. CE marked. Sinclair Pharmaceuticals Ltd. Perfectha FineLines Perfectha Complement Perfectha Derm Perfectha Deep Perfectha SubSkin - 1 x 3 ml and 3 x 1 ml Ellansé 2 x 1 ml (-S, -M, -L, -E) Biodegradable crosslinked Hyaluronic Acid of non-animal origin CMC, Polycaprolactone (PCL) 20 mg/ml syringe of hyaluronic acid gel; variants available for filling superficial, moderate and deep wrinkles, non-surgical rhinoplasty, lip augmentation and contouring, facial contouring (jaw line redefinition, cheeks, chin, malar area) and volume loss. Perfectha SubSkin is also used for hand rejuvenation. Family of products with immediate volumizing effects and subsequent biostimulation with unique STAT Technology: Sustained performance throughout desired duration; Tunable longevity for choice and versatility and proven Total Bioresorbability. High safety and efficacy profile, available in four distinct formulations for results lasting from one to four years.* CE marked. KFDA. Class III Medical Device. CE marked. KFDA. CE marked. KFDA. CE marked. KFDA. CE marked. KFDA. CE Marked. Class III Medical Device. International regulatory approvals include, but are not limited to, Australia, Iran, Mexico, Russia, South Korea, UAE. *Expected longevity in vivo based on extrapolation of clinical data from S and M and accepted degradation behavior. Teoxane Teosyal Ultimate Teosyal Ultra Deep Teosyal Kiss Teosyal Deep Lines Teosyal Touch Up Teosyal Global Action Teosyal First Lines Teosyal Meso Teosyal PureSense Ultimate Teosyal PureSense Ultra Deep Teosyal PureSense Kiss Teosyal PureSense Deep Lines Teosyal PureSense Global Action Teosyal PureSense First Lines Teosyal PureSense Redensity I Teosyal PureSense Redensity II Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid Non Cross-Linked Hyaluronic Acid Cross-Linked Hyaluronic Acid plus Lidocaine Cross-Linked Hyaluronic Acid plus Lidocaine Cross-Linked Hyaluronic Acid plus Lidocaine Cross-Linked Hyaluronic Acid plus Lidocaine Cross-Linked Hyaluronic Acid plus Lidocaine Cross-Linked Hyaluronic Acid plus Lidocaine Non Cross-Linked Hyaluronic Acid plus Lidocaine plus Dermo Restructuring Complex Semi Cross-Linked Hyaluronic Acid plus Lidocaine plus Dermo Restructuring Complex Non-animal, cross-linked hyaluronic acid 22 mg/g. Non-animal, cross-linked hyaluronic acid 25 mg/g. Same as above. Same as above. Same as above. Same as above. Non-animal, cross-linked hyaluronic acid 20 mg/g. Non-animal, cross-linked hyaluronic acid 15 mg/g. Non-animal, cross-linked hyaluronic acid 22 mg/g plus 0.3% lidocaine. Non-animal, cross-linked hyaluronic acid 25 mg/g plus 0.3% lidocaine. Same as above. Same as above. Same as above. Non-animal, cross-linked hyaluronic acid 20 mg/g plus 0.3% lidocaine. Non-animal, cross-linked hyaluronic acid 15 mg/g plus 0.3% lidocaine plus eight amino acids, three antioxidants, two minerals and one vitamin. Same as above. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. CE Marked. Zimmer MedizinSysteme Germany ZFill refresh 2 ZFill contour 2 ZFill deep 2 Non-Animal Hyaluronic Acid Hyaluronic acid gel with glycerin. For mesotherapy, lasting hydration and revitalization. Hyaluronic acid gel implant. For correction of superficial and deeper facial lines, lip contours and lip volume. Stabilized with BDDE. Hyaluronic acid gel implant. For correction of deep lines and wrinkles, sunken areas of skin, facial contours and increased volume. CE marked. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

82 Body Shaping Technologies Comparison Chart Manufacturer Device Energy Source Mechanism of Action Regulatory Status (Europe and USA) BTL Industries, Ltd. BTL Vanquish ME BTL Exilis System Selective RF Focused Monopolar RF with Deep Cooling Contactless Selective RF system for volume reduction and body contouring. Focused RF with proprietary deep cooling system and induction of apoptosis. Precisely focused energy treats both deep subcutaneous fat and superficial skin and provides excellent results for body shaping, skin tightening and facial rejuvenation. CE cleared. FDA cleared. Health Canada cleared. KFDA cleared. CE cleared. FDA cleared. Health Canada cleared. KFDA cleared. Cutera trusculpt 3D Monopolar RF Selective, targeted heating of the subcutaneous tissue. CE cleared. FDA cleared. Cynosure, Inc. Smartlipo Smartlipo MPX Smartlipo Triplex Cellulaze PrecisionTx SmoothShapes XV PelleFirm RF Body Treatment Handpiece SculpSure Laser Lipolysis Laser Lipolysis Laser Lipolysis Cellulite Laser Platform Small Area Laser Lipolysis and Contouring Platform Non-Invasive Cellulite and Contouring Pellevé S5 RF Generator Diode (1060 nm) Designed with the 1064 nm wavelength for efficacy and safety. CE cleared. FDA cleared. ThermaGuide and SmartSense delivery systems provide real-time temperature and motion-sensing feedback. ThermaGuide temperature sensing cannula and SmartSense accelerometer for real time feedback nm and 1320 nm wavelengths CE cleared. FDA cleared. target fat and coagulate vessels; MultiPlex technology. ThermaGuide temperature sensing cannula and SmartSense accelerometer nm, 1320 nm and 1440 nm wavelengths target fat, coagulate CE cleared. FDA cleared. vessels and deliver tissue retraction; MultiPlex Technology. ThermaGuide temperature sensing cannula and SmartSense accelerometer nm wavelength; SideLaze3D side-firing fiber to treat the CE cleared. FDA cleared. three core defects of cellulite below the dermis. ThermaGuide temperature sensing cannula nm wavelength; CE cleared. FDA cleared. SideLaze800 side-firing fiber to treat small areas of fat and underneath the dermis to increase collagen production and skin thickness. Treat primary axillary glands under the arm for hyperhidrosis. Proprietary Photomology technology uses a combination of vacuum CE cleared. FDA cleared. while emitting both light (650 nm) and laser (915 nm) energy to treat the appearance of cellulite. RF monopolar tissue heating with integrated massage head for CE cleared. FDA cleared. temporary reduction in the appearance of cellulite. Non-invasive energy delivery below the skin s surface to disrupt CE cleared. FDA cleared. adipose cells for body contouring. DEKA SmartLipo 6 SmartLipo 10 SmartLipo 18 Triactive nm Nd:YAG Laser Lymphatic Massage and Skin Cooling. Ultrasound; Bipolar and Multipolar RF with / without Customized µpulsed Nd:YAG wavelength providing physiological contractions and elimination of fat with no inflammatory effects. Controlled photomechanical effect, photo-coagulative action and photo-stimulative course for immediate skin tightening due to flexible pulse design. Platform includes all available technologies for optimal body shaping. Face and body dermodynamic diode laser handpiece with cooling and vacuum. High and low frequency ultrasound; bipolar CE cleared. FDA cleared. CE cleared. Vacuum Massage and Skin Cooling and multipolar RF application with or without vacuum and skin cooling. Graphic tutorial with auto selection of parameters and proper handpiece. Store end user s protocols. Eunsung Global Corp. Cool Max PowerShape2 Cool Shaping Aurora 3Max Plus 3Max Coolshaping Well Spa Magic Pot Magic Polar Megason Beauty Pot Cooling Lipolysis Multipolar and Bipolar RF, Low Level Laser, Vacuum Cooling Lipolysis Multipolar RF, Vacuum Multipolar and Bipolar RF, Vacuum, Ultrasound Cavitation Cooling Lipolysis, Multipolar RF, Ultrasound Cavitation Vacuum and Mechanical Massage Multipolar RF, Vacuum, LED Multipolar RF Ultrasound Cavitation RF, Ultrasound Cavitation, Low Level Laser, LED Non-invasive transcutaneous delivery of cold to selectively and permanently eliminate fat cells. Combined bipolar and multipolar RF, vacuum and low level laser achieves powerful results. Non-invasive technology uses cold exposure to selectively and gradually lead to the reduction of subcutaneous fat. Multipolar RF energy induces irreversible thermal damage to adipose tissue by creating directionally controlled electrical fields within cutaneous and subcutaneous tissues. Advanced body sculpting system integrates ultrasound cavitation, RF and vacuum technologies. Advanced body slimming system integrates cooling lipolysis, ultrasound cavitation and multipolar RF. Effective treatment for fat and cellulite reduction. Special vacuum suction technology physically stimulates deep into the skin. Two rollers pull up the connective tissues to improve skin folds. RF delivers thermal energy into dermal layer and deep fatty layer in combination with strong vacuum suction technology. Applicator delivers RF energy to localized target areas in the dermal and fatty layers. Non-invasive ultrasound cavitation system delivers energy into the skin without pain. Applicator delivers RF, utrasound cavitation, LED and low level laser energy to localized target areas in the dermal and fatty layers. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. Fotona d.d. SP Dynamis XP-2 Focus Nd:YAG Nd:YAG Photothermal - heat generated by laser light. Photothermal - heat generated by laser light. CE cleared. FDA cleared. CE cleared. FDA pending. HIRONIC Micool-A VeraShape ByeLIPO Cooling Lipolysis Multipolar RF: 0.5 MHz, Vacuum, 580 mm Hg, LED 610 mm 658 nm Diode Cooling energy is delivered to the subcutaneous fat layer without any damage to surrounding tissues. Two Cryolipo handpieces can be used simultaneously. Vacuum-assisted multipolar RF and LED device for obesity care. CE cleared. CE cleared. Low level laser therapy (LLLT) for fat reduction and cellulite removal. CE cleared. Note: Data subject to change; please refer to Company Directory for supplier contact information. 82 THE Asian Aesthetic Guide Volume 13

83 Body Shaping Technologies Comparison Chart Manufacturer Device Energy Source Mechanism of Action Regulatory Status (Europe and USA) Jeisys Medical LIPOcel High Intensity Focused Ultrasound Non-invasively reduces fat cells by heating them up to 70 C without epidermal damage via HIFU with contact cooling. Surface temperature maintained at 5 C to reduce pain and deliver high energy. Three different depth cartidges (8, 11, 13 mm) allows treatment of all areas. Lutronic ACCUSCULPT encurve Pulsed Nd:YAG: 1444 nm (12 W, 300 mj, 40Hz) Radiofrequency The 600 µm optical fiber-delivered 1444 nm beam achieves effective interstitial lysis of target adipocytes through photothermal and photomechanical mechanisms. High absorption of 1444 nm in fat and water ensures powerful photothermal destructive effect aided by the tumescent approach, providing safety for overlying tissues through thermal confinement phenomenon. High peak powers and 100 µs pulse width create explosive reaction in the water at the fiber tip, causing cell membrane destruction through photomechanical stress. Ideal for laser-assisted facial contouring and fat deposits on the body. Apoptosis-inducing RF penetrates deep into the tissue, targeting adipocytes. Adipocytes oscillate rapidly causing frictional heat, which raises the adipocyte temperature to 45 initiating cells denaturization. This denaturation causes changes in the integrity of the adipocyte membrane, which leads to apoptosis, with expulsion of the intracellular lipid. The body s natural removal process takes over, permanently removing the damaged cells. CE cleared. FDA cleared. KFDA cleared. CE cleared. KFDA cleared. MedixSysteme SPASHAPE ULTRACONTOUR U.LIFT SygmaLift S.Shape Fractional Focal Ultrasound and 685 nm Laser High Focalized Ultrasound plus UMD multi-sequential drainage High Focalized Ultrasound plus UMD multi-sequential drainage, HFU, Tri- Fractional Ultrasound, 635 nm Laser HIFU, Fractionated Ultrasound combined with 685 nm Cold Laser Patented, clinically proven fractional focal ultrasound combined with 685 nm cold laser for biostimulation. Pulsed focal energy disrupts fat cell membranes while laser biostimulates immediate drainage. HFU combined with 18 probe UMD for ultrasonic lymph drainage. Pulsed focal energy disrupts fat cell membranes. Multi-sequential ultrasonic drainage stimulates lymph process. U.LIFT is a focal ultrasound probe to treat cellulite. HFU remodels facial harmony by reducing fat volume in chin and jaw lines, tri-fractional and LLLT smooth crows feet, nasolabial folds and enhance skin glow. Pulsed focal energy disrupts fat cell membranes while laser biostimulates immediate drainage. CE medical cleared. FDA pending. CE medical cleared. FDA pending. CE marked. FDA pending. CE medical cleared. FDA pending. PerfAction Technologies, Ltd. EnerJet EnerJet2.0 AirGent2.0 Pneumatic Energy Pneumatic Energy Pneumatic Energy Kinetic energy jet reaches up to 6 mm under the skin without needles, each shot covering 1 cm 2 of the target area. These nano-bullet particles of healing compounds create controlled micro-trauma sites. As these sites heal, they produce long lasting results for face-lifting, scar repair, stretch mark repair and dermal thickening. JVR powered, a new dosing system, stronger jet stream, lighter and new designed applicator, intuitive and modern user interface to allow a simpler usage of the device for non-surgical deep remodeling and long lasting skin treatments, together with needle-free intradermal compound delivery. JVR powered; a new dosing system, stronger jet stream, lighter and new designed applicator, intuitive and modern user interface to allow a simpler usage of the device. Delivers more jet-shots per minute, enabling shorter treatment sessions. CE cleared. CE cleared. CE cleared. Sciton SkinTyte ProLipo PLUS CelluSmooth Infrared Light Deep dermal heating to stimulate new collagen production nm Nd:YAG / 1064 nm Nd:YAG Laser-assisted destruction of fat cells and collagen remodeling nm Cutting fibrous septae, emulsifying fat and tightening the dermis to improve the appearance of lumpy and dimpled skin. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. Syneron Candela VelaShape III UltraShape Power Bi-Polar RF, Infrared Light, Vacuum and Mechanical Massage Focused Ultrasound Combined energies known as elōs precisely target and heat fatty tissue within Tx area. Vacuum and tissue manipulation evens out skin to reveal a smoother, tighter figure. Pulsed focused ultrasound technology for fat cell destruction using mechanical, non-thermal ultrasound for fast painless treatments. CE cleared. FDA cleared. CE cleared. FDA cleared. Thermi ThermiRF Thermi250 Temperature Controlled RF Temperature Controlled RF Temperature Controlled RF used in general surgical procedures for FDA cleared. electrocoagulation and hemostasis, and to create lesions in nerve tissue. Temperature Controlled RF to provide temporary reduction in the FDA cleared. appearance of cellulite. ZELTIQ CoolSculpting Cryolipolysis Non-invasively reduces fat through Cryolipolysis-based technology. CE cleared. FDA cleared. Fat cells are more vulnerable to energy extraction (cooling) than surrounding tissues. A non-invasive applicator is attached to the targeted procedure area to extract energy from the underlying fat tissue, while protecting the skin, nerves, muscles and other tissue. The cooled fat cells undergo apoptosis and are gradually eliminated reducing the thickness of the fat layer. Zimmer MedizinSysteme Germany ZWave ZWave Pro ZLipo Radial Shockwave Radial Shockwave Cryocontouring Lipolysis; Vacuum Unfocused low energy radial waves impact collagen structure CE cleared. and the skin s connective tissue, improving blood circulation and metabolism of fat cells. Effective treatment of connective tissue weakness, stretch marks and cellulite. Same as above. CE cleared. Targets fat deposits for permanent non-invasive reduction. Cools fat over a longer period of time to a controlled and safe temperature range. Studies have shown that combining Tx with ZWave Pro improves results. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

84 Fractional Technologies Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Asclepion Laser Technologies MCL31 Dermablate MultiPulse TattooStar Effect COMBO TattooStar Effect R TattooStar R Er:YAG CO 2 laser Q-Switched Nd:YAG / Ruby Q-Switched Ruby Q-Switched Ruby 2940 nm 10,600 nm 532 nm, 585 nm, 694 nm, 1064 nm 694 nm 694 nm 2.5 J 30 W max. 1.5 J / 1.2 J 1.2 J 1.2 J 100 1,000 μm Pulsed, Superpulse, CW, 2,000 μs max. with scanner 8 ns / 40 ns 40 ns 40 ns VarioSpot handpiece with 1 6 mm spot; VarioSpot XL handpiece with 8 12 mm spot; MicroSpot handpiece with microlens array and variable skin coverage. Smoke evacuation system integrated. Fixed Focus handpiece with 0.4 mm spot; Zoom handpiece with mm spot; Scanner MicroPulse with pitch of 200 2,000 μm. Fractional handpiece (Ruby), Dye handpiece (Nd:YAG). Fractional handpiece. Fractional handpiece. Cutera xeo pearl xeo pearl fractional YSGG YSGG 2940 nm 2940 nm Up to 3.5 J/cm 2 <400 mj 1000 µs 1000 µs Cynosure, Inc. SmartSkin+ Icon 1540 handpiece 2940 handpiece Emerge Cortex Resurfacing Work Station Fractional CO 2 Fractional Non- Ablative Laser Fractional Ablative Laser Fractional Non- Ablative Laser CO 2 / Er:YAG Laser 10,600 nm 1540 nm 2940 nm 1410 nm 10,600 nm / 2940 nm 30 W Up to 70 mj per microbeam 3 24 mj mj/mb Up to 40 W / up to 1 J ms 10 and 15 ms ms 4 20 ms Adj. to 6 ms / 300 µs Customizable power, dwell time, density and pulse stacking. Surgical and scanning handpieces with integrated scan pattern controls. Six different scan patterns. XF microlens provides high, non-ablative coverage for fast resurfacing treatments. The XD microlens offers greater treatment depth for challenging conditions. Three light delivery modes: manual activation for focused Tx areas, AutoStamp for faster treatments, AutoGlide for ease of use and enhanced comfort; five pre-set parameters for the treatment of pigment, wrinkles, or general skin resurfacing; multiple energy and microbeam density settings; each setting can be manually adjusted for a range of Tx parameters. Lightweight, compact system design; intuitive user interface. Fractional CO 2 combined with Er:YAG with 1.5, 3 and 6 mm spot sizes. One year manufacturer warranty. DEKA SmartXide DOT SmartXide 2 DOT/RF SmartXide Touch Fractional CO 2 Fractional CO 2 plus RF Fractional CO 2 plus RF 10.6 µm 10.6 µm 10.6 µm 50 W max. 80 W max. 60 W max µs µs µs DOT Scanner and freehand handpiece; touchscreen monitor; Stack feature; Smart Track delivery mode, Smart Pulse; patient database; CW, PW, traditional and fractional scanning modes available. PSD technology with selectable pulse shape (SP, DP, UP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF Scanner with RF feature; freehand; TFT touchscreen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos, patient database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. PSD technology with selectable pulse shape (SP, DP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF Scanner with RF feature; freehand; TFT touchscreen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos, patient database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. Eunsung Global Corp. Duet RF Fraction CO 2 Bipolar / Monopolar RF CO 2 10,600 nm 7 50 W mj 70 1,600 ms ms Partical handpiece with easy tip replacement. NS, NC, NCE; 64 pin, 100 pin, 196 pin. Specialized handpiece for optimum functionality. Micro spot beam size more than 70 μm. Fotona d.d. SP Dynamis XS Dynamis Nd:YAG / Er:YAG Er:YAG 1064 nm / 2940 nm 2940 nm Up to 600 J/cm 2 Up to 500 J/cm ms ms F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. Er:YAG handpieces: mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. Er:YAG handpieces: mm spot sizes. HIRONIC MIXEL CO 2 Fractional 10,600 nm 60 mj Up to 5,000 µs Metal tube; scanner type, scan size 2 x 2 mm to 20 x 20 mm, beam size: 70 µm µm. Max. spot quantity: 40,000. Note: Data subject to change; please refer to Company Directory for supplier contact information. 84 THE Asian Aesthetic Guide Volume 13

85 Fractional Technologies Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Ilooda Co., Ltd. Fraxis DUO Fraxis Secret RF Multiple IRIS CuRAS CO 2 Fractional / RF Microneedle CO 2 Fractional RF Microneedle OPS Diode Laser Q-Switched Nd:YAG 10,600 nm 10,600 nm 532 nm (Fractional); 532 nm (Normal) 1064 nm / 532 nm 30 W / 20 W 30 W 25 W 70.7 J/cm 2 ; 832 J/cm J/cm ms / ms ms ms 100 ms; 400 ms 5 20 ns; 100 ns; 300 µs RF fractional needle handpiece; CO 2 fractional handpiece; optional surgical handpiece. CO 2 fractional handpiece; optional surgical handpiece. 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas such as around the eyes; optional smart pen handpiece for acne and thread vein. 532 nm Fractional, 532 nm Normal; available to treat vascular lesions in the epidermis. Energy meter including Zoom handpiece; collimated handpiece; optional fractional handpiece. Jeisys Medical INTRAcel PRO INTRAcel IntraGen Edge Fractional ULTRAcel Fractional RF Microneedling Fractional RF Microneedling Grid Fractional RF Fractional CO 2 Laser Multi-Functional Platform (HIFU / Fractional RF Microneedling / Grid Fractional RF) 10,600 nm Up to 50 W Up to 50 W Up to 200 W mj Up to 3 J / up to W / up to 200 W 10 ms 5 sec 5 1,000 ms 0 2 sec ms ms / 60 2,000 ms / 0 2 sec 49 tip (insulated). Insulated (except 0.3 mm) at end of tips where RF is emitted. SRR Tip / 16 Tip (non-insulated). Bipolar and monopolar available. Invasive tip (FRM) and non-invasive tip (SRR). Bipolar and monopolar available. Insulated except for 0.3 mm at end of the tips where it emits the RF energy. Full tip (15 x 15 mm) and small tip (7 x 7 mm). Spot size: 120, 350, 800 μm; surgical tip; surgical handpieces (50 and 100 mm). Platform device features HIFU RF microneedling and non-invasive RF technology. HIFU: B cartridge (depth: 3.0 mm); C cartridge (depth: 4.5 mm). FRM: FRM tip; SRR tip. GFR: large (15 x 15), small (7 x 7) tip. Lutronic ACTION II Lasemd eco2 INFINI MOSAIC HP Fractional Er:YAG Laser Thulium CO 2 Fractional laser Bi-Polar Fractional RF Er:Glass 2950 nm 1927 nm 10,600 nm 1550 nm Normal: 50 J, Long pulse: 180 J Up to 20 mj Up to 240 mj 50 W Up to 120 mj Normal: 250 µs, Long Pulse: 1,000 ms Ultra Pulse: 40 1,000 µs; Super Pulse: 1 5 ms 10 ms - 1,000 ms Fractional, Zoom, Shining Peel and Petit Lady handpieces. Roller set, comb tip set, square tip set, Lasemd ampoules and cosmetics. Fractional or Insicional handpieces. Variety of fractional handpiece tips available: 120, 300, 500 micron tip. Variety of handpieces and tips available. MFR handpiece: 49 tip (7 x 7 needles, scan size: 10 x 10 mm), Comfort / 16 tip (4 x 4 needles, scan size: 5 x 5 mm); SFR handpiece: 144L tip (12 x 12 electrodes, Dual Channels, scan size: 20 x 20 mm), 64S tip (8 x 8 electrodes, Single Channel, scan size: 10 x 10 mm). 10 x 10 mm, 8 x 8 mm, 6 x 6 mm, 5 x 10 mm, Contact tip, Hair tip. Sciton ProFractional Halo diva Er:YAG Hybrid Fractional Laser (ablative and non-ablative) Hybrid Fractional Laser (ablative and non-ablative) 2940 nm 1470 nm / 2940 nm 1470 nm / 2940 nm Up to 400 J/cm mj/mtz / 50 mj/ MTZ 150 mj/mtz, 200 mj/ MTZ Variable Up to 5 ms Up to 5 ms Expandable module/density 1.5% to 26%. Delivery of ablative and non-ablative wavelengths in single pass. Dynamic Thermal Optimization (DTO) for precise energy delivery. Roller tip adaptors; optical navigation; integrated Zimmer cooling advanced mode for precise and independent control of depth and density. Pre-programmed modes and integrated smoke evacuation system. Hybrid Fractional Laser Technology for the improvement of vaginal tissue. Independently configurable delivery of both ablation and coagulation. High Precision Automation (HPA) Technology allows configurable treatment parameters with automatic energy delivery. Strengthened Quartz Dilator (SQD) optimized energy delivery by dilating tissue and providing 360º of laser delivery. Syneron Candela Profound elōs plus/etwo Sublative Rejuvenation CO 2RE PicoWay Bi-Polar RF 460, 5 khz Fractional Bi-Polar RF CO 2 Resurfacing System Picosecond 10,600 nm 1064 nm, 532 nm fractional handpiece Max. output voltage 84 VRMS Up to 100 mj/pin / up to 62 mj/pin Up to 453 J/cm ms 450 picoseconds, 375 picoseconds RF microneedling device for mandibular and submandibular contouring and wrinkles. elōs: 64/44 pins. etwo: standard 64 pin tip with 12 x 12 mm spot. Focal 44 pin tip with 11 x 3 mm spot. Reusable, tapered fractional and surgical Tx handpieces. Four digital super pulsed fractional treatment modes including CO 2RE Light, Mid, Deep and Fusion. Classical ablation and CW Surgical Mode. Rejuvenation, pigmentation and toning with limited or no downtime. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE Asian Aesthetic Guide Volume

86 Emerging Aesthetic Technologies Comparison Chart Supplier Product Technology Applications Asclepion Laser Technologies BTL Industries, Ltd. Juliet BTL Vanquish ME Exilis Ultra 360 BTL Intima BTL X-Wave MCL31 Dermablate 2940 nm Er:YAG Patented Selective RF Monopolar RF and Ultrasound with Controlled Cooling Focused Monopolar RF; EFC Elite Acoustic Wave Therapy Cutera trusculpt 3D Monopolar RF Body sculpting. Cynosure, Inc. PicoSure Alexandrite; 755 nm and 532 nm, Picosecond Pulses DEKA MonaLisa Touch SmartXide 2 with Hi Scan V 2 LR Scanning; Fractional CO 2 with PSD Eunsung Global Corp. Dr.Skin OctoLine2 AquaClean Beauty Heart Spring Hydra Beauty Jet Clear Smartline EPN Electroporation, Microdermabrasion, Vacuum; 27 W; 2,600 ms Ultrasound, Water Jet Peel; 2.6 W; ms Aqua Peeling Electroporation; ms Electroporation, Cryoelectroporation; 680 ms Multi-Polarity Electroporation, Aqua Peeling Water Jet Peel Electroporation, Iontophoresis, Ultrasound, Cryo Microneedling, Electroporation (0 2 mm needle penetration depth) Fotona IntimaLase 2940 nm Er:YAG with SmoothMode HIRONIC The HydraFacial Company EasyMo Graft Ultra Vera HydraFacial Perk Automated Follicular Unit Extraction (FUE) Hair Transplant Device High Intensity Focused Ultrasound (HIFU) Hydradermabrasion Hybrid Exfoliation Vaginal atrophy and mild stress urinary incontinence. Body shaping / fat removal device with FDA clearance for circumferential reduction of abdomen and thighs. Advanced technology for body contouring, skin tightening, facial rejuvenation and intimate health / wellness. Applicators for face and body (head to toe treatment) and exchangable single use tips for vulvovaginal procedure. Feminine rejuvenation and labia remodeling. Skin and connective tissue tightening, cellulite treatment, improvement of uneven lipoplasty results and lymphatic system stimulation. Skin rejuvenation, tattoo removal and pigmented lesions. Feminine rejuvenation - restore natural physiological and mechanical mucosa conditions; improve reduced vaginal lubrication, vulvar itching and painful intercourse. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Acne treatment. Skin rejuvenation. Skin rejuvenation and acne treatment. Feminine rejuvenation - tightening of internal vaginal tissues. Ilooda Co., Ltd. Gynolaser Handpiece CO 2 Fractional; 10,600 nm; 30 W Vaginal tightening and urinary incontinence. Lutronic Lasemd Pico + 4 Petit Lady Thulium Fractional Laser; 1927 nm Picosecond Nd:YAG (1064 nm, 532 nm, 595 nm and 660 nm); 750 ps, 2 ns 2940 nm Er:YAG with Dual Mode 10,600 nm CO 2 Fractional Supports extraction and implantation processes with automated mechanical technologies: pneumatic for extraction and implantation, rotation power for extraction and positive pressure for implantation. Equipped with a low temperature storage system (1 C - 5 C) to improve the survival rate of follicular units. Non-invasive vaginal tightening to improve vaginal dryness and urinary incontinence. Treatment takes 20 minutes and is painless with no downtime or bleeding. Non-laser skincare offering customizable facial procedure to improve appearance of fine lines, wrinkles, enlarged pores, congested skin and brown spots. Targets sensitive zones including the delicate eye and lip areas through liquid exfoliation. Treatment vial transforms into take-home product for extended benefits. Delivery of cosmeceutical ampoules: Vitamin C, Vitamin A, Tranexamic Acid, CK (Human blood cell conditioned Media + KGF) and RS (Resveratrol). Pigmented lesions, tattoos. Vaginal tightening. Urinary incontinence. Vestibule and introitus tightening. mesoestetic mct injector mesocarboxytherapy Anti-aging and skin rejuvenation. PerfAction Technologies, Ltd. EnerJet2.0 Jet Volumetric Remodeling (JVR) Kinetic non-surgical lifting; dermal remodeling for face, neck and decollette; scar tissue remodeling including all types of acne scars, red and white stretch marks, keloid and hypertrophic scars. Sciton diva 1470 nm / 2940 nm Hybrid Fractional Laser (Ablative and Non-Ablative) Sinclair Pharmaceuticals, Ltd. Silhouette Soft Poly-L-Lactic Acid Resorbable Device with Poly-L-Lactide / Glycolide Bi-Directional Cones (8, 12 or 16 cones) Improvement of vaginal tissue. Independently configurable delivery of both ablation and coagulation. High Precision Automation (HPA) Technology allows configurable treatment parameters with automatic energy delivery. Strengthened Quartz Dilator (SQD) optimized energy delivery by dilating tissue and providing 360º of laser energy. Used for elevation and compression of facial and neck tissues. Syneron Candela Thermi Ulthera, Inc., a division of Merz, Inc. PicoWay PicoWay Resolve CO 2RE Intima ThermiRF ThermiVa Thermi250 The Ulthera System Cellfina System 532 nm, 1064 nm, Picoseconds 532 nm, 1064 nm Fractional Handpieces CO 2 Temperature-Controlled RF Temperature-Controlled RF Temperature-Controlled RF Micro-Focused Ultrasound with Visualization Tissue Stabilized-Guided Subcision (TS-GS) Tattoo removal. Skin rejuvenation, pigmentation and toning. Women s wellness and vaginal rejuvenation. Offers a myriad of soft tissue applications. Heats tissue in the vulvovaginal area. Temporary reduction in the appearance of cellulite. Neck, chin and brow lifting; chest wrinkles. Viveve, Inc. Viveve System Cryogenically-Cooled Monopolar RF Womens health and wellness. Long-term reduction of cellulite, up to two years by precise release of targeted structural tissue (fibrous septae). WONIK INNOJECTOR Needle-Free Injection System powered by Highly Pressurized Pneumatic Technology Zimmer MedizinSystems ZWave ZCryo Ballistic Radial Pulse Cold Air (up to -22º F) Scars, lifting, wrinkles, stretch marks, etc. Temporary reduction in the appearance of cellulite. Skin cooling pre, intra and post laser treatments without interfering with the laser beam. Minimizes pain and thermal injury during laser and dermatological treatments. Temporary topical anesthetic relief for injections. Can be used for hair removal, tattoo removal and skin rejuvenation procedures. Note: Data subject to change; please refer to Company Directory for supplier contact information. 86 THE Asian Aesthetic Guide Volume 13

87 PRODUCT PROFILES ZLipo As you would expect from a world leader in cryotherapeutic solutions, ZLipo is based on the latest research and technology. High functionality and modern design meet all requirements of an innovative practice. Two holders on the outside of the device are convenient spots for handpiece storage. In addition, a tray on top of the device is perfect for accessories, etc. The sophisticated design makes it easy to reach all areas selected for treatment. Juliet Juliet the feminine laser concept by Asclepion is an innovative, minimally invasive laser technology for the treatment of vaginal atrophy and stress urinary incontinence. It provides fast and painless treatments, with no need for anesthesia and minimal downtime. A newly designed handpiece, combined with the latest fractional Erbium:YAG technology, allows for the selective stimulation of sub-mucosal collagen synthesis, leading to an improvement of the tissue and its metabolism restoration with immediate results. Zimmer MedizinSysteme: or visit or HydraFacial HydraFacial is the only hydradermabrasion procedure that uses patented technology to cleanse, extract and hydrate. Packed with vital nutrients like antioxidants, peptides and hyaluronic acid, the super serums create an instantly gratifying glow and it is the unique serum delivery that puts HydraFacial into a category of its own. Asclepion Laser Technologies: +49 (0) or visit The HydraFacial Company: or visit Enerjet2.0 The Enerjet2.0 further advances the category of nonsurgical therapies for deep remodeling and long lasting skin treatments, together with supreme needle-free intradermal compound delivery. The synergy between these two effects sets in motion a cascade healing process, resulting in natural healing and hydrating that generates production of new collagen, ultimately volumizing, hydrating and remodeling collagen in one short and simple treatment. This single, innovative, non-thermal and nonsurgical solution is suitable for all skin types and all areas of the body. PerfAction, Ltd or visit enerjet-med.com Body By BTL Founded in 1993, BTL has become a major manufacturer of medical and aesthetic equipment, offering advanced non-invasive solutions for body shaping, skin tightening and other medical aesthetic treatments. With an unlimited number of product combinations, the new Body By BTL program takes the aesthetic market to the next level. BTL Vanquish ME, BTL Exilis, BTL X-Wave and BTL Exilite treat the body from head to toe with outstanding results and no costly consumables. The range of clinically proven devices offers a safe and non-invasive solution without any downtime. BTL Industries: or visit Ulthera System The Ulthera System delivers Ultherapy Treatment a non-surgical procedure using micro-focused ultrasound to stimulate the body s natural healing process to non-invasively lift and tighten skin. Ultrasound technology enables physicians to see and treat the deepest support layers of the skin without cutting the surface of the skin. The system s unique DeepSEE imaging ensures proper coupling of the transducer to the skin and confirms appropriate depth of treatment to avoid bone and vessels. Ultherapy has received the EU CE Mark for lifting and sculpting the dermis of the upper and lower face, neck and décolleté, and is the only U.S. FDA cleared non-invasive lift. In just one minute treatment results appear naturally and gradually over the course of 2-3 months. Ulthera, Inc., a division of Merz, Inc.: or visit THE Asian Aesthetic Guide Volume

88 PRODUCT PROFILES MOTUS AX The new MOTUS AX 755 nm high frequency alex laser system offers totally painless and smokeless hair removal procedures to all types of patients. Utilizing DEKA s proprietary new Mŏveō Technology, MOTUS AX provides a high comfort procedure with excellent tolerability. MOTUS AX allows for no stress procedures for users also. The easy and full parameter controls (three levels: Soft, Medium, High) and countdown selectable energy levels give physicians the ability to tailor treatments on all patients and for all skin types. Viveve System Viveve Medical, Inc. is committed to advancing solutions to improve women s overall wellbeing. Backed by randomized, placebocontrolled data, their flagship product, the Viveve System, uses patented, cryogencooled, monopolar radiofrequency (CMRF) to remodel vaginal tissue in a single, 30-minute session satisfying patient demand for a painless solution for vaginal laxity. Vaginal laxity is associated with decreased sexual sensation and urinary incontinence. DEKA: or visit Ultracontour Ultracontour, an advanced ultrasonic device for body contouring, features two focal transducers one dedicated to fat (UC HIFU), the second for cellulite (U.Lift) combined with 18 ultrasonic probes for lymphatic drainage (UMD). This system is completely non-invasive and internationally patented with CE medical accreditation. With no consumable transducers and a complete treatment taking only 45 minutes, Ultracontour saves time and money. The fat removal efficiency has been scientifically proven by sonography in compression. Viveve Medical, Inc.: or visit MedixSysteme: or visit INNOJECTOR INNOJECTOR features micro-jet vortex technology to induce collagen synthesis. This vortex technology delivers millions of micro compounds pneumatically, penetrating deep into the skin. A recently published paper confirmed that INNOJECTOR s vortex stream reaches beyond the SMAS layer.* * Lasers in Surgery Investigating Skin Penetration Depth and Shape Following Needle-Free Injection at Different Pressures: A Cadaveric Study. WONIK Corporation: or visit Aquamid Aquamid Reconstruction is a non-absorbable hydrophilic gel consisting of 97.5% water and 2.5% crosslinked polyacrylamide. It is designed for soft tissue augmentation for aesthetic and reconstructive purposes and acts by adding volume to soft tissue. Aquamid gives an immediate, natural look and feel, and integrates completely into subcutaneous tissue. It does not degrade over time, and the aesthetic results will remain for years. The efficacy and safety of Aquamid have been documented in several international clinical studies. ThermiRF ThermiRF is a platform technology that combines temperature control with advanced realtime temperature monitoring to enable various minimally and non-invasive aesthetic applications. The temperature control capability of ThermiRF allows physicians to customize the selected therapeutic endpoint for each patient. Contura International A/S: or visit Thermi, an Almirall Company: or visit 88 THE Asian Aesthetic Guide Volume 13

89 PRODUCT PROFILES encurve The encurve is an easy and comfortable way to reduce fat through apoptosis-inducing radiofrquency. Working via controlled delivery of energy deep into the adipose tissue, encurve utilizes a specialized frequency (27.12 MHz) combined with the ideal 300 Watts of power to selectively target and heat adipocytes to the optimal temperature causing denaturation of cells, leading to death of adipocytes. Halo Halo is a Hybrid Fractional Laser that delivers a non-ablative and ablative wavelength to the same microscopic treatment zone. Combining these two wavelengths creates a strong synergistic effect, resulting in ablative results with non-ablative downtime. The non-ablative wavelength of 1470 nm is tunable from 200 to 700 microns, the optimal depth for treating the epidermis and papillary dermis. The 2940 nm Er:YAG laser provides pure ablation with no bulk heating, tunable from 20 to 100 microns. Lutronic: or visit PowerShape2 PowerShape2 is a non-invasive system that combines bipolar radiofrequency (RF), low level laser and vacuum in one platform for safe and convenient treatments. RF delivers thermal energy deep into the dermal layer and applies electromagnetic waves to initiate physiological processes. Low level laser increases blood circulation and boosts metabolism, while vacuum massage alleviates minor muscle pain, etc. PowerShape2 provides three different handpieces for the treatment of various regions. Sciton: or visit Eunsung: or visit SP Dynamis This all-in-one, anti-aging laser platform, allows fast, precise and efficient procedures with reduced recovery times. With fully customizable settings, the system offers true third-generation Er:YAG resurfacing. The Nd:YAG wavelength is a gold standard for hair removal, rejuvenation, acne, pigmented and vascular indications. Nd:YAG scanner compatibility further enhances treatment speed, safety and efficacy, especially for large application areas. The SP Dynamis combines popular aesthetic treatments with additional minimally-invasive surgical procedures (laser lipolysis, hyperhidrosis treatment etc.). Fotona: or visit LIPOcel LIPOcel is an advanced technology for body contouring and fat reduction with high intensity focused ultrasound (HIFU). The LIPOcel procedure guarantees high safety by using a non-invasive method, so as not to damage the peripheral tissues, and transmits energy precisely only to the subcutaneous fat layer. VISIA 7 The all new 7th Generation VISIA Complexion Analysis System revolutionizes skincare with improved functionality in a smaller, sleeker design. The VISIA 7 delivers a significantly improved experience for both patient and practitioner with improved workflow, faster capture and enhanced analysis software. The VISIA offers automated skin type classification, refined feature detection and enhanced product recommendations. The 7th Generation VISIA is available in 24 languages. Jeisys Medical: or visit Canfield Imaging Systems or visit THE Asian Aesthetic Guide Volume

90 PRODUCT PROFILES CoolSculpting CoolSculpting by ZELTIQ Aesthetics is the number one most requested, non-surgical body sculpting procedure. The groundbreaking CoolSculpting technology uses a patented cooling process to target and eliminate fat cells, without downtime, anesthesia, or pain medication during treatment. Millions of CoolSculpting treatments have been performed worldwide. SmartXide 2 DOT/RF The new SmartXide 2 DOT/RF system offers unsurpassed flexibility and control. Utilizing DEKA s proprietary Pulse Shape Technology (PSD ), a complete array of pulses are selectable upon necessity. Stack technology, plug and play accessories and computer-based protocols complete this state-of-the-art platform. SmartXide 2 DOT/RF provides less downtime, less intraoperative and post-op pain, and excellent skin tightening with a bi-polar RF scanner, as well as vulvovaginal reshaping. ZELTIQ Aesthetics: 888-ZELTIQ-1 or visit PicoWay PicoWay, the dual wavelength 532 nm/1064 nm laser with the shortest picosecond pulse duration, is the clear choice for tattoo and pigment removal. PicoWay can treat a broad range of pigmented lesions, as well as tattoo types and colors on any skin type. Proprietary technology effectively impacts tattoo ink and pigmented lesions, without the negative thermal effects of other lasers. PicoWay Resolve handpieces target skin at both the epidermal and dermal layers. As the latest addition to the PicoWay system, the 785 nm wavelength enables optimal treatment for blue and green inks, making PicoWay the first 785 nm picosecond-domain laser. DEKA: or visit Syneron Candela: or visit mesoéclat mesoéclat is the first complete anti-aging method with instant, lasting action. Treatment combines professional sessions in office and maintenance phases at home. With deeper penetration of the active ingredients at each session, the results accumulate over time and the benefits become more visible. mesoéclat helps promote a renewal of the upper layers of the epidermis, restores the radiance to the skin and hydrates deep down into the dermis. As a result, it eliminates wrinkles and expression lines and the skin is softer, smoother and more even. mesoestetic: or visit European Society of Aesthetic Gynecology The European Society of Aesthetic Gynecology (ESAG) is a leading organization specializing in cosmetic and aesthetic gynecology. ESAG constantly contributes to the promotion of innovation within the field of cosmetic and aesthetic gynecology, and since 2014 it has delivered comprehensive live surgery training courses on invasive and non-invasive female genital procedures. For the first time ever, in 2018 ESAG will offer the Chinese Master Class Live Cases Demonstration Workshop. Learn more about ESAG and its professional network, or enjoy the benefits of a senior member by subscribing for an annual senior membership today. ESAG: +44 (0) / or visit BTL Vanquish ME The BTL Vanquish ME redefines body contouring with enhanced features for consistent results in trimmed waistlines and thighs. This FDA cleared system provides non-surgical circumferential reduction of the abdominal area. Scientific studies published in peerreviewed journals validate BTL Vanquish ME s patented technology to induce death of fat cells via apoptosis without disturbing values of serum lipid and liver-related blood tests. This contactless device employs a first-of-its-kind technology using a panel array that creates a high-frequency Selective RF energy field. BTL Industries: or visit 90 THE Asian Aesthetic Guide Volume 13

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