Welcome back, everyone. Next, we have SBC Medical Group Holdings, trades on the Nasdaq under the symbol SBC, headquartered in Irvine, California, and Tokyo, Japan. Owns and provides management services and products to cosmetic treatment centers. Happy to welcome Head of Global Planning and Strategy, Stephen Rogers, and Head of Investor Relations, Hikaru Fukui. Welcome, gentlemen. Happy to have you on the conference today.
Happy to be here. Thank you so much.
Thank you very much. Thank you, Ana. Good afternoon, everybody. I'm Hikaru, Head of IR of SBC Medical Group Holdings. Thank you very much for joining our conference call today, despite your busy schedule. As some of you may be meeting us for the first time today, I will begin with briefly introducing our overview of SBC based on Q3 figures. In the latter half of this presentation, Stephen, our Head of Global Planning and Strategy, will explain our current global business expansion strategy, as well as Orange Twist, the US-based med spa in which we have recently invested. Firstly, SBC is the biggest aesthetic medical group in Japan, and we provide comprehensive management support services to franchise clinics. We generate income through franchise fees.
While aesthetic medicine remains our primary area of focus, our franchise clinics have expanded their offering to include a comprehensive range of specialized medical services, including orthopedics, ophthalmology, hair loss treatment, and infertility treatment. This diversification allows us to meet a broader spectrum of customer needs, enhance customer retention, and further strengthen our position. Let me begin with the current status of our franchise clinics. The number of locations has been expanded to 258, and the annual number of customers continues to increase steadily and has now expanded to approximately 6.5 million. Meanwhile, amid intensifying competition in the domestic market, the average revenue per customer visit temporarily declined, but the turnaround has already begun. We will provide more detail on this next page. The graph on the left shows the quarterly trend of average spend per customer.
As you can see, thanks to initiatives such as pricing and promotion strategy optimization and our multi-branding strategy in the dermatology segment, which has successfully captured a higher spending customer group, the overall average revenue per customer visit is clearly showing a sign of recovery. We intend to sustain this positive trend by accurately capturing customer needs and continuing to provide high-quality, high-satisfaction services. Next, our financial performance for the third quarter of 2025. Sales had been declined through the second quarter due to business restructuring and revising to franchise fees, but it is showing signs of bottom out. Additionally, the decline in listing-related costs, including share-based compensation expense, contributed to turnaround in both operating income and net income. We maintain a high level of EBITDA margin. Next, our financial foundation. We maintain a sound and robust financial base with sufficient cash and deposits.
To further accelerate growth, we believe building a strong relationship with a financial institution would be effective. So recently, we utilized bank financing for working capital purposes. Our ample liquidity will continue to be actively deployed for strategic investment, including both organic growth and M&A in Japan and overseas. That concludes my remarks. Stephen, please take care from here.
Absolutely. Thanks, Hikaru. Are you able to hear me okay?
Yeah, I can hear you.
Perfect. Perfect. Okay. Well, a lot of exciting things happening in Japan, obviously some strong growth happening there, and then also some very exciting news globally. Really excited to announce that we have recently signed a minority investment deal with Orange Twist here in the U.S. to start our global expansion and to start working with them as our U.S. partner. Taking a step back, what we've built in Japan, it's taken 25 years. We've got just everything from surgical to non-invasive, medical, a very powerful and flexible platform that is continuing to grow. It's just really amazing what the Japan team has done. As we think about more globally, how can we take all of that success and that scale, and how can we more broadly export that globally?
One of the things that we wanted to do was just figure out, hey, we don't want to copy and paste the SBC model, but how can we find really strong partners in different markets that we can work with, that we feel like have really aligned with our values in providing great medical care, making it more available and providing a great customer experience along with a really strong leadership team and a strong platform. How can we supercharge that and add in a lot of the strong points of SBC and really start to figure out where those touch points are and how we can kind of build that out a little bit more. That was the whole logic between doing this partnership with Orange Twist.
And one of the things that we really love is that the experience when you go into an Orange Twist is just so the bar is so high, and you get such a high level when you get in, and the customer experience is probably some of the best that you're going to find within any med spa. And it's started by Clint Carnell, who's been in the business for a long time and has deep industry knowledge. And we're also working with Phil Jordan at Orange Twist, who have done a lot over the last few years to really start to operationalize the business. I think that's one of the challenges of med spa is you can have a great service and a great offering, but if you're not really able to operationalize it and make it efficient, it's not going to work.
So we feel like we've got a really strong team there, and we're already seeing growth. The company has grown into Nevada and Colorado recently. They're already in California, Texas, and Washington, New Jersey, so a lot more room for them to continue to grow. So we feel like this is the right size and the right time to start working with them and get into the US, so you can go to the next slide. One of the things that would get us excited too is just the overall business development in the US. There's obviously a demand for the aesthetic market. It is continuing to grow. Some estimates have it getting up to $71 billion in 2033, so we feel really excited about the overall market trend and kind of getting in at the right time to really capitalize on some of that.
Obviously, a lot of that's moving into non-invasive treatments, and there's a lot of cool technologies and treatments coming out. We've been doing a lot. I would say SBC Japan is probably on the front cutting edge of a lot of those treatments and technologies. We have so many. We have our doctors traveling all over the world that kind of bring in and kind of curate what that looks like, and we're excited to work with Orange Twist to figure out where we can help and lean in to create a really unique, differentiated experience, so people are not only getting that amazing customer experience at Orange Twist, but they're also getting just really deep, high-class, latest and greatest in terms of the technology and medical treatments so that they can feel and look their best, so we also have a future collaboration agreement.
We've started to identify really key touch points where we feel like we can continue to support each other, where Orange Twist can also help our business in Japan. We're going to look at potentially expanding SBC's clinics in the U.S. through partnerships with Orange Twist. SBC has so many different brands and service offerings. We curate a lot of our clinics based on different demographics. For example, we have women's clinics. We've got our flagship SBC. We've also got clinics for men with our Gorilla Clinic. There's a lot of flexibility there. We feel like, hey, there's opportunity to figure out what we have in Japan and what we could potentially make in the U.S. that could complement Orange Twist and create a really unique and fun experience. The other thing too is that we don't really have these high-class med spas in Japan.
So we're also looking at areas about maybe this is a unique opportunity for us to kind of add this into our brand of offerings within the Japan clinics, as most of our clinics right now are more clinical. You're not getting kind of that luxury, relaxing experience that you might get at an Orange Twist. And then we're also looking at other things like product development and some other really cool things. But a lot of cool areas that we're working on in terms of collaboration with the Orange Twist team. You can go to the next slide. In terms of how this fits into our overall global strategy, we want to be the top medical group in Japan by 2035 and then in the world by 2050.
And so as part of that, we are working with the regional top operators like Orange Twist in the U.S. We're looking at other regions too, like in Asia and in other parts of the world. We're working on creating really unique, differentiated experience in terms of not just aesthetics, but where else we can lean in in terms of wellness and overall health. And then also looking at what is the newest technologies, treatments that are going on, and where can we leverage that first-mover advantage with our clinics and really start to implement some of that. So things that are getting us excited. Obviously, regenerative aesthetic is our backbone, but we're really excited about Longevity Medicine 4.0, and also really utilizing AI and some of the new technologies coming out to help make our treatments and experience that much better. You can go to slide 11.
And as I mentioned before, we're looking to partner with different regional operators. So last year and this year, we're continuing to look for different partners. We're not trying to reinvent the wheel, but we're trying to look for a team that we feel like, hey, they've got a great platform, they've got great leadership, maybe they're lacking in resources, and maybe they're lacking in some areas just in terms of getting access to some of the great different technologies that SBC has. And so how can we kind of supercharge those teams and work together to build something truly great and global? So this year, we're still continuing to look for different partners, develop our own knowledge. I think we're not looking to jump in and just start building really quickly by ourselves.
We really want to make sure that we're working with the best in each of the different regions, so we'll continue to do some minority investments, some different partnerships, maybe some small M&A where we feel like it makes sense, and then as we start to develop more knowledge in the different markets and regions, really start to double down on things that we feel like are working for us and are successful and start to move into bigger M&A and moving into more of an operational-type role, and then in the next three to five years, really start to scale that out a bit more, and so that's how we're thinking about it for the next three to five plus years from our standpoint, so I'll stop there and hand it back to you, Hikaru.
Thank you very much. Ana, this concludes our presentation. So I want to move to the Q&A session.
Perfect. Thank you. Great job. Let's talk a little bit about how you attract, train, and retain high-quality doctors. Talk a little bit about that.
Yeah. I think that in Japan, first of all, overall, we have a strong brand in Japan, and also we have a high quality of education and a training system. So many doctors want to join our group. And of course, definitely, we provide very comprehensive services, excluding treatment, so doctors can focus on their own treatment. So they have a strong incentive to belong to our company.
Talk a little bit about the company's three-to-five-year expectation for growth internationally and what percentage of revenue would you expect be generated from international operations?
Stephen, please.
Yeah. I would expect that we're going to continue to grow substantially in the next three to five years, specifically in the U.S. and in parts of Southeast Asia. Our revenue in Japan is pretty impressive, but my goal is that most of the revenue growth in the next three to five years will be coming globally from different M&A and different deals that we're doing. But I'm not sure exactly what percentage of total revenue that's going to be yet. Right now, we're at 1%, but I expect that to substantially increase to maybe 20% plus in the next three to five years.
And we're seeing more men seek out aesthetic treatment. So what trends are you noticing in your business? And do you think this is a meaningful growth driver?
Sorry, what business? Sorry?
Men. Males and men, not just women seeking aesthetic treatments.
Yes, definitely. Yeah, recently, our customer mix has been changing, especially for young men. The number of the customers has been increasing dramatically. In the past, the aesthetic medicine is for women, but for now, it's more common for men, especially for the young men as well. And in addition to that, I think that middle-aged customers have already been increasing in Japan. Yes. So I think that our customer mix has been expanded now.
Perfect. Thank you. And is your company compliant with US GAAP accounting?
U.S. GAAP accounting. Sorry, what is your question?
Stephen, do you want to answer that?
Yeah, I think we are U.S. GAAP. Yeah, because we're listed on the NASDAQ, yes.
Okay, great. And our viewer is wanting. He's assuming the clinics, are they franchised? If you can talk about that. What's the upfront startup cost? And how is the fee structure set up?
Can you explain that franchise model a little bit and kind of the relationship with the holding company and the clinic?
Yeah. I think that situation is slightly different in Japan and the United States. Yeah. For example, in Japan, basically, the medical corporation is not for profit. Of course, they are making money, but they are not for profit. Under the Japanese medical law. So we have to make the franchise relationship with them. And basically, our franchise fee consists of the fixed type of the franchise fee and the variable type of franchise fee based on the service we provide to them. So yeah. So I think that the most biggest parameter for which contributes our revenue is the number of franchise clinics. And at the same time, if they can increase the number of treatments, it causes the increase of our revenue.
Perfect. Thank you. And can you talk about what your acquisitions look like? Do you use cash, stock, debt?
Hikaru, do you want to talk about it?
Basically, as I commented earlier, we have huge cash at this moment. So basically, we directly utilize this ample cash for the M&A. Yeah, but sometimes we are financed from the financial company, banks, commercial bank. And if we make a big deal, we may raise capital from market.
Yeah. And to the extent that from my perspective, I think to the extent that we are able to use SBC stock in any type of transaction, I think it's really beneficial, especially for us. I know that we've talked a little bit about some of the liquidity issues, but I think that's maybe one thing that we're thinking about as well.
Okay, perfect. Thank you. And elaborate on SBC's medical tourism strategy and how cross-border patient referrals enhance revenue?
Yeah, definitely. Recently, the number of medical tourism customers has been expanding dramatically, especially from East Asian people such as Chinese and Taiwanese. And I think from their point of view, our service quality is very high, and our service is very safe. So many customers are coming to Japanese clinics. And recently, we are trying to expand our recognition through the Chinese SNS name called RED (Xiaohongshu), and I think that we support such expanding.
Great. And what are the primary operational or regulatory challenges as you expand outside of Japan into markets like the U.S. and Southeast Asia?
Regulatory challenges. I think that's also why we partner with local players on the ground already. Obviously, you have to be HIPAA compliant, and there's different structuring when you're dealing with medical operations like in the U.S., going through professional companies. And so just how you structure everything. Obviously, we want to make sure we're being fully compliant. That's the great thing about Orange Twist too is that they're well above and beyond the compliance required from a governance perspective, which is also why we like them too. And then as we look for partners in Southeast Asia, that's kind of why we and also why we're hesitant to kind of start de novo. When you start from scratch, there's a lot more upfront costs and learnings.
And so we just want to make sure that we're already working with teams and partners that are well above the curve on that.
Can you tell us what the average revenue per clinic is, and how does that vary by geography or brand?
Is it in Japan or overseas?
I think the question's general. What is the average revenue per clinic in Japan and in other places?
Again, so this is the total revenue of the medical corporation, and this is the number of the franchise location, so it means roughly 2.5 million should be the average of our clinic level in total.
Okay. And what is the current clinic count? How many clinics do you have? And if you can talk about the target growth rate for the next 12-24 months?
Yeah. As for the number of locations, I think that actually, we don't have the concrete plan, but I think that 10%-50% growth should be the reasonable expectation, including the M&A.
Great. And can you talk about what is your outlook on returning to historical revenue growth rates, example, 10%-15%?
Yeah. I think, yeah, of course, there are many ad hoc factors, but yeah, generally speaking, I think that, yeah, again, 10%-50% should be fair, I think.
Wonderful. Well, Stephen or Hikaru, would you like to give our viewers some closing remarks as we end our conference today?
Yeah. Thank you very much for everybody. Yeah. I think that 2025 is, I think, kind of the preparation year for us. And for the 2026, we want to make this year for the growth year for us. And we consider the communication with each investor is very important. I would like to hear your voice and advice. Yeah. Thank you very much for today.
Perfect. Thank you.
Yeah. Great. Yeah. I was just going to say thank you so much. We're really excited. Obviously, last year was a lot of restructuring, a lot of things happening. And it feels like now we're finally in a place where we can really think about continuing to grow, build partnerships, and just continue to maintain that fiscal discipline that we have in Japan and continue to maintain that globally as well too as we think about growing and expanding and try to be as smart and logical as possible. But thank you so much for your time.
Yes. Thank you guys for joining us, and we look forward to continuing on this conversation more in 2026.
Thank you.
Thank you.
All right, everyone. That concludes our conference today. In just a second, you'll be redirected to the registration page for our next conference next month. On behalf of all of us at Emerging Growth, I'd like to thank our presenters and attendees for making this such a great success. Remember, a complete replay of the conference separated by company is on our YouTube channel, and follow us on X @EmergingGrowthC. I'll see you all next month. Thank you.