Similar 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.
Throughout APAC, practitioners have grown more interested in the many minimally or non-invasive energy-based (laser, light, radiofrequency, cryolipolysis, radial shockwaves, CO2, 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 2021. 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.”
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 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.”
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 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.”
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.”
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 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.”