Good afternoon and welcome to the Apyx Medical Virtual KOL event. At this time, all attendees are in a listen only mode. A question and answer session will follow the presentations. If you'd like to submit a question, you may do so by using the Q&A text box at the bottom of the webcast player. As a reminder, this call is being recorded and a replay will be made available on the Apyx Medical website following the conclusion of the event. I'd now like to turn the call over to your host, Charlie Goodwin, President and CEO of Apyx Medical. Please go ahead, Charlie.
Thanks, Tara. Thank you for everybody who's taking time today to join us on this call. It is my pleasure to have you here, and it is my pleasure to have Dr. Vanek here as our KOL. I'm sure you'll find what he has to say very exciting. Next slide, please. All right, next slide. Brief agenda of what we'll do today is obviously there's an introduction from me. We'll talk about the commercial launch of AON. The majority of the time will be spent with Dr. Vanek, and he will be talking about his experience with AON. Then we'll conclude the meeting and open the call for Q&A at the end. Next.
At Apyx Medical, we actually view ourselves as the leader in surgical aesthetics. Surgical aesthetics is different from all other forms of aesthetics, because in surgery, we actually believe that that is the only thing that really provides durable and transformational results for patients. The market is uniquely changed because of the GLP-1 drugs for weight loss. There are a lot of patients now that have lost a lot of weight and they need to have. They got loose and lax skin and they need to have a solution for that. The AON body contouring system, along with Renuvion, we believe provides the best technologies and the best tools to help the doctors achieve those needs. We just did get approval for AON in May of 2025. We have successfully conducted a soft launch with key surgeons in multiple geographies all over the states.
The results so far have been overwhelmingly positive for the performance of the technology and the console in their ORs. In September, we had said that we would start commercially selling the AON to other doctors. We actually have started that and are continuing that here in the fourth quarter. Most recently, we just announced that we did file our 510 for the power-assisted handpiece portion of AON that we had said that we would do. We would expect to have that clearance sometime in the first quarter of 2026. Next slide, please. Just a reminder of the market and what is going on in procedures and a little bit in consumer behavior. We think that AON is uniquely positioned to lead this market and capture this tremendous growth that is coming from post-weight loss patients.
If you look at McKinsey, they talk about the GLP-1 therapies are going to exceed $100 billion by 2030. 44% of GLP-1 users spend between $2,000 and $5,000 on aesthetics, which is a 25% increase in their spend. Really important is about 63% of these patients are new to aesthetics post-weight loss. It is going to be a growing patient population for plastic surgeons to come. I think that the next decade is going to be one of the best decades that plastic surgeons have ever seen addressing the needs of these patients. Technology has actually lagged behind the industry. If you look at body contouring technology, there has really not been any significant improvement in some of these technologies in over 20 years. These procedural shifts are great that are happening because a lot of patients now will need some kind of combination treatment.
That is a combination of surgical incisional surgery and body contouring surgery. And so these procedures now are more complicated. If you look at just the ISAPS data from last year, it shows that liposuction procedures actually declined by 10.7%, but surgical lifts were up in the 20%. That makes all the sense in the world because the amount of laxity that these patients have is going to, in a lot of times, require some form of surgical intervention, some kind of skin incision. And a lot of times it's accompanied by body contouring or by liposuction. And skin tightening n ow it is the number one requested treatment post-weight loss. I talked about these combination treatments and I think Dr. Vanek actually has a couple patients that he's going to show that on later.
And you can see the dramatic results from these procedures, but you can also see the complexity in getting these patients to where they need and want to be. And out of the GLP-1 users, 72% report loose skin as their top concern. People are looking for a natural look versus a total transformational change. 57% seek treatment within six months post-weight loss. Next slide, please. This is AON, and this is what we have launched. I'd like you to formally meet her. I would like to talk a little bit about what is in AON from a technology point of view. There is nothing like it on the marketplace that is completely revolutionary. There is nothing that exists to have this surgical console on the marketplace today. If you're looking at the top left of AON, that is your traditional Bovie generator. It has monopolar and bipolar.
At the top left, if you move to the top right, that is your Renuvion portion of it for skin tightening. Renuvion still remains the brains, if you will, of AON. The Apyx One generator is the center of that. And then if you go to the console down below, it has infiltration, aspiration, it has ultrasound-assisted liposuction. It has a closed loop for contouring . And that is what is approved today. As I mentioned earlier, we filed the 510 for the power-assisted portion of that. And the two buttons on the right that don't have anything to them yet, those are the buttons where there can be two power-assisted handpieces in AON. I think it's important to note that we developed the AON system, but we actually didn't design AON.
AON was actually designed by a group of plastic surgeons, some top surgeons from all over the world, that went through every existing technology that is out there today and told us what they needed and wanted to have improved in a body contouring system, in a surgical system. Our engineers and our development team did an incredible job of developing this and taking care of all of these things and everything that is in AON from a technology point of view. The ultrasound-assisted liposuction, the closed loop for contouring, the infiltration, the aspiration, everything is best in class from a single technology perspective. Everything is integrated into one surgical console, and the surgical workflow for the doctor and his team is second to none. Not only can you perform individual tasks, but you can actually have simultaneous technologies going on at the same time.
If you have a team that is performing this, if it is just you, then you just use each individual technology. It is designed to be the most advanced surgical system for aesthetic surgery on the market today, and there is not a surgical procedure that the doctor cannot do with this system. Next slide, please. The feedback that we have gotten from clinicians, and you're going to hear from one of them here in a few minutes, has been anything short of remarkable for AON. I can't even begin to tell you how proud I am of the team that put this together, and the performance of AON has been spectacular.
In fact, I would go as far to say I've been in the medical device space for 30 years and I have launched a tremendous amount of products and technologies, and I have never had one that has been as exciting as this. The doctors have just been ecstatic about the performance of AON. There's a comment on here that there is no other machine like this. It is the next generation of body contouring. We have doctors that are calling it a Ferrari. We're having doctors that are calling it a Rolls Royce, a Lamborghini, you name it. The accolades are there, and the technology is unique and special. I think that Dr. Vanek will talk a little bit about that because he used to be a KOL for one of the competing technologies for over 16 years. So the feedback has been incredible. Next slide.
And the summer has been incredibly busy for us at Apyx Medical Corporation. We've been all over talking about AON, showing AON, having doctors in the room listening to it. The interest from the community has been spectacular. And so it is my pleasure right now to introduce for today's call, Dr. Paul Vanek. Dr. Vanek is a double board-certified plastic surgeon. He's recognized by both the American Board of Surgery and the American Board of Plastic Surgery. He brings extensive training and experience across all areas of surgery and has a particular expertise in breast augmentation, advanced liposuction techniques, facial rejuvenation, laser skin treatments, and comprehensive skin care. He earned his medical degree with distinction in research from the University of Rochester School of Medicine, where he also served as Chief Resident in General Surgery. Dr. Vanek then completed a fellowship in plastic surgery at the University of Michigan. Currently, Dr.
Vanek serves as President and CEO of Mentor Plastic Surgery and MedSpa, a practice he founded nearly 30 years ago. Although it doesn't look possible if you're looking at him, during this time, he has been voted Best of the Best in plastic surgery five times by readers of the News Herald. In addition, Dr. Vanek has pioneered and implemented cutting-edge technologies leading to the publication of multiple clinical papers and the development of innovative medical products. It is my pleasure to turn the call over to Dr. Vanek. Dr. Vanek, thank you very much.
Thank you so much, Charlie. What a gracious introduction. I want to start by thanking you all for your attention today. My general background includes research fellowships in biophysics at Cal Berkeley, at the B field unit in microwave radiation and radio wave research. Bioelectromagnetics has been integrated into my life before I got into medical school. During medical school I worked in animal labs and published articles in bioelectromagnetics. This has led me directly to my enthusiasm for something that was on the theoretical horizon but didn't manifest until Apyx Medical Corporation put together this most incredible platform. I have to say as a person who's had a background in electromagnetics in surgery since the 80s, there is nothing more exciting than when 2015 hit and they rolled out this incredible system called Renuvion. Then it was called J-Plasma.
Even the 1.0 handpieces, which were now in the 2.0 development of handpiece delivery, the 1.0 handpieces were so efficacious in tightening in an environment in which patients were clamoring for something more. There was nothing on the horizon for over 20 years since the advent of ultrasound-assisted liposuction in its third generation, now in fourth generation. The Apyx Medical Corporation UAL system is the first step, a great innovation in tightening the body and collaborating with the regular surgery of plastic surgery. Then the add on, the secret sauce, is the UAL surgery, then the Renuvion helium plasma. When you look at my practice in the Midwest, I've been in practice since 1996, there have been a lot of changes based upon the last years of the advent of GLP-1s and GIP inhibitors. As you saw in the slides that Charlie shared with us, in my practice, it's about 60%.
Depending upon who you survey around the country, the penetration of these drugs is ubiquitous in our society because people are looking for weight loss avenues. In the wake of their weight loss, or even before they've achieved their weight loss permanent goals, they often initiate the inquiry about what am I going to do with this loose skin, my arms, my neck, my breasts, my abdomen, my thighs. And that's where my practice has been for a long time. So I have a practice that has a nurse practitioner, I have an OR team of a PA, a circulator, a scrub, I have board certified anesthesiology. So I have a crack team that's very familiar with the paradigm of body contouring and facial rejuvenation surgery. My most common procedures have been UAL associated body contouring.
Once the Renuvion paradigm came on the market, it was something me and a host of other busy liposuction doctors that did body contouring and neck and face rejuvenation grabbed onto once it demonstrated efficacy. Us early adopters have been encouraged by the kind of science commitment that Apyx has demonstrated. With over 90 publications that show things like are there worsening outcomes with using this energy? The clear definition in a publication I authored last year was that we add Renuvion with our Apyx UAL and we have no differences in adverse events, meaning the risks of surgery are not enhanced by adding something that's revolutionary. That sole conclusion was pretty evident to those of us who are already using it before we codified it with science.
But essentially, the surgical methods, when you go to the next slide, you look in the operating room and you see that the surgeons have pieced together this technology, that technology, another technology, and they're time consuming to set up, they are a bit dizzying to initiate. When we can put it all together with the tower that you saw a few minutes ago, in one harmonious device, it's wheeled into the operating room, it plugs in in two centers with regular AC power, and it gives me a complete suite of treatment parameters in which I can execute the ENT case from that. Of course, there's instrumentation and expertise and there are the staff members that are the scrubs and the circulators that get everything ready.
But in terms of simplifying the startup, all those individual pieces of material that you see stacked up on different trays, boxes, carts, they're a thing of the past now that AON is on the market. So the non surgical methods that we have that the patients are clamoring for, can you please put this device on my skin and can I walk out looking 30 pounds lighter and 30 years younger? That is something that is a market niche because people have the hope that non operative methods are going to take their loose skin and their post-weight loss body problems and have the magic trick that that's going to work.
But those freezing techniques, the radio wave techniques, the ultrasonic external techniques, they do not simply do not perform to the level of the patient satisfaction that they have set as expectation, nor clearly the clinic that have experience with these devices. Those devices have a niche for spa events and for modest enhancement, but they have nothing to do with what's actually happening in the major body contouring post-weight loss patient. That's the strike zone of my practice, right down the middle. Strike zone patients come in, they need complex procedures for arm lifts, neck lifts, facelifts, tummy tucks, breast lifts, thigh lifts. But now we can say the skin we took away is no better than the skin we left behind. We've been saying that for 40 years in body contouring.
But with the advent of the AON Renuvion UAL, the efficiency of the fat dissolution—I mean, you essentially say, what's UAL? Ultrasound-assisted liposuction means I pass a 3 millimeter probe that selectively pops my fat cell, bursts it in situ, changes the fat geography. I can then evacuate that reliably with very low blood loss. And then I follow on immediately with helium plasma Renuvion through another small 3 millimeter cannula that's passed smoothly under the skin. In doing so, it creates results that you're going to see in our next slide. In a single procedure, we're able to take a patient who does not have the best body habitus, but who's had her 48-year-old, three children. She says, this is my one-year follow-up. Use my selfies and tell a woman that she really can restore her body to incredible harmony and make herself really love her body.
This is an example of what's called high definition in which we sculpt the abdomen musculature with the advent of ultrasonic liposuction. We do a tummy tuck to tighten her muscles and remove some skin that was disillusioned by three children. And then we add the, again, the secret sauce is the AON Renuvion helium plasma. That is the true method of taking loose skin and restoring it to what you're seeing in these pictures before and after. These are one-year follow-ups along the way. They have no increased risks or no increased duration of recovery from a regular traditional surgery, but they're getting the kind of transcendent picture that my colleagues and I across the country are achieving. Go to the next slide please. This next patient is the first person in the Midwest that had the TruSuite deployed in a single surgery.
On the right picture, in her own view, is her six-week follow-up. The person who says they may be skeptical, you can say to yourself, there's no way that that's the same person. Except it is. I did it yesterday too. A person who's 61 years old. I circumferentially treated her body. I used the suite of energies and then the technology of really reinstilling fat in another area that we call Brazilian buttock lift. But the AON system technology gives me every tool at my disposal to bring the state of the art, from what you see of taking her skin above her belly button, treating that three dimensionally with UAL infusion of fluid, safely evacuating her fat layer, and then transcendently taking the Renuvion helium plasma and treating her skin so she gets that circumference. I have many other patients in this circumstance that have achieved these goals.
For the investor, for you that are thinking, is this the real deal? I can assure you as a person who's been in this market since 1989 that this is the real deal. We have waited for something like this and the performance of this has never underperformed. In clinicians that are in this vertical, we totally see this and say, I got to get that as soon as they can get it. I talk to patients and doctors all over the country at this point because I have a robust practice. What we're really responding to is the GLP-1 patient. This patient lost her weight on her own, lost 83 pounds, but she's stuck in this body now. The GLP-1s that we see are a very persistent presence in our market.
Our American society has said to us all we want to be thinner, but we can't get there because we have a lot of pressures on our diet and on our lifestyle and our food chain that are precluding us from making a difference. The GLP and GIP administration, including on the horizon even a pill that's got efficacy across the board. My patients are coming as a pipeline, either in the wake of using GLP-1s or they're seeking a solution that they're not finding with their current insurance paradigm. They're coming directly to my practice to have GLP-1s by me, supervised, and they may be six months, 12 months, two years out from the pipeline of having surgery.
They already know when they show up at 350 pounds, that if they, if should they get to their ideal body weight, that they're going to have some negative consequences that before did not have a very good solution. We just did amputation procedures that had, you know, hopefully properly placed scars, but we could never do anything about their severe laxity. And so this example is just one of many in my practice that have manifested these kind of transformations. In my practice, about 40% of my patients are using GLP-1s. We suspend them for two weeks prior to surgery. Many patients after this transformation may go to microdosing. But their concept is once they've re-established their relationship with food, we often wean them off because they so love their body, they say, I'm not going back.
So GLP-1s can be a post-op use, or the patients are so delighted with their new body habitus that they may just wean themselves off. There are off ramps for GLP1s. But in general, the patient's desires are I want to never go back to where I was. GLP-1s are an integral portion of my perioperative discussion. When we see that search terms for SEO, patients are no longer naive to the notion that they have both search terms direct type into top line Google. They have an awareness that these devices, these drugs are now utilized. And so it goes with ultrasound-assisted liposuction (UAL) and AON and Renuvion. Top search terms are they're finding me because they typed the word Renuvion into Google and I'm a local user.
When they see other things that are consequences like Ozempic face, Ozempic buttock, that is a consequence not of the drug per se, but of the actual outcome of the drug, which is to deflate this body into the degree you see on the picture on the left. The tightening manifestation is how. What is my solution this body. What I see is the experience of this, of the system. I've done the last seven weeks, have done nine major body procedures. This procedure took eight hours. I have a practice that does not involve Renuvion or AON, but I have other patients that are looking at their side breast and say I want to tighten the skin there. When they get a breast augmentation or they have a rhinoplasty and says, can you do something about my neck?
So I use this agent under their neck in a minimally invasive way through three small incisions. I use it on the arms to get the arms that were loose to take away the redundancy and then use UAL and AON on the arms. So each procedure that has been so fantastically explosive growth, except for liposuction, liposuction has gone down because people are disillusioned with the notion that if I suck up my fat, I'm going to have hanging skin. Now the paradigm is we can take that hanging skin and we can make it tightened with FDA approval with an indication of a device that's very reliable.
So combining these procedures with traditional procedural plastic surgery and ultrasound-assisted liposuction (UAL) and Renuvion helium plasma tightening has been something we've never been able to offer patients with such authority or with such self-assurance that you really can get the results that are seen right in front of your eyes. The impact on my practice has been in efficiency. The UAL that I've had as a traditional previous user of another technology, I see about a 60% enhancement in my speed of getting to clinical endpoint. If you know what I mean, I have to use time on target with the device that oscillates with ultrasound. It took a certain amount of minutes, let's say 10 per zone. Now I'm down to three to four minutes per zone because my UAL intraoperative time, what does that mean? Shorter procedure times. I'm getting this result that's so transcendent.
And then I add on top of it the manifestation of the Renuvion helium plasma effects. They're just making such an impact on my patient and the patient is so grateful. They say, I just don't even believe that I was going to get here and that two weeks ago you told me I could do this. You can look on Mentor Plastic Surgery on Instagram and you can see these patient testimonials that are up there. And if you type in or search other UAL Renuvion users, they have equally marvelous results. I don't want to say that I'm the king of the world, but I have such a regard for the technology that Apyx Medical Corporation has brought to me and they also onboard us, they teach us how to use it. We collaborate, we're talking to each other. Talk about a commitment as a business partner to make us successful.
I have to say that Apyx Medical Corporation from the jump has been a collaborative physician with a private practitioner like me. The general feedback I get, my staff is happy. The technology is easy to turn over in terms of its cleaning and sterilization. There are no issues with it. The support from this company is incredible. The representatives are responsive, the resources I have at my fingertips have made an incredible impact on my practice, my staff onboarding for how to market it to my patients. Soup to nuts. This company has been a business partner since we engaged nine years ago. I've had such an incredible run with this. My enthusiasm is a sincere Eagle Scout appeal to those of you who think, is this company what they say? You can ask anybody who's on board with this energy. They just say it's transformative.
I can talk all day on this. I'm going to open this up if Charlie would like to come back and we can go back and forth with some system elements or any clinical decision or any business discussion that's germane to this conversation.
Dr. Vanek, thank you very much. Thank you for all of your comments. I'm still amazed by that picture that is up on the screen right now. That just shows how difficult these procedures are and how transformative they are in the right hands, that's for sure. We'll go ahead and take questions and we'll answer anybody's questions that you have right now.
Great. Thank you, Charlie and Dr. Vanek. Please hold for a brief moment while we pull for questions.
And if there's not one that comes directly to mind, I'm happy to say that with the onboard of the power lipo add on, I am enthusiastically awaiting that. I'm anticipating its launch in the first quarter of the year. Yesterday I did a case with fat transfer to the buttocks. Using a power lipo material, we are able to use that technology to both take out fat, process it in real time, and reinstill it in another body area. Having a state-of-the-art ergonomic power lipo device, which I held in my hand at the recent American Society of Plastic Surgery meeting, I had that in my hands in New Orleans just this past weekend. I am very enthusiastic about its implementation.
Thanks, Dr. Vanek.
So we have a question from Sam Eiber at BTIG. Please go ahead Sam.
Hi, y es, good afternoon, Charlie and Dr. Vanek. Thank you for putting this KOL event together and for sharing your thoughts. The picture you're showing right now looks very transformational, and Dr. Vanek, if I'm listening right, it sounds like a lot of that is being driven by maybe some of the changes on the UAL technology. We'd love to hear thoughts on maybe if that's the case. Is it more of a function of.
The UAL being more powerful?
What else is driving, you know, such dramatic changes versus maybe some more legacy ultrasound-assisted liposuction (UAL) technologies?
I would say to you, because of the lift technology, we modify, or this should say, the software modifies itself as we're administering the power. It senses the impedance change in the fat as it's having ultrasonic dissolution. Because of that, we're able to be, we're able to reach the end point. Now, Charlie, I will defer to you as to what I can disclose in terms of proprietary information as to what is the direct reason. The short answer to you, Sam, is when I see that the end clinical endpoint on this UAL goes more efficiently, I'm actually more efficiently eliminating fat, which is the density—five densities: fat, blood vessels, nerves, collagen, lymphatics.
If I can more efficiently reduce this, it leaves behind for me these other stromal elements that we have left behind safely, have selectively preserved them so that those are the recipient energies for the efficiency and delivery of the radio frequency helium plasma. That energy of the helium plasma heats the tissue to a certain temperature in 0.04 seconds and doesn't cook them or make them destroyed. If I can more efficiently remove the resistors of electronic energy and radio frequency helium plasma, I can more efficiently, and I see it in this picture, having done a lot of cases with the other UAL technology and getting this case as its first one, this is the first one that's now seven weeks out. I know for a fact that the previous UAL interaction and the previous RF helium plasma energy gets a certain amount.
But this is a whiz bang outcome because, and I'm attributing it to the efficacy of the UAL component. Your insightful observation, Sam, is exactly on point. As a surgical scientist, what would you like to add to that, Charlie?
Yeah, Sam, it's a great question and Dr. Vanek is exactly right in his explanation. Because the lift technology is more efficient than traditional ultrasonic technologies, it actually does less damage to the surrounding tissues because it uses less heat to separate the fat, like Dr. Vanek was talking about. That makes the fibrous septal network more intact, and because that is now more intact and more receptive to Renuvion, it actually does a better job of tightening the skin. It's a combination of both technologies actually working better that are allowing the surgeons to have these kind of results because of that. It is a direct function of the improvements that we made in the ultrasonic technology that lead to this being able to use better. Dr. Vanek was right on, and you didn't disclose anything that you weren't supposed to, so it's all good there.
Very good. Thank you for your thoughts there. Maybe I can just ask a follow up here and I'll leave it open to both of you.
In terms of capturing more, I.
Guess practice economics versus before with just Renuvion because you have the added.
Capability use of fat removal and along.
With tissue contraction and electrosurgical capabilities, wondering what device utilization can maybe look like.
Going forward, now that you have a.
You can potentially do more procedures versus maybe before when you just had Renuvion?
There are two components of this answer. The first component is there's an efficiency in time motion of having one car drive into the garage than having five cars driving in and working on the same element or five mechanics. The tower itself is an efficiency in time motion. The execution component with the ultrasound-assisted liposuction, as I'm seeing it, is more efficient in time motion. The integrated components are more efficient. The patient selection is a bit broader, so my funnel is a little bigger. The patients are auto-selecting for a practice like mine that is energy-based, and they're very wizened to the idea that old-fashioned liposuction is essentially so 2003, which is the advent of the ultrasonic energy of the third generation. We're in the fourth generation now.
Fourth is that the volume driver from my practice, in my own personal practice, has gone up because now I have these two components of ultrasound-assisted liposuction, state of the art, and especially Renuvion. The market position has been enhanced because of my availability to the state of the art. It self-perpetuates. The surgeons recognize its efficacy, they promote it in their own channels, which results in search engine optimization that has patients now searching top line Google search for the Renuvion helium plasma concept and where to find it. There are multi levels in which I've had a practice funnel enhancement.
Yeah, the other thing too, Sam, that we're hearing from other doctors is because of the lift technology, because of it working more efficiently and Dr. Vanek already alluded to the time savings having with that. Because it goes through tissue easier, the patients are having less bruising, less pain, and quicker recoveries also. That obviously helps in everything because as patients start to talk about these procedures and these technologies and have better experiences with them where they have less downtime, they have less pain, they have faster healing, that just brings more patients to Dr. Vanek's office and other users' offices that want to have the same results and want to have it because the issue is that to have this kind of transformation, the only way that you can do that is in the hands of a plastic surgeon.
That's a true statement. We have a lot of posers in this country. There's no cream that does this, there's no exercise. I mean, the patients come in with great recrimination to say look what has happened to me. They used to have no solution. This technological innovation combined with plastic surgical technology and expertise can make this kind of transformation happen in every zip code in the United States and around the world.
Got it. Very helpful. Thank you so much.
Thanks for the question, Sam. Our next question comes from Matt Hewitt at Craig-Hallum Capital Group. Please go ahead.
Matt, good afternoon and thank you for hosting this event. Paul, thank you very much for your time. Maybe first up, you've talked about the time efficiencies and some of the other areas. From a practice perspective, are you finding that it is making you more efficient where maybe you've got less people in the room when you're performing a procedure on someone or you're able to get more patients in during the day? What else are you seeing?
All of the above. For example, a patient that used to have a small problem that said, I can't do anything for that in the scope of putting them through an entire larger procedure. Let's just say a person has some loose skin under their chin or neck that I'd say, look, the RF devices, the ultrasound devices, externally they're not going to get you what you want. We didn't have a modality of treatment that would bring them to that next interval of improvement. I'm able to do that in the office now under local anesthetic. It was unavailable until 2016, 2015. So that's one throughput interval. Because of Ohio revised code, there's a specificity of the amount of staff you have in a typical operating room. That is not per se requirement, but I am not needing an assistant to do these cases. That's with an innovation.
You often need technical support or, as you're alluding to, Matt, you're needing more something. This does not need more something. All the something is in the tower. The device is a unit. You just plug in the handpiece and it's ready to go. It's intuitive to use, so there's not a long ramp up or learning curve for people that have some reluctance in the world of energy distribution to tissue. We clearly help you steward this onboarding with both the trainers as well as complete availability of KOLs like me in the country. We're willing to take calls because I think we're true believers. The final portion of it is my staff can, with a straight face, say your procedure may have a slightly longer procedure time because of the energy administration, but it does not result in an increased time duration of recovery.
So those time savings that patients say, okay, I have to go through more to get more, the answer is you get to go through more about the same to get more. That proposition essentially says to the patient, this makes total sense. I should be in a practice that has a Renuvion RF device in it. If my competitors don't even have it implemented, they're not in the game. They're not in the same sphere of discussion, SEO, search engine research, and top line explosive growth in body contouring that we're experiencing with these energy devices. I hope I answered your question, Matt.
Absolutely. That's very helpful. Maybe just one follow up. I realize it's early days since we started using AON, but what types of procedures is it, you know, across your entire platform, or have you focused at least early on in a very specific subset of the procedures you offer at your practice?
Well let's be clear. I've been using this device since 2016, so this is not early days for me. I published the largest series of abdominoplasties with ultrasound-assisted liposuction (UAL) and Renuvion in the world. That's a seven year data analysis. My colleagues and I around the country have been using this for years. So this is the first of its kind in which the whole unit has been put together. It's early days for the UAL performance, and as a KOL for other ultrasound energy devices, I have a great deal of gestalt understanding of how that device works and an understanding of its physics. Seeing its performance from the very first cases, as you alluded to seeing it perform, is extremely exciting for me. I've got a lot of objectivity and scientific skepticism. To see it work like this is very exciting.
I know next is more cases because people look at what's going on at those of us who are plugged into the world of bioelectromagnetics and plastic surgery. Very helpful.
Thank you very much.
Thanks for the questions, Matt. Our next question comes from Alex Fuhrman at Lucid Capital Markets. Please go ahead, Alex.
Hey guys, thanks very much for taking my question. Charlie, you mentioned you've seen a lot of interest in the AON system, maybe the most you've seen in anything in your career. I'm curious, you know, who you've really been seeing the most interest from and who's actually been placing orders. Is it mostly customers of yours that already have the Apyx One Console in place and understand the value of Renuvion, or has it been a lot of new customers that you're talking to here?
Yeah, no thanks, Alex. It's a good question. If you look at the customers that we have sold units to between now and the end of the year, there's three buckets of customers. The first one is people who already had an Apyx One Console and just want to get the rest of Renuvion.
There's another group of customers that had our previous generation RS3 that need to upgrade to the Apyx One Console and then get the rest of AON. There's obviously customers that don't have any of our technologies and want an AON system. I would say if you put the first two of those together, we're probably at about 80% of our existing customers so far and probably about 20% of people who did not have our technology at all. That's probably about where it comes out to in the sales that we've had so far.
Okay, that's really helpful, Charlie.
Thanks.
How should we think about the pending application here for the handheld power lipo? It seems to me like that's a pretty big value add for the new system here. Are physicians that are buying it today going out on a limb a little bit, assuming that this is going to be ready for use in Q1? Are you talking to a lot of physicians that maybe will be ready to pull the trigger after that approval goes through?
I think that you've got, first, the power-assisted handpiece is truly important. I think Dr. Vanek talked about it, the importance of retrieving the fat and getting the fat out after you separate it. With ultrasound-assisted liposuction (UAL), they either do it with a power-assisted handpiece or they do it with straight suction.
And a lot of the top body contouring doctors all over the world use the power-assisted device to get that out. There is no question that the power assist completes, if you will, the body contouring system of Renuvion. That being said, we sold quite a few without anybody even seeing what the power assist looked like. I think it was partially because we, as a company—Dr. Vanek talked about dealing with us—as a company, we believe in evidence-based medicine. We've always tried to treat our customers as true surgical partners because if their surgical business grows, so does ours. And so there was a level of trust there. But as Dr.
Vanek also mentioned, we just came back, both of us were in New Orleans this past weekend at Plastic Surgery The Meeting, and we had our power-assisted handpieces available for doctors to see and put in their hands and to basically show them, obviously with the sign that we don't have, that it's pending FDA clearance and it's not available yet. We can't sell them yet or take orders for them yet or anything like that, but the doctors got to see what we have done. I think there's also just a sense from the surgeon community that we didn't design this; this was designed by the top body contouring doctors all over the world that came up with the things that they did not like or care for or needed improvement on the existing technologies. And power assist obviously was one of those.
And so I think there's a level of comfort, if you will, from a lot of the top doctors because they know who these doctors are and they know that they are very good body contouring surgeons and they're comfortable with the work that they're going to do and the improvements that are going to be made for this. Everything else on the system when you look at it is state of the art. Dr. Vanek showed in his slide what the OR looked like before. You can see that looks archaic in so many different ways when you compare it to the sophistication, the elegance, the everything that goes with the AON system. So I just think that there are a lot of people that are willing to go, all right, I will buy this now, I will wait for it.
We're not going to charge them anything to activate their power-assisted handpiece when it comes because that's not the way that we work. And so I just think that there's a lot of people that are willing to get in line and to get the system now knowing that when they get there it's going to be what they expect. In most cases, everything's exceeded their expectations.
I'd like to jump in with one more thing besides that answer, Charlie. This power-assisted handpiece, once you have it in your hand as a surgeon, it is not an also-ran. You think about something that's emerging. They took the best of the best, the ideas of the best top surgeons, but they also discarded some of the elements that are the source of frustration and failure for devices that have up to a 30% disability rate. What I mean is the device you have has a one in three chance of breaking down today, which is an incredible uncertainty and frustration. So those devices have chronically been the underperformance metric, the underperformance touch point for having to have lots of backups and a lot of time motion wasted.
The way the mechanics are, this device, I've spoken with the engineers, we've reviewed things, this thing is a very exciting innovation and it doesn't have the failure points that other power-assisted handpieces have suffered from. I want to congratulate out loud to the engineers and developers and what an incredible innovation this is going to have when it does deploy.
Great, thank you guys, that's very helpful.
Thanks for the questions, Alex. Our next question comes from Dave Turkaly at Citizens JMP. Please go ahead, Dave.
Oh great. Can you hear me?
Yep.
Yes.
thank you.
I just wanted to clarify something here. It sounds like, you know, this is for, you know, kind of the emerging heavy lifting patients. I just wanted to get your thoughts, Dr. Vanek, on some of the other technologies out there, whether they be ultrasound or RF or laser based. Do you use any of those things maybe on people that don't have as much of a problem? Do you have any of those other technologies and do you plan to keep those for maybe a separate class of patients?
That's an insightful question, Dave. The following way is to think of it. There are certain technologies that rise and fall as they emerge for either they have intellectual property that sounds promising. I have trialed and utilized many technologies over the last 30 years. Most of the time when I implement one, it is after I've seen the biophysics and electromagnetics interaction with tissue, either a scientific basis, not purely the empiric clinical result. What I mean in a little sarcasm is a claim of a box does not mean the box does it when you get it in your hands. That being said, for example, you enumerated laser lipo. Laser lipo has some very significant negatives in that it overheats the tissue and is fraught with higher, higher theoretical and actual complication rates.
So that was the device that wasn't so smart when it was implemented, even though it sounded like the whiz bang of laser this or laser that. Lasers have incredible position in my practice for skin resurfacing, and as a KOL for Cyton, I can attribute to a great deal of outcome improvement with lasers. Other devices that are radio frequency, monopolar, bipolar, ultrasound combined with needle distribution, all these devices I have great familiarity with. Some of them are implemented in my practice. Some of them never made the cut for implementation because of either their practical discussion with other users in advance of my deploying them, or their theoretical descriptions and energy and bioelectromagnetics did not seem to meet the threshold. But since the advent of helium plasma, it theoretically met the criterion of my own for implementation.
Number two, it practically met my implementation because when I saw it used in person and saw the technical and clinical scientific descriptions, it immediately said this one will work. It did work. On my first case that I saw, it looked like a two month follow up on a previous liposuction patient because the ultrasound-assisted liposuction device used was the traditional one, and then the RF energy that was used on it made the patient right in the operating room look like they'd recovered two months of post op therapy. It is an amazing innovation that since its time of deployment has really performed as even better performed than I expected. That's why I implemented immediately. Immediately.
And yeah.
Dave, just so you know, the other thing too is Dr. Vanek's showing some pretty incredible before and afters. AON can be used on anybody that is having a surgical procedure. It doesn't have to be this dramatic or this, as you said, heavy lifting. It can be on your standard run of a body contouring patient. Also, because there's not a surgical procedure that it can't do, you would still use those advanced technologies to get the best result. Again, remember, the patient's going to have less bruising, quicker healing, less down time, all of that. It's only for surgery here.
Yeah. Thank you for cleaning it up for me, Charlie. Every patient that sees me that wants a little nipper tuck, some of them can be done in the office like we did before. Now I can give them more tightening. A person whose BMI is darn near perfect but has a little laxity, I'm able to just use the AON Renuvion portion of it and don't even have to take any fat out. I have every tool in my palette as a painter of making their body go from here to there. If they're darn near perfect, we can enhance them in a very minimally invasive way with great efficacy and confidence.
Thank you for that. Just one quick follow up. You said, I think I heard you say eight hours. I was not aware that plastic surgeons spend that kind of OR time. I think you said you've done nine major patients so far. As you look at this, is that, I imagine those are again, but what's sort of an average time you'd expect to do? How many patients could you see, or what's the average time that you would think would be reasonable for a surgeon like yourself?
It's reasonable to do one case on one person for eight hours because I can do seven zip codes in the same surgery with safety and low blood loss. They go home and I saw her the next morning. She's walking into neural power. To be clear about case duration and anesthesia, I can do a one hour procedure on someone's abdomen or a one hour procedure on their flanks. Each zone is dependent. The time duration is depending somewhat on their BMI and their tissue characteristics, but some cases can be done awake under local. The case you're seeing in this shot here is something that's done surgically in the operating room for patient satisfaction and safety. The case duration that patients are looking for means I can use this device on all parts of her body.
She's actually going to come back, she said, and do her arms after this. The spectacle of transformation means, oh, I can do my arms too. Yeah, come back in a couple weeks, we'll do your arms. That's a quick turnaround. Dave.
thank you so much.
Great. Thank you for the questions, Dave. We're going to move to questions from the webcast, so I'll turn it over to Jeremy Feffer at LifeSci Advisors to read those.
Thank you. I'll probably take one here. There are a couple of questions here asking about how AON compares to InMode's BodyTite in terms of clinical outcomes, patient experience, and ease of use for practitioners. Are there specific advantages or limitations that stand out in real world feedback?
Well hold on before I let Dr. Vanek answer that question, I just want to delineate those between BodyTite and AON. Because AON doesn't actually compete with BodyTite. AON is a complete surgical platform. BodyTite is a modality that's used to tighten skin, that uses RF to tighten skin. BodyTite competes with Renuvion, the Renuvion portion, but it doesn't have anything to do with any of the rest of AON. I'll let Dr. Vanek take the rest. I just wanted to delineate that portion of it.
I'm glad you did that. What should I say? Diplomatically and expertly, I don't want to get into the realm of knocking other modalities, but my friends and I who deployed BodyTite have had a great deal of disappointment in that it was rolled out as a device you could delegate in most states because it's a radio frequency needle device. The reality of it is it can really only be used because it's so painful to administer that the only way to use it is essentially in the operating room anyway. The notion of having it as a spa treatment or a topical local procedure that is then administered to a patient with comfort, ease, and great efficacy has, I think, substantially underperformed. The tightening they see is not to the degree that you can.
When you have a helium plasma interaction with soft tissue, it nowhere in any way, as Charlie said, does it do anything with the fat layer and its appearance. It does give some skin tone improvements after the recovery, but it doesn't give what I think is so manifest in front of your eyes. Is this such a substantial intervention? The last thing is it just can't do, based on the theory of physics and tissue interaction, it doesn't have the bioelectromagnetic position to do what plasma does to interstitial tissue. It just doesn't have the ability. It has a market niche, it has a cachet, it has a lot of marketing in terms of its claim. Its performance, I think, is just not in the same category, especially if you line it up directly with Renuvion outcome and body type, best of class outcomes.
So it's almost self-evident that it's a device that's in the business unit or in the sphere of body contouring, but that's where the rest of it is. It's a show horse and a donkey.
S o maybe one more.
I think we have time for one more here, Dr. Vanek. For patients expressing interest in body contouring, how many of these are existing patients or are they new to your practice? Do you see this AON really as being a driver of new volumes to your practice?
That's a great question. That's a question that I can straight up answer. It's been a direct driver of volume to my practice. There are patients who've lost weight, that I may have done one thing on them five years ago. Because they have a contact with my practice, they say, oh, tell me about the AON Renuvion. Now, the AON is only months old. The Renuvion has been present in my practice. So I have gotten a surge of individual patients that come back and say, oh, you have this. I wanted my legs done. I did my arms three years ago. So like I said earlier, the top line Google search for Ozempic face, Ozempic buttock. There's explosive growth in the search engine awareness of tightening procedures. The laxity terminology, if you look at the curves, it's almost three times higher. More searches for that kind of outcome.
When I'm positioned in the market to have Renuvion, it absolutely puts me in a position of driving patients into my practice, which then the whole algorithm of do you want to lose more weight? Okay, we'll put you on GLP-1s. Have you reached your body goal endpoints? All right, we're going to talk about treating your laxity. This availability has been a tremendous boon to my practice in general. One of my friends and on boards that I've heard as a KOL, I get to talk to these people who are implementing this technology in their practice. They have a great enthusiasm for what they're able to achieve that they could not achieve before. We've been chasing it for my whole career. This is my 30th year in practice.
Dr. Vanek, thank you for that.
I think we are now at the t op of the hour.
Charlie, I'll turn it back to you for closing remarks.
No, I would just like to thank everybody for their time today, for their interest in Apyx. I especially like to thank Dr. Vanek for his time and thank you to the LifeSci Group for putting this all together. I appreciate everybody's support. And we're just going to keep focusing on letting everybody know about this wonderful technology and keep bringing this to surgeons all over the world. So thank you all for your time and thanks to everybody at Apyx for doing everything that you do to make all of this possible. I appreciate it a lot.