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SPECIAL REPORT CATCHING UP WITH BOTOX COSMETIC’S NEWEST SPOKESPERSON ACTRESS JENNY MOLLEN Modern Aesthetics® chats with actress Jenny Mollen and her derm BFF Patricia Wexler, MD BY DENISE MANN, MS

enny Mollen and her go-to dermatologist, New York City’s Patricia Wexler, MD have such a close rapport that they can, and often do, finish each other’s sentences. And it was like this from the get-go, shares Dr. Wexler. “It’s a chemistry that doesn’t happen that Joften,” she admits. “I love all of my patients, but I don’t always get to express my personality. You can’t do that with every patient.” Ms. Mollen, 40, clearly isn’t just any patient. She is an actress, New York Times-best selling author, and something of an Instagram phenom. She calls Dr. Wexler “Pat” and sees her often for treatments, touch ups, or just to say hi and show off a new coat. Ms. Mollen and her husband actor Jason Biggs often double date with Dr. Wexler and her husband. “It just works,” they both say, almost in unison. feels about growing older. She first started getting Botox in “She is clearly an influencer, but I don’t call her that,” her late twenties. “The one in my eleven was getting very Dr. Wexler adds. That said, Ms. Mollen is influential. Her strong and I wanted to curb it,” she recalls. At the time she Instagram account boasts 408k followers who take her was living in Los Angeles and there was no stigma attached advice on everything and anything from making kids lunch- to injectables or any cosmetic treatment. “It wasn’t a secret. es (she packs an elaborate Bento box for her sons) and all Everyone did it, including my mom.” things parenting and style including Botox Cosmetic and Ms. Mollen and Dr. Wexler are now in a committed doc- other anti-aging tweakments. tor-patient relationship, and Ms. Mollen admits that she Dr. Wexler and Ms. Mollen sat down with Modern had her share of “flings” with other aesthetic health care Aesthetics® as part of a media blitz to promote Allergan’s providers. She was very public about the severe bruising she first annual National Botox Cosmetic Day, which was experienced after having her lip fillers dissolved. held on November 20. “I like filler,” she says. “I may have gone to the wrong doc- So how did Ms. Mollen celebrate National Botox Day? tor at first.” Scooping up special “Buy one/Get one” gift cards for every- Dr. Wexler had her at “skin cancer check.” one on her holiday list. “It’s the best Christmas gift and it “You can go to any storefront med spa to get injections can expose my friends who haven’t gotten there yet. It’s a at your own risk, but I wanted to give her a proper exam,” cool way to say ‘Listen, I am hooking you up.’“ Dr. Wexler says. Ms. Mollen’s first visit involved a head-to- Ms. Mollen’s book titles “I Like You Just the Way I Am” toe skin cancer screening. “I liked that she was a straight and “Live Fast, Diet Hot” speak volumes about how she shooter,” Ms. Mollen recalls. The rest is history.

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REVANCE’S DAXI NOW ONE STEP trials, SAKURA 1 and SAKURA 2, were medical aesthetics to develop and CLOSER TO FDA NOD recently presented at the American commercialize innovative treatments Revance Therapeutics, Inc. has sub- Society for Dermatologic Surgery for hair loss disorders,” says Dr. David mitted a Biologics License Application (ASDS) 2019 Annual Meeting and Giljohann, CEO of Exicure. “This col- (BLA) to the FDA for daxibotulinum- published in Plastic and Reconstructive laboration is an exciting opportunity toxinA for Injection (DAXI) in the Surgery as well as accepted for future to advance Exicure’s SNA technology treatment of moderate to severe gla- publication in the Journal of the in an important new therapeutic bellar lines. American Academy of Dermatology. area.” Under the current Prescription Drug User Fee Agreement (PDUFA VI), the FDA has agreed to file acceptable ALLERGAN, EXICURE ENTER DR. ROY GERONEMUS AWARDED THE applications within 60 days of receipt COLLABORATION DEAL TO DISCOVER VIC NARURKAR, MD INNOVATIONS and to review the majority of BLAs AND DEVELOP SNA-BASED TREATMENTS IN AESTHETIC DERMATOLOGY within 10 months following the Day FOR HAIR LOSS DISORDERS LECTURESHIP AWARD 60 filing date. Based on that timeline, Revance anticipates potential product approval in the second half of 2020. “The submission of our BLA rep- resents a significant milestone in the company’s history and initiates Exicure, Inc. and Allergan’s our transition from a development wholly-owned subsidiary, Allergan company to a commercial organiza- Pharmaceuticals International Limited, tion. I’m incredibly excited about the have entered into a global collabora- opportunity to introduce the first tion agreement to discover and develop truly novel advancement in neuro- novel treatments for hair loss disorders modulator products in over 30 years. based on Exicure’s proprietary spherical Roy Geronemus, MD of Laser and We believe that a long-acting neuro- nucleic acid (SNA) technology. Skin Surgery Center of New York modulator product will fill a signifi- Under terms of the agreement, received, The American Society for cant, unmet need in both aesthetics Allergan will receive exclusive access Dermatologic Surgery inaugural Vic and therapeutics and that the market and options to license SNA-based thera- Narurkar, M.D., Innovations in Aesthetic is hungry for innovation,” says Mark peutics arising from two collaboration Dermatology Lectureship Award. Foley, President and Chief Executive programs related to the treatment of Dr. Geronemus received the Officer of Revance, in a news release. hair loss disorders. Exicure will receive award at the 2019 ASDS annual “As we manufacture our own product an upfront payment of $25 million and meeting in Chicago. He delivered in the United States, the BLA filing will conduct discovery and develop- the lecture “Expanding the Scope represents a monumental achieve- ment in two collaboration programs of Dermatologic Surgery Through ment for a company of our size, which for hair loss disorders. In the event that Lasers and Related Technologies” at was only made possible through the Allergan exercises an option, Allergan the meeting. This lecture honors the incredible dedication and commit- will be responsible for the clinical devel- legacy of Dr. Vic Narurkar. ment of our employees.” opment and commercialization of the Dr. Narurkar is a great educator DAXI has been evaluated in three licensed products. Exicure will be eligible and exercised excellent clinical judg- Phase 3 trials (SAKURA 1, 2, 3). to receive development and regulatory ment and care to his patients,” Dr. Both SAKURA 1 and SAKURA 2 milestones of up to $97.5 million per Geronemus told Practical Dermatology®, demonstrated that half of the patients program and commercial milestones of Modern Aesthetics’®, sister publication, treated maintained none or only up to $265 million per program. Exicure in a recent interview. mild frown lines for at least 24 weeks will also be eligible to receive tiered roy- (approximately six months), after a alties on worldwide net product sales of single treatment. Additionally, frown mid-single-digit to mid-teens percent- MERZ: CELLFINA FOR CELLULITE lines did not return to their pre- ages on worldwide net product sales. CLEARED FOR 5 YEARS OF BENEFIT treatment severity for at least 26–28 “We are excited to combine our The FDA has cleared a new indica- weeks for half of the patients treated. knowledge of nucleic acid therapeu- tion for Cellfina that shows the ben- Results from the two pivotal Phase 3 tics with Allergan’s deep expertise in efits of treatment last for five years,

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five years. We are proud of this new taboo, she said with a nod to the old indication, and it is a true testament tagline “only her hairdresser knows for to Cellfina’s efficacy and our commit- sure.” Today, women are open about ment to bring customers the latest their aesthetic treatments, she says. innovations in medical aesthetics.” A poster presentation from Endo included data from the RELEASE-1 and RELEASE-2 Phase 3 studies, previ- an increase from the previous three- AMERICAN SOCIETY FOR ously presented at the 2019 Aesthetic year indication. Cellfina from Merz DERMATOLOGIC SURGERY ANNUAL Society meeting. The identically demonstrated five-year improvement MEETING UPDATES designed, randomized, double-blind- in the appearance of cellulite on the New and emerging technologies ed, placebo-controlled trials assessed buttocks and thighs of adult females. as well as innovative approaches to the efficacy, safety, and tolerability of Five-year durability makes Cellfina the existing treatments took the spotlight collagenase clostridium histolyticum longest-lasting FDA-cleared treatment at the 2019 annual meeting of the (CCH) for the treatment of cellulite for cellulite on the market. American Society for Dermatologic in women. A greater percentage of The new indication is based on Surgery in Chicago this fall. the 843 women treated during the observations by an independent phy- Presenters addressed aesthetic studies met the primary endpoint of sician using before and after patient topics like small volume filler place- response with CCH versus placebo photographs at five years post-treat- ment. “Focus on certain areas,” says in both studies. Most adverse events ment. Results showed that after a sin- Terrence Keaney, MD. He notes that observed in CCH-treated patients gle in-office treatment, 100 percent of when using small volumes, “you can were transient, mild/moderate, and follow-up patients still had noticeable optimize filler by placing it in certain injection-site related (e.g., bruising, improvements. Follow-up studies at locations where you get bigger bang pain, induration, pruritus, erythema, one, three, and five years after a single for your buck.” and discoloration). in-office treatment showed sustained In a similar vein, Sabrina Fabi, MD Endo launched a “Redefining improvements. explained how she achieves dramatic Scientific Artistry” campaign at the “Cellfina is the benchmark and improvement in the lower face— ASDS Annual Meeting with a mobile- continues raising the bar for any including indirect lip enhancement—by first website intended to serve as an other cellulite treatments, with both injecting in the chin. “With just 1cc of educational platform for consumers longevity of results and effectiveness,” filler…in the chin, you can have beauti- and physicians who want to learn said board-certified Miami cosmetic ful aesthetic outcomes,” Dr. Fabi says. more about the company and cellu- dermatologist Jeremy Green, MD In an interview with Joel L. Cohen, lite science. “Cellulite is an emotionally charged MD, dermatologist Nazanin Saedi, Allergan celebrated the enrollment medical condition that affects 85 per- MD talked about maximizing treat- of six million members in its Brilliant cent of women worldwide. While the ments through combinations. For Distinctions program at a reception data has clearly shown that Cellfina example, she often pairs a pico treat- during the meeting. works, and does so for five years, the ment for pigmentation with ablative Galderma reported positive results of FDA clearance indicates to consumers or non-ablative lasers to address its randomized, controlled, evaluator- that they can, and should, expect to color and texture in a single session. blinded, multi-center study to evaluate see proven, long-lasting results after RF microneedling plus low-energy the effectiveness and safety of HARK for

treatment with Cellfina.” CO2 is another popular option, she lip augmentation, noting that the data “This formal recognition from the says. (Dr. Cohen interviewed various are being used to support FDA submis- FDA is a significant milestone for speakers from the meeting for Modern sion of the novel injectable. Cellfina customers, their patients, and Aesthetics® magazine’s sister publi- Merz. Research shows women often- cation Practical Dermatology®. You times feel defeated by their battle can watch the interviews online at FDA PROPOSES BOXED WARNING ON with cellulite, and we want to make PracticalDermatology.com.) BREAST IMPLANT RISKS sure our customers have an effective Merz Aesthetics brought spokes- The FDA released a statement cellulite treatment option,” says Merz model Christie Brinkley to the exhibit on its continued efforts to protect Americas CEO Bob Rhatigan. “Cellfina hall, where she addressed changing women’s health and enhance safety is the only cellulite treatment FDA- attitudes about aesthetics. A genera- information available to patients con- cleared for visible results that last tion ago, hair coloring was considered sidering breast implants.

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MY NEW FAVORITE THING: TEMPSURE FIRM

“Cynosure’s benefit from both a physician and TempSure platform has been a total Tempsure patient perspective. TempSure Firm’s game changer for my practice and the Firm 60mm combination of radiofrequency heat results really do speak for themselves.” handpiece uses and specialized massage head help the innovative tech- skin look more youthful and evenly nology to gently textured—and because it gently and BRUCE E. KATZ, MD heat deep tis- gradually delivers heat, my clients n Medical Director, JUVA Skin and Laser Center, New sue. It allows me to confidently treat actually enjoy the treatments and say York City larger areas of the body quickly and it feels like being at the spa. With no n Clinical Professor of Dermatology, The Mount Sinai effectively. The results I’ve been see- downtime, they’re free to drive them- School of Medicine ing are absolutely fantastic, and the selves home after their appointments. n Director, Cosmetic Surgery & Laser Clinic, Mount quick treatment times are an added The addition of TempSure Firm to the Sinai Medical Center

In draft guidance issued in late list gives patients the opportunity to Lumenis. The transaction, which val- October, the FDA proposed labeling acknowledge individual risks of breast ues Lumenis at an enterprise value of recommendations to manufacturers of implants, such as potential risks from more than $1 billion, remains subject breast implants to help ensure women the surgery, the risk of BIA-ALCL and to the customary regulatory approval receive and understand information risk of implant rupture, among others. process. It is expected to be complet- regarding the benefits and risks of “We believe the information con- ed in early 2020. breast implants. The draft guidance tained in the example of the patient “Baring Private Equity Asia’s (BPEA) offers numerous recommendations to decision checklist can contribute to a investment is a tremendous vote of help ensure women have access to this patient’s understanding of both the confidence in Lumenis and in the information, including that manufac- benefits and risks of breast implants,” achievements of our entire global orga- turers incorporate a boxed warning the statement says. nization. In recent years, we have devel- and patient decision checklist in the Earlier this year in July, just days after oped and introduced multiple ground- device’s labeling, update recommenda- surgeons from the British Association breaking technological solutions that tions for patient screening for device of Aesthetic Plastic Surgeons (BAAPS) have redefined our industry and opened rupture, and more. and elsewhere called for warnings on entirely new market segments.,” says The FDA guidance says that the silicone-filled breast implants due to Tzipi Ozer-Armon, CEO of Lumenis, in a boxed warning should help com- risk of “breast implant illness,” Allergan news release. municate risks that patients may not issued a voluntary worldwide recall of know, including that breast implants Biocell textured breast implants and are not lifetime devices; the chances of tissue expanders due to concerns of DR. MARY LYNN MORAN TAKES THE developing complications increase the BIA-ALCL. HELM AT AAFPRS longer a patient has the implant and Following the recall, Modern Mary Lynn Moran, additional surgery may be required to Aesthetics® spoke to Bryan G. Forley, MD is the new address the complications; and that MD about what is known about the President of breast implants have been associated reported cases of BIA-ALCL. Watch The American with the risk of developing breast the interview now: modernaesthetics. Academy of implant-associated anaplastic large cell com/videos/breast-implants-assess- Facial Plastic and lymphoma (BIA-ALCL) and may be ing-the-risk-for-bia-alcl Reconstructive associated with systemic symptoms. Surgery (AAFPRS). The draft guidance also includes a Dr. Moran, who will serve the 2019- recommendation that manufacturers BARING PRIVATE EQUITY ASIA TO 2020 year term, is the first female to include a patient decision checklist to ACQUIRE LUMENIS serve as AAFPRS president. She is a help guide discussion during a patient’s Baring Private Equity Asia’s affiliated facial plastic surgeon in Franklin, TN. consultation with a surgeon. A check- private equity funds are acquiring Read more from Dr. Moran on p. 28.

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HOLOGIC TO SELL CYNOSURE “We are pleased to announce Robotics moved its corporate head- Hologic is selling the Cynosure the closing of our merger with quarters to Toronto, Canada. medical aesthetics business to an Restoration Robotics,” says Domenic affiliate of investment funds man- Serafino, Chief Executive Officer of aged by Clayton, Dubilier & Rice for Venus Concept, in a news release. KYLIE JENNER SELLS MAJORITY STAKE a total purchase price of $205 million “We have made significant progress IN BEAUTY BUSINESS TO COTY in cash, subject to certain closing in enhancing our financial condition Kylie Jenner sold a $600M major- adjustments. This is a tenth of the with our recent financing activities. ity stake in Kylie Cosmetics and Kylie $1.6B that Hologic, a women’s health The outlook for Venus Concept is Skin to Coty Inc. care company, paid two years ago to very positive and we believe the com- Under the terms of the agreement, acquire Cynosure. bined company is well-positioned as Coty will acquire a 51 percent owner- Net of these adjustments, Hologic a leading player in both the global ship in the partnership for $600M. expects net cash proceeds of approxi- minimally invasive/non-invasive The acquisition is expected to close mately $138 million, the company medical aesthetics market and the in the third quarter of fiscal year reports. minimally invasive surgical hair resto- 2020. Coty’s family of brands includes “Divesting our medical aesthetics ration market.” Covergirl, Max Factor, Rimmel, Clairol, business will enable us to focus on Following the merger, Restoration Sally Hansen, Adidas and Nautica. n what we do best – helping women and their families live healthier lives through early detection of disease,” says Steve MacMillan, the Company’s Chairman, President and Chief CLARIFICATION Executive Officer, in a news release. Please note that in the September/October edition of Modern Aesthetics® magazine, our “Since we acquired Cynosure in 2017, device listings inadvertantly contained duplicate listings for RF Microneedling devices. it has significantly underperformed our expectations. We believe this trans- Cutera’s Secret RF listing should have appeared on p. 46. action will unlock value for Hologic shareholders, and at the same time provide Cynosure and its employees Secret RF uses semi-insulated and non-insulated tips to deliver RF energy within the best opportunity to succeed in various adjustable depths of skin from 0.5-3.5mm. It has been joined by the the medical aesthetics marketplace. company’s newest device truSculpt flex, which is FDA-cleared for the improvement Moving forward, our business develop- of abdominal tone, strengthening of the abdominal muscles, and development of a ment strategy remains focused on the firmer abdomen. In addition, it is cleared for the strengthening, toning and firming of smaller, tuck-in deals that have been buttocks and thighs. performing well for us and strengthen- ing our core franchises.” An updated PDF is available at ModernAesthetics.com

VENUS CONCEPT COMPLETES MERGER WITH RESTORATION ROBOTICS Following the completion of the merger, Venus Concept completed a $28 million equity financing by EW Healthcare Partners, HealthQuest Capital, SEDCO Capital and others. Restoration Robotics changed its name to Venus Concept Inc. The combined company will commence trading on November 8, 2019 on the Nasdaq Global Market under the ticker symbol “VERO.”

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