Advancing Laser & Energy-Based Aesthetic Technologies

Dr. Grant Stevens

Hello everyone, and welcome back to the Technology of Beauty, where I have the opportunity to interview the movers and the shakers of the beauty business. And today is no exception. With us today is my dear friend Gus Rhodes. Gus is now with Solta Medical, but he's been with a number of companies, as you're gonna hear, and he's been a friend for many years. Welcome, Gus.

Gus Rhodes

Thank you Grant. Nice to be here.

Dr. Grant Stevens

It's so great that you came in to see us and share all of your intelligence and your background and so forth. Why don't you start by telling the audience where you came from, where you went to school, and that sort of thing. Give us a little feel for Gus.

Gus Rhodes

Sure, I grew up East Coast actually, which most folks don't know, so I didn't know that. Outside of Philadelphia and went to Villanova University back when Howie Long was actually at Villanova University, so I remember it a long time ago. After I graduated though I started heading west and actually had a job in San Diego and I thought, this is gonna be sweet and a great transition.

And as I was driving through Texas stopped at her friend's house and I wound up staying and never left. So we started a, an antique reproduction company. Is that right? And I was, we were making roll top desks and barrister bookcases and the old wooden ice boxes. And it was pretty fun.

Dr. Grant Stevens

What part of Texas?

Gus Rhodes

So that was in San Antonio. And so we had a wholesale business. And we were up at the Dallas Furniture Show and highlighting all of our products. And after a week we came back and I needed to see where our controller was. And they apparently thought he was with us and.

That was the end of that company because he had taken all of our money. Oh no. So it was a good lesson. So you pivoted. So we pivoted and and eventually got into to medical and started actually with us surgical. and, they had the initial surgical staplers to replace hand suturing of internal anastomosis, et cetera.

Yep. And then they developed the laparoscopic products to allow us to take gallbladders out laparoscopically, and then just kept going and going and that was a great career. That was, nine years actually that I spent with them. Didn't Dennis Conden work for them also? So I think he did spend some time there in his early days. Prior to the laparoscopic approach.

Dr. Grant Stevens

And so then how did you transition to the aesthetics field and when?

Gus Rhodes

In early, no, I guess it was late 2000 and. I started with a company that was actually called Thermage. And we launched the first radio frequency skin tightening device that was called the TC three. And you remember those days? One centimeter tips.

Dr. Grant Stevens

And circulated how often, again, was like every 10 seconds or something.

Gus Rhodes

Oh, it, no, it was, it took forever. It did. It did. I think it was three seconds, but it, three seconds. But it seemed like 10. In one centimeter.

Exactly. So it took a while to treat a full face. And we really didn't know what we know now clearly. But at that time we were figuring out the algorithms and making things happen. But it was in, in late 2004 that Dennis Condon reached out to me and he was just about to launch the Fraxel laser.

And, he was telling me about, how we're going to only treat a fraction of the skin rather than try and resurface the entire skin and everyone's calling him crazy. Why would you want to do that? Let's just only treat a portion of the skin. Makes no. Of course, it's turned out everything has turned fractionated down these days.

That's right. And it was, those were great days. We started with the SR 750, remember that. And then went to the 1500. And then we wound up doing a series of three, then we had a family of three. The refine, which was the baby. Then we had the restore, which was the 15. and then of course the repair. And that was outstanding, that was some of the most fun that we've ever had.

Dr. Grant Stevens

And didn't that morph into the dual.

Gus Rhodes

So the repair didn't, so the repair was the fractionated co2. Oh, that's right. Yes, that's right.

Dr. Grant Stevens

It was, yes. Not the 15, 15, 19 27.

Gus Rhodes

That's right. So the Restore then went to the dual. To the dual, that's right.

Dr. Grant Stevens

So those were good days. So you stayed with Dennis at then? It wasn't Solta yet at that point.

Gus Rhodes

No. No. So you went to Reliant. So I went to Reliant and I was there for about five years, I think and I was I was.

A lot of, we all wore a lot of different hats back in those days. And we were, between, managing, strategic accounts and sales teams and, working with folks like yourself, to see if we could maybe get a little bit of exposure on the podium.

It was just whatever we had to do. And I don't know, do you remember, were you at the a d in San Antonio in 2008? I was. And we launched the Repair. That's right. Remember that? Yes, I do. And we had who was it? Chris Zachary had done an interview on the Today Show and it wa it aired the day that conference opened

That's sweet. He was talking about the repair, cuz that's when we launched it. And we got so much traffic. That is at your booth at also on our website, and so our website crashed three times that day because of the volume of people who were going to our website.

Dr. Grant Stevens

Those are champagne problems, as Aaron loves to say.

Gus Rhodes

Indeed. indeed. And nothing is ever topped that that was a great launch. We sold a hundred at the booth. Did you really? A hundred at the. That show it was, they had a $10,000 deposit and it was incredible. Yeah, it was a lot of fun. So in 2008, you remember what happened to the economy in 2008?

It tank. Totally tanked. And people, really didn't have a lot of money for cosmetic procedures at that time. And companies were struggling and that was the time. That Thermage and Reliant decided we need to work together and merge to become Solta.

That's how that happened. And at that point, honestly, grant I wasn't sure where that in aesthetic business was going to go. Because the economy was tanking and I said, I think if it's all with you I'm gonna take a pause on this. And so we agreed to go separate ways and they continued obviously.

But then I got into the interventional spine. Market with with implants to repair the and will stabilize the sacroiliac joint. And and so that's down in the hip. And a lot of like postpartum females, where their hips have changed and their sacroiliac joint gets very unstable and the pain is excruciating.

And it was really interesting for me to visit different practices and actually meet patients who would tell me their story on how debilitated they were and how they could no longer work, no longer be a wife or a husband, and the, how this changed their life and it really brought them their life back.

It was extremely rewarding.

Dr. Grant Stevens

Yeah, a lot of. and the, in that business you stabilized the SIG.

Gus Rhodes

Yeah, so we had triangular implants and so we metallic. It was titanium. Titanium and and they were fenestrated, and so as we would. get them placed into the joint itself through the ileum, into the sacrum,

And we would place three just like this in a row so that we would get full stabilization of that joint. And it was a very easy. Percutaneous procedure. That's what I was wondering. Is it percutaneous? Endoscopic small. Endoscopic. Just a, you would lead it with a pin, place the pin first, and then you'd put an auger over the pin and then just tap that implant down in place under fluoro.

And make sure it's, and it worked in the right spot. It has been, it continues to work. They have dominated the market. They're, the company's called SI Bone. And SI Bone currently is the only company that actually has reimbursement from CMS for minimally invasive sacroiliac joint fixation.

Dr. Grant Stevens

So you were enjoying your time there. You were changing lives of people. When did you come back to the aesthetic business?

Gus Rhodes

It wasn't until the end of 2019 actually.

Dr. Grant Stevens

So you were gone for 10 years?

Gus Rhodes

I was gone for 10 years. I was in interventional cardiology after interventional spine. And so that was the remaining years in between, so stents and that sort of thing.

It, it bef, before I was doing plumbing with the stents and balloons, but this was actually an ectomy device. And so it would, we put it in through the groin. In the femoral artery, lead it up to the heart and it had. A crown on the top of it that would sand away the plaque from within the arteries of the heart and open them up so that you could actually get a stent placed in there.

Dr. Grant Stevens

So, a roto-Rooter?

Gus Rhodes

A roto-Rooter. Yeah. Yeah, pretty much. Except it was eccentrically placed on the wire. So as it spun centrifugal force would have it circum, circumvent the entire artery. So it's not just drilling a hole. We actually were sanding, it was differential sanding. So it's if you take a nail file and you rub it across the top of your finger, okay?

It won't hurt your skin, but it will definitely file where it's resistance. And that's the same principle of this. So how it would protect the artery itself. But take the plaque out. Really cool stuff. That is very cool. But anyway, long story short, bill Humphreys, our friend Bill Humphrey.

Yeah. Who he was at Valiant the time he was at Valiant. And then he was over at Ortho Dermatologics. As part of Bausch and Solta reported up to ortho under. and not many people knew that. I don't know that. Not many people knew that. And he, Solta had been for sale for God knows how many years when Valiant took over. And when a company is for sale how much do you invest in that?

Dr. Grant Stevens

Not a whole lot.

Gus Rhodes

Not you try to dump it, trim the fat. You're trying to, cut as much excess out. Exactly. And as it was on sale for sale it was still growing, but it was pretty much stagnant.

And then once it became part of Ortho Dermatologics and Bosch Health and Bill was like, no, we're going to invest in. And we're going to give it the attention and the funding that it needs to grow. And, I'd love for you to come back and help with that. And Dave Haggy, our friend, Dave, your neighbor was just brought back himself and so he reached out and, Dave and I were at Thermage in those early days. That's right. And had been keeping in touch ever since.

Dr. Grant Stevens

So you were at Thermage, then you were at Fraxel.

Gus Rhodes

Oh, reliant. Reliant, yeah.

Dr. Grant Stevens

Interesting. And now you're back at Solta, which has both Thermage and Fraxel. And our dear friend Liz also, is there Indeed? So what is your position now at ?

Gus Rhodes

So now I am, I'm over all of our strategic accounts in North America. And I also help run our professional relations as I once did at Reliance and worked with people such as yourself and all of our friends out there. And elevating the name.

But the funny thing is though, that we just, we're in the, we're just getting out of this. Incredible pandemic that has forever changed the way everybody does business. And you look back at how we grew and Joe Papa, the chairman of Bausch, had a town hall meeting and he was going through year over year growth of the different divisions within Bausch.

And, Bausch and Lamb had, I think two or 3% growth year over year. Solta had a 39% year over year growth in the last 12 months.

Dr. Grant Stevens

Is that right? I didn't know that. It's incredible. You've launched new products.

Gus Rhodes

Yes. That certainly has helped.

Dr. Grant Stevens

You have the FLX for Thermage.

Gus Rhodes

Correct. The FLX is the latest and greatest on our Thermage line. We, I think we launched that the beginning of 2019. and it has now taken off incredibly well. It's really remarkable to see the change from those early days.

Dr. Grant Stevens

Tell us a little bit about the Thermage FLX, because there are a number of people watching right now that either have, don't know about Thermage or think it doesn't work. And they haven't heard of FLX. Tell us a little bit about it. First of all, how big is the spot? How often does it cycle, and what does it do?

Gus Rhodes

You're right. They think one of those two things or that it hurts like the dickens. And cuz it did. And it did originally. That was a fair thing.

Dr. Grant Stevens

And you've been through four or five at least. Five generations. Five generations. Five generation, so this is not. This is not the old Thermage that you introduced many years ago.

Gus Rhodes

No, thank you. This is a brand new device. It's remarkable. So it's a four centimeter square tip now, so it's significantly larger. And it has this Accu Pulses technology. And I know you know what this is, but just for everyone else who's watching. We used to just get the general impedance of a patient by placing the tip on the forehead at first and just get what that impedance was because this is radio frequency, which is really electricity.

Going through the body and coming out through a return pad in the back. And that was it worked, but this uses this technology where it takes the impedance, every single pulse. So what optimizes the energy, depending on the thickness of the skin in that area, the amount of adipose tissue underneath the skin.

So that we're making sure to heat it to that optimum temperature to actually get the collagen contraction and get that not only two-dimensional tightening, but three-dimensional tightening as we contract the fibrous septae within the subcutaneous space all the while cooling with cryogen, before the pulse, during the pulse, and after the pulse.

So that, those two things. So that minimizes the pain. That minimizes the pain. One of the ways we minimize the pain. And that was a great softball, by the way. Thank you for that. You're welcome.

Dr. Grant Stevens

And I've had the FLX. In fact, Dave Haggy, you mentioned earlier, my neighbor here in Hermosa Beach, Manhattan Beach he came and introduced it to me. And I was afraid of the pain, cuz I know how much the Thermage of old used to hurt. And I had the FLX and to my amazement, it didn't hurt.

Gus Rhodes

And the vibration, did that make an impact as well?

Dr. Grant Stevens

Yes, because using the gate theory of pain. And we use that with injectables and other things.

Of course. It's been used with anesthesia and so forth. But the cooling, the vibration, the gait theory, and the impedance, checking it as you go makes so much sense because we used to just ta do it once and then assume that the impedance, which is the reciprocal of resistance, would be the same.

And in fact it isn't because my cheek is not the same as my forehead. Indeed. And the fact that we can do it on an ongoing basis, God, it sounds like I own the company. I actually have no interest in Solta or the company, but I have had an FLX. And I need another one. Thank you. Reminded me, you probably do need another one.

This covid has killed me. Okay, so we have, you have the new Thermage FLX. Tell us a little bit about clear and brilliant. If you would please.

Gus Rhodes

Clear and brilliant, I believe was launched 10, 11 years ago. And it has been an amazing laser to, really address three things now, people that want to prevent the signs of aging.

And so I think it's probably fair to say that the millennial generation really started that that phase in aesthetics where they want to prevent the signs of aging. So this is a great device for, but it's also to maintain your investment in maybe some other procedures that you've done.

And to maintain that youthful look and that glow. But also to improve, there's two different wavelengths one for fine lines and wrinkles, and one's more superficial for pigment and poor size and tone and texture. and they were usually used one or the other. You either use the one for the lines or use more superficial for pigment and tone and texture.

But just this year we launched the new. Clear and brilliant touch and that has been a game changer. The interest and the demand for that device has been incredible and we did a number of things. We certainly updated the user interface so that it's so much more easy to work with and to be able to select what you want to do.

But we also were able to now, anytime within the procedure, interchange wavelengths from either the 1440 or the 1927 with one one treatment tip.

Dr. Grant Stevens

So that 1440, 1927, for those of you who aren't in the business, refers to the nanometers, that's the wavelength of the laser. So they can interchange between the two wavelength and they do different things. Right guys?

Gus Rhodes

You got it. Absolutely. Absolutely. And as this thing just took off and we really expected that this would be something that would expand our market and expand our reach beyond those that have had our legacy device for many years.

But remarkably enough the interest with current owners has been really high. It's always exciting when you launch another generation, it's always exciting when you launch anything. Something as brand new clearly has a lot of possess to it but another generation that really makes a difference. It's been a great success so far.

Dr. Grant Stevens

And that's probably partly to, to account for the 37, 38% growth. No doubt. So the clear and brilliant is new. The FLX is not brand new, but it's relative, new to the marketplace, what's going on with Fraxel and Fraxel Dual.

Gus Rhodes

So Fraxel dual. When we design the Fraxel, this is something you may not know. I'm curious to, to see if you. The engineers were brilliant. Len DeBenedictis and his team were stellar.

Dr. Grant Stevens

I know Len very well. Yeah, somebody just, he was on a conference call with me just a couple weeks ago.

Gus Rhodes

Is that right? Great guy. Say hi for him. I haven't talked to him for a while, but, his team, led by Ken Chan and many others. Over-engineered that device because they really wanted to make sure that this was going to be durable and stay on the test of time and not be something that was going to be breaking down often.

It was the only thing we had going at the time at Reliant Technology we really were a one trick pony, but what I mean by that is that, the laser source itself, Is a telecom grade laser source. So it's the same source that runs the transatlantic cable to transmit all of that data underneath the Atlantic Ocean.

Did not know that. Yeah, either. And did we have to do that? Absolutely not. But Len engineered that. Len said, we need to do this and so I think that has probably been the one most important thing that has. Led to the longevity of this product line. But of course, the Fraxel was the first fractionated laser, with that scanning technology that really it's like you're roller painting the skin as opposed to stamping the skin. And that really was a game changer.

Dr. Grant Stevens

And it's pixelated. You say fractionated. So for those of you, it's pixelated, if you will. The laser comes out and they can roll across instead of doing stamps.

Gus Rhodes

Yes. So it's a smoother delivery basically, is what that meant. Smooth. But right now we have the dual, so we do have the two wavelengths, so it's the 1550 and the 1927. The big difference between the one in the dual and the one in the clear and brilliant touch is that this is a much more powerful device for the 1550, it's a 30 30 Watts system. For the 1927, I think it's a 20 watt system. But the Clear and Willings brilliant is only a single watt. It's a diode, it's a, it's not the same source. And it's meant to be more superficial and not as powerful.

But those are still, the Fraxel dual is still kicking, it's. There's rumors out there that we're doing something with it. We'll have to wait and find out, but I think it's safe to say that we would love to see something come out in the Fraxel line again.

Dr. Grant Stevens

Yeah. I'm waiting for it. I've heard those rumors also, but I have no insight information. And. You're starting to market now, the combination therapy of Thermage to tighten and lift and create more collagen, elastin, and so forth. And then the Fraxel duel to smooth and remove pigment and so forth, and talk about the surface of the skin. So you've we them together and you're marketing them under the name ThermaFrax.

Gus Rhodes

And we thank you very much for that because as many of you may not know Dr. Stevens was the one who came up with the term, "the ThermaFrax" like 2008. In those early days, wasn't it?

Dr. Grant Stevens

It was yes, it was when Clint Carnell sued me, I think, for, from, for infringement on the terms. That's how I met Clint, who's my co-founder of Orange Twist. And he brought that up on this program. Clint brought that up. He gave into my office and said, I've gotta sue you for using that name, frax or ThermaFrax.

Gus Rhodes

I'll tell you, it was a brilliant move because you were well ahead of the times. No one was really thinking about combination therapy, and many companies were really just thinking about mono. Therapy. But as we know, when we look at any patient that comes into your door no one technology's gonna address everything they need. And so being able to combine, the Fraxel laser with the tightening of Thermage was a brilliant move.

Corporately, with your help, we have really over the last year launched this Therma FRAX campaign. And putting together a lot of not only, physician marketing materials, but direct to consumer, because we really think that this speaks so, so near and dear to people who have been on Zoom calls for the last 18 months who have been working from home, and they're looking at themselves on the screen as we are now and saying, I look like crap. And I need to do something to help tighten and brighten my skin. We're gonna continue with that. No, no question. And look. Expand that market.

And one of the things I, while we're talking about Zoom. Can I bring up the eyes? Because there's not a lot to, to treat the eyes, and Thra is one of the only technologies that you can actually treat right over the eyelid safely to get rid of that crepiness and brighten those eyes up and and open them up so that those zoom. Appear a little bit better.

Dr. Grant Stevens

In addition to that, if you treat the forehead, the brow lifts up a little bit and you have more visibility of the lid and you look less sleepy, less dreary, and so forth. And you mentioned Titan and Brightening, you said that, and that addresses really the concept that I talked about with Therma Frax years ago, because the Titan part.

Is the Thermage, the Brighton generally is referred to the skin, which is pigment and wrinkles and so forth. So when you get tightened and brightened, that's Thermo Therma racks. Basically you can do both in one. And there are other ways to do that also. But I happen to believe that's a wonderful marriage of two different technologies, radio frequency and lasers, two different technologies that come together and patient.

They don't really care. The frequency, they don't really care. No. The energy source, they just wanna look better. They say, Hey, I wanna look. I look terrible on my Zoom calls. All this stuff about Zoom neck and zoom eyelids and looking down and all, and I, we get calls all the time because people are looking at themselves so much.

Most guys look at themselves historically before Covid 10. Minutes max a day in a mirror, is that right? Generally five, because they're sh they're brushing their teeth or shaving. That's generally what they did. Now they're spending multiple hours a day looking at themselves. On Zoom calls.

Yeah. And unfortunately, looking down most. Of the time, which makes their eyes look up and makes their bags pop out even more. Their double chin, and all the rest. And then they're calling me up and saying, Hey Granto, you're not gonna believe it, but I look like crap on Zoom, you and me and all of us.

Gus Rhodes

All of us. That's right.

Dr. Grant Stevens

Yeah. So that's what's opened the gateway actually for a lot of males coming in. Frankly, cuz women have looked at themselves for hours a day, for years, forever. And we love them. We makeup and we love 'em for it. Yes, absolutely. But we as guys. Traditionally and typically not been as aware and now we're painfully aware that we need some help.

Gus Rhodes

I think that's very fair to say without question.

Dr. Grant Stevens

Tighten and brighten is a good thing.

Gus Rhodes

Yep. And I think, as we continue to expand the market depending on who the patient is, maybe we use Thermage with clear and brilliant. Depending on what they need. Why not to, to the same tighten and brighten. Cuz you, you just mentioned there's many ways to get. So that's something that maybe we'll be looking at too in the future.

Dr. Grant Stevens

There's no reason why you can't couple those two together, if they have less needs on the skin surface.

Less brightening needs, if you will. So that opens the door to my next question. And that is about the future. So I noticed you brought your crystal ball. I saw that. And I'd like you to tell me, you've been in this business for many years. You left for about 10 years. You came.

you've seen the development of these various energy-based technologies all in the non-surgical area. Tell me what the future looks like. Let's say 3, 5, 10 years from now. What are we gonna look up? What's it gonna look like three years from now?

Gus Rhodes

Five years, 10 years. One thing we know for sure is that technology doesn't slow down. It's going faster than it's ever gone, in my opinion. And I think whoever can come up with the answer to hair loss. and cellulite is probably going to have a good run. There's the mechanical hair transplant systems, but to get natural hair growth PRP I think is going to play a big role in that, in, in some form or fashion.

I know there was controversy recently about whether that's appropriate or not, but I think if, as long as it's autologous that, using your own blood to use, I think that's probably is that right? Still cellulite, we have, some technologies out now, some injectables that I'm looking forward to seeing how that goes.

I Thank you. Probably have started using that. Absolutely. Those are two things that I immediately think about. Are probably going to be interesting to see how that goes. But beyond that you, we talk about this pandemic and the response that we had from industry to generate the vaccines and you look at the vehicles, the drug delivery systems that they're using. A lot of this mRNA technology, and lipid mediated delivery of. Obviously in the medical dermatology side, I think, drug delivery is a huge opportunity, but it might also come into aesthetics at some point.

I I look at a couple companies in the Bay Area right now. One in particular that is using mRNA technology to deliver product that actually restores youthfulness.

Dr. Grant Stevens

Is this transcutaneous delivery?

Gus Rhodes

Yes. So topical. And I don't know enough about it to speak intelligently.

Dr. Grant Stevens

But that's never stopped you before.

Gus Rhodes

Don't let the truth get in the way of a good story. But but it's actually, fascinating to me. I think that's, drug delivery. At some form or fashion, I think is as a result of this pandemic I think might have a needs I would agree with you. A neat thing.

Dr. Grant Stevens

I would agree with you. We had Ryan Beal on this program talking to us about Dyve, D Y V E that is, not d i v e. And he has a very interesting technology that affords and allows transcutaneous delivery of drugs into the blood. Actually transcutaneous, topical, transcutaneous with measurable levels in the blood, in the urine and so forth, in ways almost the same as an injection.

But transcutaneous. It's amazing. And I was asking about the possibility of other things such as Botox and other drugs. It might be, was tried for a while. Yeah, that's right. Revance. Tried that for a while and had, spotty results and, that would be fantastic to throw away the needles, I hadn't heard about the mRNA.

Gus Rhodes

You may know that the person who's leading that charge Anya Kramer. She used to be the VP of marketing at Reliant for the Fraxel.

Dr. Grant Stevens

That's right. And so Anya's running the messenger RNA transcutaneous, I've gotta give her call. She needs to be on this program. She does need to be on.

Gus Rhodes

She does. But it, I just was talking to her a number of weeks ago, she was telling me, the, this regenerative property that they're beginning to see early stage, there's much work to be done, but Fascinating stuff.

Dr. Grant Stevens

Yeah. Sign me up. Listen, Gus, we could be talking for days on this and I want to thank you so much for coming here from Texas. Thank you for having me appearing on our program here in beautiful Manhattan Beach. Always good to, always welcome and I love working with. And can't wait to hear about new developments at Solta with Fraxel and various other exciting technologies.

Gus Rhodes

We'll have to get together in the mountains too sometimes soon.

Dr. Grant Stevens

Absolutely. I look forward to it and hopefully I'll be seeing you shortly at Cosmetic Bootcamp. We'll see you in Aspen. Absolutely. So I'd like to thank all of you for joining us once again here at the Technology of Beauty, where we get to interview the movers and the shakers of the beauty business.

And today we learned all about Gus Rhodes and Solta, and where he came from and where we're going, and his predictions for the future with. Transcutaneous topical rejuvenation of our skin and our bodies. So thank you once again, Gus for coming. And thank you all for joining us. I'll see you each and every Tuesday on the technology of Beauty.