The demand for surgical and nonsurgical aesthetic or cosmetic treatment has exploded in the United States (U.S.), with dozens of new treatments for improving the appearance of the 75 million aging Baby Boomers. From the incredible growth in Botox injections and dermal fillers such as Restylane, to the recent reapproval and growth in sales of silicone breast implants, the surgical and nonsurgical cosmetic market included nearly 11.5 million procedures in 2006, according to the American Society for Aesthetic Plastic Surgery (ASAPS). Nonsurgical procedures such as injectable dermal fillers have, in particular, experienced significant growth due to their growing popularity and virtually painless, noninvasive, highly profitable, office-based administration, and their ability to make patients’ faces look younger and fuller for longer periods of time.

This report discusses selected surgical and nonsurgical aesthetic products (dermal fillers, facial neurotoxins, breast implants, microdermabrasion and liposuction devices/equipment), which contributed approximately $1.2 billion in U.S. sales in 2006. This high-demand, primarily patient-pay market is expected to more than double, at a compound annual rate of approximately 18%, reaching more than $2.7 billion in 2011.

The top 3 aesthetic growth segments over the next 5 years will be facial neurotoxins, breast implants, and dermal fillers. Facial neurotoxins (Botox) reached nearly $660 in annual U.S. sales in 2006 and is expected to continue double-digit growth; however, this area may see the entrance of new products that may break Allergan’s monopoly. The companion facial injectable market of dermal fillers will continue to benefit from popular products such as Perlane, Restylane and Juvéderm, as well as several new, next-generation longer-life, improved fillers. Together, dermal fillers and neurotoxins will contribute more than 65% of total aesthetic product sales, totaling approximately $1.9 billion in 2011. Breast implants, which contributed 2006 U.S. sales of more than $300 million, are expected to continue annual growth of more than 20% due to new, improved silicone implants with lengthy safety histories and stringent patient monitoring. These implants more closely mimic the natural breast and, like the facial injectable market, are aggressively advertised/marketed by leading competitors Allergan and Mentor.

This comprehensive new report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities. Covered topics in this report include: breast implants, dermal fillers, facial neurotoxins, microdermabrasion systems, facial reconstruction implants, liposuction surgical systems, and emerging aesthetic products and technologies.

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TABLE OF CONTENTS

EXECUTIVE SUMMARY

i.    Leading Surgical and Nonsurgical Aesthetic Procedures

ii.    Market Analysis

iii.   Competitive Analysis—Dermal Fillers and Neurotoxins

iv.   Competitive Analysis—Breast Implants

v.   Methodology

Exhibit ES-1:    2006, Top 5 Surgical Aesthetic Procedures

Exhibit ES-2:    2006, Top 5 Nonsurgical Aesthetic Procedures

Exhibit ES-3:    2006, Selected Leading Surgical and Nonsurgical Aesthetic Procedures

Exhibit ES-4:    Leading Aesthetic Procedures, Physician and Patient Expenditures, 1997, 2005, and 2006

Exhibit ES-5:    2006, Dermal Fillers, by Type

Exhibit ES-6:    Leading Surgical and Nonsurgical Aesthetic Products, Market Forecast, by Type, 2006-2011

Exhibit ES-7:    2006, Surgical and Nonsurgical Aesthetic Products Market, Estimated Share of Sales, by Segment

Exhibit ES-8:    2011, Surgical and Nonsurgical Aesthetic Products Market, Estimated Share of Sales, by Segment

Exhibit ES-9:    2006, Dermal Fillers and Neurotoxins Market, Share by Supplier

Exhibit ES-10:  2006, Dermal Fillers Market, Share by Supplier

Exhibit ES-11:  2006, Allergan, Medicis Aesthetics/Medicis Pharmaceutical, and Mentor:  Dermal Filler and Neurotoxin Product Lines

Exhibit ES-12:  2006, Breast Implants Market, Share by Supplier

1. AESTHETICS OVERVIEW

1.1 Anatomy of the Skin

1.1.1 Epidermis

1.1.2 Dermis

1.1.3 Subcutaneous Tissue

1.1.4 Collagen and Elastin

1.2 Anatomic Changes Associated with Photoaging of the Skin

1.2.1 Sagging

1.2.2 Wrinkles and Creases

1.2.3 Pigmentation Defects

1.2.4 Vascular Defects

1.3 Acne

1.4 Body Shape

Exhibit 1-1:      Anatomy of the Skin

Exhibit 1-2:      Collagen

Exhibit 1-3:      The Collagen Remodeling Process

Exhibit 1-4:      The Effects of Time and Gravity on Facial Skin

2. DERMAL FILLERS AND NEUROTOXINS

2.1 Dermal Fillers

2.1.1 Collagen

2.1.1.1 Allergan:  CosmoDerm and CosmoPlast, and Zyderm and Zyplast

2.1.1.2 Other Collagen and Natural Tissue Fillers

2.1.1.2.1 ColBar LifeScience /Johnson & Johnson:  EVOLENCE

2.1.1.2.2 Fascia Biosystems:  Fascian

2.1.1.2.3 Isolagen Technologies/Isolagen:  Isolagen Therapy

2.1.1.2.4 Lifecell Corporation:  Cymetra

2.1.2 Hyaluronic Acid

2.1.2.1 Allergan:  Juvéderm

2.1.2.2 Allergan and Genzyme:  Captique and Hylaform

2.1.2.3 Medicis Aesthetics/Medicis Pharmaceutical:  Perlane and Restylane

2.1.2.4 Other Hyaluronic Acid Fillers

2.1.2.4.1 Groupe Cornéal Laboratoires/Allergan:  Surgiderm

2.1.2.4.2 Anika Therapeutics:  Cosmetic Tissue Augmentation

2.1.2.4.3 Anteis:  Esthélis

2.1.2.4.4 BioPolymer:  Matridex, Matridur, and Matrigel

2.1.2.4.5 Dermatech:  Dermadeep and Dermalive

2.1.2.4.6 Mentor:  Prevelle and Puragen

2.1.2.4.7 Merz Pharmaceuticals/Merz Group:  Belotero and Hyal-System

2.1.2.4.8 O.R.Gé.V. Laboratories:  MacDermol

2.1.2.4.9 Prollenium Medical Technologies:  Revanesse

2.1.2.4.10 Q-Med:  Macrolane

2.1.2.4.11 Rofil Medical International:  Artecoll and Rofilan

2.1.2.4.12 Teoxane Laboratories/Teoxane:  Teosyal

2.1.3 Synthetic Dermal Fillers

2.1.3.1 Artes Medical:  ArteFill

2.1.3.2 BioForm Medical:  Radiesse

2.1.3.3 Contura International:  Aquamid

2.1.3.4 Dermik Laboratories/sanofi-aventis:  Sculptra

2.1.3.5 FzioMed:  Laresse

2.2 Neurotoxins

2.2.1 Allergan:  BOTOX Cosmetic

2.2.2 Emerging Neurotoxins

2.2.2.1 Medicis Aesthetics/Medicis Pharmaceutical and Ipsen:  Reloxin and Dysport

2.2.2.2 Mentor:  Puretox

2.2.2.3 Merz Pharmaceuticals/Merz Group:  NT 201

2.2.2.4 Prollenium Medical Technologies:  Botulinum Neurotoxin Type A

2.2.2.5 Revance Therapeutics:  Topical Botulinum Neurotoxin Type A

Exhibit 2-1:      2006, Dermal Filler Procedures, Average Physician Fees

Exhibit 2-2:      Injectable Dermal Filler Process

Exhibit 2-3:      Selected Smile Line and Lip Border Treatment Using CosmoDerm and CosmoPlast, Before and After

Exhibit 2-4:      Dermal Filler Material Processed with Glymatrix Technology

Exhibit 2-5:      2007, Commercialized Hyaluronic Acid Dermal Fillers, Dates of United States Food and Drug Administration Approval

Exhibit 2-6:      2007, Selected New Hyaluronic Acid Dermal Fillers:  Duration, Collagen Synthesis, and Lidocaine Incorporation

Exhibit 2-7:      2007, Selected Hyaluronic Acid Dermal Fillers

Exhibit 2-8:      Restylane’s Long-Term, Volume-Enhancing Process

Exhibit 2-9:      Restylane Compared to Zyplast, Clinical Trial Results

Exhibit 2-10:    Selected Surgiderm Treatment, Before and After

Exhibit 2-11:    Selected Puragen Treatment, Before and After

Exhibit 2-12:    2007, Selected Synthetic, Non-Hyaluronic Acid Dermal Fillers

Exhibit 2-13:    Radiesse Compared to CosmoPlast, Clinical Trial Results

Exhibit 2-14:    2007, Radiesse versus Restylane, Patient Cost Comparison

Exhibit 2-15:    Selected Radiesse Treatment, Before and After

Exhibit 2-16:    Advantages of FzioMed’s Laresse, Compared to Conventional Dermal Fillers

Exhibit 2-17:    Clumping Effects of Competitive Hyaluronic Acid Fillers, Compared to Nonparticulate Laresse

Exhibit 2-18:    Selected Laresse Treatment, Before and After

Exhibit 2-19:    2007, Selected Injectable Cosmetic Neurotoxins

Exhibit 2-20:    Selected BOTOX Cosmetic Treatment, Before and After

3. MICRODERMABRASION

3.1 Overview

3.2 Products

3.2.1 Aesthetic Solutions

3.2.2 Aesthetic Technologies

3.2.3 Altair Instruments

3.2.4 DermaMed International

3.2.5 Dynatronics

3.2.6 Edge Systems

3.2.7 Genesis Biosystems

3.2.8 Lumenis

3.2.9 Mattioli Engineering

3.2.10 RAJA Medical

3.2.11 Sybaritic

3.2.12 Syneron

3.3 Laser-Based Peels

3.3.1 Candela

3.3.2 Sciton

3.3.3 Sybaritic

Exhibit 3-1:      Chemical Peel’s Effect on Skin Tissue

Exhibit 3-2:      Microdermabrasion, Selected Features, Benefits, and Indications

Exhibit 3-3:      2007, Selected Microdermabrasion Systems

Exhibit 3-4:      Aesthetic Solutions’ Parisian Peel Dermaglow II Microdermabrasion System

Exhibit 3-5:      Altair Instruments’ DiamondTome System

Exhibit 3-6:      DermaMed International’s MegaPeel Microdermabrasion Systems

Exhibit 3-7:      Edge Systems’ Delphia IIe Plus Microdermabrasion System

Exhibit 3-8:      Edge Systems’ Delphia Del Sol System

Exhibit 3-9:      Genesis Biosystems’ MT-2 Turbo Medical Microdermabrasion System with Plug-n-Peel

Exhibit 3-10:    Lumenis’ Crystal-Stream and Crystal-Free Tips

Exhibit 3-11:    Mattioli Engineering’s Ultrapeel Patented Delivery Kit System and 45-Degree, V-Shaped Handpiece

Exhibit 3-12:    RAJA Medical’s VitasoniX Sapphire 3 Photo Abrasion System

Exhibit 3-13:    VitasoniX Sapphire 3 Photo Abrasion, Features and Benefits

Exhibit 3-14:    Sybaritic’s SkinBella System

Exhibit 3-15:    Sybaritic’s LaserPeel Soft-MET System

4. BREAST IMPLANTS

4.1 History of Breast Implants

4.2 Safety of Breast Implants

4.2.1 Post-Approval Requirements for Saline and Silicone Gel-Filled Implant Manufacturers

4.2.1.1 Allergan

4.2.1.2 Mentor

4.2.2 Mentor’s Core Study, Three-Year Results

4.2.2.1 Implant Rupture

4.2.2.2 Capsular Contracture

4.2.2.3 Other Risks

4.2.2.4 Overall Patient Satisfaction

4.3 Products

4.3.1 Allergan

4.3.2 Mentor

4.3.3 Other Suppliers Breast Implant Companies

4.3.3.1 AorTech International

4.3.3.2 Ideal Implant

4.3.3.3 MediCor LTD

4.3.3.4 Rofil Medical International

4.3.3.5 Sientra

Exhibit 4-1:      Diagram of the Female Breast

Exhibit 4-2:      Post-Market Approval Conditions for Allergan’s Silicone-Filled Breast Implants

Exhibit 4-3:      Breast Implant Shapes and Sizes

Exhibit 4-4:      2007, Selected Breast Implants

Exhibit 4-5:      Allergan’s Natrelle (Inamed) Saline and Silicone Breast Implants

Exhibit 4-6:      Mentor’s MemoryGel and Saline Breast Implants

Exhibit 4-7:      Comparison of Mentor’s Saline and MemoryGel Breast Implants

Exhibit 4-8:      Mentor’s Spectrum Postoperatively Adjustable Breast Implants

Exhibit 4-9:      Features and Benefits of AorTech International’s Elast-Eon Breast Implant Shell

5. FACIAL RECONSTRUCTION

5.1 Blepharoplasty

5.2 Face Lift

5.3 Forehead Lift

5.4 Minimally Invasive Midface Lift

5.4.1 Coapt Systems:  ENDOTINE Line

5.4.2 Kolster Methods Incorporated:  Silhouette Mid-Face Suture

5.4.3 Surgical Specialties/Angiotech:  Contour Threads

5.5 Cheek Implants and Chin Augmentation

5.6 Rhinoplasty

5.7 Lip Augmentation

Exhibit 5-1:      Selected Facial Cosmetic Surgical Procedures, 1997, 2005, and 2006

Exhibit 5-2:      Blepharoplasty Procedure

Exhibit 5-3:      Face Lift Procedure

Exhibit 5-4:      Forehead Lift Procedure

Exhibit 5-5:      Coapt Systems’ ENDOTINE Line of Fixation Products

Exhibit 5-6:      Coapt Systems’ ENDOTINE Midface ST Tines, Leash, and Deployment

Exhibit 5-7:      Coapt Systems’ ENDOTINE Midface ST Implantation Technique

Exhibit 5-8:      Coapt System’s ENDOTINE ST Treatment, Before and After

Exhibit 5-9:      Coapt Systems’ ENDOTINE Midface B Technique, Before and After

Exhibit 5-10:    Claimed Advantages of the Silhouette over Barbed Sutures

Exhibit 5-11:    The Silhouette Mid-Face Procedure

Exhibit 5-12:    Images of the ContourLift Procedure

Exhibit 5-13:    Allergan’s Spectrum Facial Implants

6. LIPOSUCTION

6.1 Fat Reduction Techniques

6.1.1 Abdominoplasty

6.1.2 Gastric Bypass and Gastric Banding

6.1.3 Mesotherapy

6.1.4 Liposuction

6.1.4.1 Products

6.1.4.1.1 Byron Medical/Mentor

6.1.4.1.2 MicroAire Surgical Instruments

6.1.4.1.3 Sound Surgical Technologies

6.1.4.1.4 Wells Johnson

6.2 Noninvasive Cellulite Reduction and Fat Removal Systems

Exhibit 6-1:      Abdominoplasty Technique

Exhibit 6-2:      Common Body Areas Targeted by Liposuction

Exhibit 6-3:      2007, Selected Liposuction Devices

Exhibit 6-4:      Selected Byron Medical/Mentor’s UltraSculpt Treatment, Before and After

Exhibit 6-5:      Selected Features and Benefits of Sound Surgical Technologies’ VASER LipoSelection System

7. MARKET ANALYSIS

7.1 Leading Surgical and Nonsurgical Aesthetic Procedures

7.2 Market Forecast

7.3 Market Segments

7.3.1 Neurotoxins

7.3.1.1 Market Drivers

7.3.1.2 Market Limiters

7.3.1.3 Competitive Analysis

7.3.2 Dermal Fillers

7.3.2.1 Market Drivers

7.3.2.2 Market Limiters

7.3.2.3 Competitive Analysis

7.3.3 Microdermabrasion

7.3.3.1 Market Drivers

7.3.3.2 Market Limiters

7.3.3.3 Competitive Analysis

7.3.4 Breast Implants

7.3.4.1 Market Drivers

7.3.4.2 Market Limiters

7.3.4.3 Competitive Analysis

7.3.5 Liposuction

7.3.5.1 Market Drivers

7.3.5.2 Market Limiters

7.3.5.3 Competitive Analysis

Exhibit 7-1:      2006, Top 5 Surgical Aesthetic Procedures

Exhibit 7-2:      2006, Top 5 Nonsurgical Aesthetic Procedures

Exhibit 7-3:      2006, Selected Leading Surgical and Nonsurgical Aesthetic Procedures

Exhibit 7-4:      Leading Aesthetic Procedures, Physician and Patient Expenditures, 1997, 2005, and 2006

Exhibit 7-5:      Leading Surgical and Nonsurgical Aesthetic Treatments, Procedure Volumes Forecast, 2006-2011

Exhibit 7-6:      2006, Dermal Fillers, by Type

Exhibit 7-7:      Leading Surgical and Nonsurgical Aesthetic Products, Market Forecast, by Type, 2006-2011

Exhibit 7-8:      2006, Surgical and Nonsurgical Aesthetic Products Market, Estimated Share of Sales, by Segment

Exhibit 7-9:      2011, Surgical and Nonsurgical Aesthetic Products Market, Estimated Share of Sales, by Segment

Exhibit 7-10:    2006, Dermal Fillers Market, Share by Supplier

Exhibit 7-11:    2006, Dermal Fillers and Neurotoxins Market, Share by Supplier

Exhibit 7-12:    2006, Allergan, Medicis Aesthetics/Medicis Pharmaceutical, and Mentor:  Dermal Filler and Neurotoxin Product Lines

Exhibit 7-13:    Allergan and Medicis Aesthetics/Medicis Pharmaceutical:  BOTOX and Dermal Fillers, Worldwide Sales Growth, 2005-2007

Exhibit 7-14:    Allergan, Medicis Aesthetics/Medicis Pharmaceutical, and Mentor:  Worldwide Sales Growth, 2005-2007

Exhibit 7-15:    2006, Breast Implants Market, Share by Supplier

Exhibit 7-16:    Allergan and Mentor:  Breast Implants, Worldwide Sales Growth, 2005-2007

8. COMPANY PROFILES

8.1       Aesthetic Solutions, Inc.

8.2       Allergan, Inc.

8.3       Anika Therapeutics, Inc.

8.4       AorTech International PLC

8.5       Artes Medical, Inc.

8.6       BioForm Medical, Inc.

8.7       Coapt Systems, Inc.

8.8       ColBar LifeScience LTD/Johnson & Johnson

8.9       Dermik Laboratories, Inc./sanofi-aventis SA

8.10     Edge Systems Corporation

8.11     FzioMed, Inc.

8.12     Kolster Methods Incorporated

8.13     Medicis Aesthetics, Inc./Medicis Pharmaceutical Corporation

8.14     MediCor LTD

8.15     Mentor Corporation

8.16     Merz Pharmaceuticals LLC/Merz GmbH & Company KGaA

8.17     Prollenium Medical Technologies, Inc.

8.18     Revance Therapeutics, Inc.

8.19     Rofil Medical International NV

8.20     Sound Surgical Technologies LLC

APPENDIX:  COMPANY LISTING