This article was originally published on MedTech Intelligence.
In recent decades, Asia’s aesthetics medicine market has grown very quickly. According to the American Society for Aesthetic Plastic Surgery, global cosmetic procedures have increased by nearly 40% over the past five years, with nonsurgical procedures up 44%. While countries such as South Korea, Japan and Thailand have long been well-known aesthetics medicine hubs and markets, others markets such as mainland China, Taiwan, and India are quickly taking market share. This change has been driven by rising disposable income, advancing technology, and a higher interest in beauty, as well as an increasing demand and awareness of aesthetics medical technologies.
East Asian blepharoplasty surgery, or double-eyelid surgery, continues to see sustained growth in the region. According to a 2016 HSBC report, the cosmetic surgery market value in China is estimated to double from 2014 to 2019, when it is expected to reach $116 billion and become the world’s third-largest market. The majority of consumers seeking double-eyelid surgery are young women, but the number of middle-aged women is also growing. Asian men are also increasingly receptive to cosmetic surgery and make up around 15-20% of the cosmetic market. Aside from blepharoplasty, other facial reconstruction procedures such as nose reconstruction and chin alteration are popular in Korea, Japan, and the greater China region.
Derma fillers, medical device implants designed to fix wrinkles and tighten skin, have traditionally not been as popular in Asia as in Europe or America. However, demand is beginning to increase as the populations of many Asian countries age. Japan has the oldest population in the world, with over one-quarter of its population over the age of 65. Korea, Hong Kong, Singapore, and Taiwan are also some of the fastest aging populations in the world. According to the UN, China’s elderly population, currently one-quarter of the world’s elderly population, is set to double in the next 20 years.
In 2014, Allergan (Dublin, Ireland), the manufacturer of Botox, established its Asia-Pacific headquarters in Singapore in anticipation of growth in the region. Allergan has focused on developing its “Juvéderm” brand, which has remained one of the top-selling derma fillers in Asia. In March 2017, Allgergan received US FDA approval for its Juvéderm Vollure XC to target deep wrinkles, and Juvéderm Volbella for lips.
Valeant Pharmaceuticals (Laval, Canada) is also a key player in the Asian derma filler market with its “Restylane” brand Hyaluronic Acid (HA) filler. According to the Valeant’s 2015 Annual Report, the company’s sales revenue in China grew over 150% from 2013-14 and is expected to continue growing in the upcoming years. In the same period from 2013-14, the China and Japan markets generated $480 million dollars of revenue for Valeant.
Body Fat Reduction
Liposuction and other fat reduction procedures have traditionally had much less demand in Asia than in Europe and North America due to the low prevalence of obesity and the dislike of invasive techniques. However, with the development of non-surgical and minimally-invasive techniques, as well as the rise of unhealthy diets and increasingly sedentary lifestyles, fat reducing products are witnessing a dramatic rise in the Asia-Pacific markets.
In April 2017, Allergan acquired Zeltiq Aesthetics (Pleasanton, CA), which developed the cryolipolysis technique for non-invasive fat reduction, commonly marketed under the brand name “CoolSculpting.” CoolSculpting involves applying a specialized medical device that freezes and kills targeted fat areas in the body. In July 2016, the CoolSculpting procedure for use in the abdomen and flanks received approval from China’s CFDA.
In 2015, Cynosure received US FDA clearance for its non-invasive laser fat reduction device “Sculpsure” for use in the abdomen and flanks. Similar to CoolSculpting, Sculpsure permanently destroys fat cells using heat from a diode laser. The use of Sculpsure in the back and thighs was later approved by the US FDA in June 2017. In June 2016, Cynosure received approval from the Korean MFDS to market Sculpsure in the country.
Other non-invasive fat removal techniques currently marketed in the Asia-Pacific include Ultrashape, Liposonix, and BTL Vanquish.
Breast implantation is among the most popular cosmetic surgical procedures worldwide. While market growth in North America and Europe is beginning to stagnate, there is a much larger growth potential in the Asia-Pacific. The growth of disposable personal income and increasing aesthetic consciousness have been the main drivers of this trend. Saline implants are more popular than silicone implants in Asia compared to Europe and North America due to genetic factors. A number of developments in breast implant technology, including cohesive gels and breast tissue expanders have also driven recent growth.
Allergan and Johnson & Johnson are among the major multinational players in the Asian breast implant market. In September 2016, Allergan received US FDA approval for its “Natrelle Inspira” cohesive gel product, which enables more customized implants. In April 2017, Johnson & Johnson (New Brunswick, NJ) also received US FDA approval for its Mentor brand MemoryGel Xtra, and Johnson & Johnson is also currently developing a breast tissue expander product under the Mentor Artoura brand. A number of Asian companies, such as Hans Biomed (Seoul, Korea), have also emerged as important regional players.
Laser and Other Energy Medical Devices
Laser hair removal is one of the fastest growing segments of the global laser and energy medical device market, and has seen immense growth in Asia. Unlike waxing, shaving or using creams, the use of lasers permanently reduces the total amount of hair on the body. The demand for laser hair removal devices has grown faster in Asia than in North America and Europe due to Asian beauty standards, which highly value smooth, hairless skin. Aside from hair removal, laser and other energy technologies have also been used to treat wrinkles, lesions, liver spots, other types of skin damage, as well as for skin tightening.
Tria Beauty (Dublin, CA), has been one of the first major foreign laser medical device companies to establish an Asia-Pacific office in Tokyo. Tria’s anti-aging laser is the company’s best-selling product in Japan, while its hair removal products dominate in China and other Asian markets. Other major brands in laser hair removal and skincare in the Asian markets include Silk’n, Remmington, and Lumenis.
Venus Concept (Toronto, Canada), a medical aesthetics company that produces medical devices for hair removal, skincare, and body contouring, established a sales office in Shanghai in 2014 to promote sales in the region. Venus Concept’s “Venus Freeze” is the one of the only radiofrequency skin-aging technology that has received approval from both the FDA and China CFDA.
While the demand for tattoo removal laser technology in Asia has been lower than in the US or Europe, there has been recent growth in the region, particularly in China and Japan. The global tattoo removal market has increased over fourfold in the last decade, with laser technologies taking an increasingly large portion of that market. Although tattoos have recently gained more social acceptance in East Asia, they often still remain stigmatized with association to gangs or criminal activity. As tattoos become more prevalent particularly among the younger generation in China and Japan, so do the instances of “tattoo regret” and subsequent removal.
Cynosure, Inc. (Westford, MA), a leading laser-based aesthetics medical device firm, produces a number of hair, tattoo and lesion removal lasers, as well as plastic surgery technologies. The company has established two offices in China, and one in both Japan and Korea. According to Cynosure’s 2016 10K report, the company’s sales revenue in the Asia-Pacific region increased by 46% in the second quarter of 2016 after the approval of its “PicoSure” tattoo removal system in China at the end of 2015.
Cutera Inc. (Brisbane, CA), another top laser aesthetics medical device firm, has set up a regional office in Tokyo and has also established a distribution partnership with ConBio China to facilitate the distribution of its tattoo and laser removal products in China. According to Cutera’s 2016 10K report, the company’s sales in the Asia Pacific excluding Japan (APEJ) region increased by 41%, compared to its 21% global average.
Medical Tourism for Aesthetics
Medical tourism has also been a key driver of the aesthetics medical market in Asia. The global medical tourism market is predicted to surpass $48 billion by 2021, with the Asian medical tourism market valued at $17 billion. The top medical tourism countries for cosmetic procedures in 2017 include Korea, Taiwan, and Thailand.
Korea has been commonly called the “plastic surgery capital of world,” as it has the highest number of cosmetic procedures per capita. In 2016, Korea’s medical tourism industry was worth $1.5 billion and nearly half a million individuals traveled to the country as medical tourists, many of whom received cosmetic procedures.
As Asians get wealthier and more concerned about how they look, opportunities in Asia’s aesthetic market will skyrocket.