Contents:

Introduction & Report Overview Abstract Measurement Objectives Sample Design & Distribution Measurement & Data Collection Design How to read this report Executive Summary & Key Findings Detailed Findings I. Plastic Surgeon Demographics a. Plastic Surgeon Years in practice b. Plastic Surgeon Sites of care (where do they perform their procedures) i. Primary hospitals ii. Surgery centers iii. Private offices c. Plastic Surgeon gender II. Plastic Surgeons Procedures a. Plastic Surgeons procedures performed by category i. Reconstructive ii. Cosmetic non-invasive iii. Cosmetic minimally invasive iv. Cosmetic surgical invasive v. Other b. Plastic Surgeons cosmetic surgical procedures performed by type i. Rhinoplasty ii. Liposuction iii. Blepharoplasty iv. Breast augmentation v. Rhytidectomy vi. Abdominoplasty vii. Brow lift c. Plastic Surgeons cosmetic surgical procedures performed at various sites of care i. Hospital ii. Ambulatory / Surgery center iii. Private office d. Plastic Surgeons cosmetic surgical procedural trends i. Increase from past year ii. Decrease from past year iii. No change from past year e. Plastic Surgeons cosmetic non-surgical treatments by type i. Botox Injections ii. Chemical Peels iii. Microdermabrasion iv. Laser Hair Removal v. Sclerotherapy vi. Soft Tissue Filler f. Plastic Surgeons cosmetic non-surgical treatments performed at various sites of care i. Hospital ii. Ambulatory / Surgery center iii. Private office g. Plastic Surgeons cosmetic non-surgical treatment trends i. Increase from past year ii. Decrease from past year iii. No change from past year III. The Cosmetic Patient Profile a. Plastic Surgeons patients seen by procedural type i. Overall / Typical month ii. Cosmetic b. Plastic Surgeons cosmetic patients conversion trends i. Consultation ii. Cosmetic Procedural Outcomes c. Repeat patients treated by surgeon personally vs. another surgeon d. Patient age e. Patient gender f. Patient ethnicity Conclusions Recommendations Suggested Analysis About the Author Table of Figures Figure A-1 Geographical Spread of respondents Table 1-1 Number of Years in Practice Figure 1-1 Years in Practice Pie chart (Quartile %) Figure 1-2 Years in Practice Histogram Table 1-2 Sites of Care Table 1-3 Operating Suites Table 1-4 Other Plastic Surgeons Figure 1-3 Sites of Care Demographic Table 1-5 Male vs. Female Surgeon Respondents Figure 1-4 Surgeon Respondent Gender Pie Chart Table 2-1 Specific Procedures Performed Per Month Figure 2-1 Number of Specific Procedures Performed Per Month Table 2-2 Specific Cosmetic Surgical Procedures Performed Per Month Figure 2-2 Specific Cosmetic Surgical Procedures Performed Per Month Table 2-3 Specific Cosmetic Surgical Procedures Performed at Various Sites of Care Figure 2-3 Percentage of Specific Cosmetic Surgical Procedures Performed at Various Sites of Care Table 2-4 Changes to the Number of Cosmetic Surgical Procedures Over The Past Year Figure 2-4 Net Percentage of Surgeons Reporting an Increase in the Number of Featured Procedures Table 2-5 Specific Cosmetic Non-Surgical Procedures Performed Per Month Figure 2-5 Number of Specific Cosmetic Non-Surgical Procedures Performed Per Month Table 2-6 Specific Cosmetic Non-Surgical Procedures Performed at Various Sites of Care Figure 2-6 Percent of Specific Cosmetic Non-Surgical Procedures Performed at Various Sites of Care Table 2-7 Changes to the Number of Cosmetic Non-Surgical Procedures Over the Past Year Figure 2-7 Net Percent of Surgeons Reporting an Increase in the Number of Featured Procedures per Year Table 3-1 Cosmetic Patients Seen and Not Treated Figure 3-1 Cosmetic vs. Reconstruction Patients and Consultation Only vs. Therapy Received Table 3-2 Changes in the Number of Patients Electing Cosmetic Treatments Following Consultation Figure 3-2 Percent of Surgeons Who Experience Changes in the Number of Patients Electing Cosmetic Treatments Following Consultation Table 3-3 Repeat Patients Treated by Surgeons Personally vs. another Surgeon Figure 3-3 Percentage of Repeat Patients Treated by Surgeons Personally vs. another surgeon Table 3-4 Cosmetic Patients per Age Category Figure 3-4 Percentage of Cosmetic Patients per age Category Table 3-5 Cosmetic Patients Gender Figure 3-5 Percentage of Female vs. Male Cosmetic Patient Table 3-6 Cosmetic Patients Race Figure 3-6 Percentage of Cosmetic Patients per Race Category Plastic Surgery - Plastic Surgery - The Customer Connection - How to Increase the Efficiency and Effectiveness of Sales Calls, Marketing And Professional Education - How to Increase the Efficiency and Effectiveness of Sales Calls, Marketing and Professional Education Introduction & Report Overview Abstract Measurement Objectives Sample Design & Distribution Measurement & Data Collection Design How to read this report Executive Summary & Key Findings Detailed Findings IV. Medical Sales Representatives seen by Plastic Surgeons a. # of times sales reps are seen in a typical month (for any company) b. Frequency of specific sales rep visits for each of the listed companies i. Allergan ii. Bard / Davol iii. BioForm iv. Byron Medical v. Candela vi. Ethicon vii. Implantech viii. Inamed ix. Integra x. Medicis xi. Mentor xii. Spectrum xiii. Thermage xiv. Tyco c. Quality of information presented in sales rep meetings for specific companies 18 (New and Valuable) (New, Not Valuable) (Not New, Valuable) (Neither New nor Valuable) i. Allergan ii. Bard / Davol iii. BioForm iv. Byron Medical v. Candela vi. Ethicon vii. Implantech viii. Inamed ix. Integra x. Medicis xi. Mentor xii. Spectrum xiii. Thermage xiv. Tyco d. How often do plastic surgeons prefer to be seen by sales reps i. Weekly ii. 2 Times per Month iii. Monthly iv. 3-4 Times per Year v. 1 Time per Year or Less vi. Never vii. Only When I Request viii. Only When They Have New Products or Information to Share V. Professional Medical Education for Plastic Surgeons a. How many professional education events do plastic surgeons attend annually b. How often do plastic surgeons attend events by the following companies i. Allergan ii. Bard / Davol iii. BioForm iv. Byron Medical v. Candela vi. Ethicon vii. Implantech viii. Inamed ix. Integra x. Medicis xi. Mentor xii. Spectrum xiii. Thermage xiv. Tyco c. What is the quality of the professional education events attended by plastic surgeons (Poor) (Needs Improvement) (About Average) (Good) (Excellent) i. Allergan ii. Bard / Davol iii. BioForm iv. Byron Medical v. Candela vi. Ethicon vii. Implantech viii. Inamed ix. Integra x. Medicis xi. Mentor xii. Spectrum xiii. Thermage xiv. Tyco VI. Information Sources for Plastic Surgeons a. Plastic Surgeons preferences for learning about new products i. Internet ii. Journals iii. Conventions iv. Sales reps v. Company sponsored events vi. Colleagues vii. Multimedia (CD/DVD) viii. Academic environment (University, Grand rounds, etc.) b. Plastic Surgeons preferences for learning about new methods, techniques, treatments i. Internet ii. Journals iii. Conventions iv. Sales reps v. Company sponsored events vi. Colleagues vii. Multimedia (CD/DVD) viii. Academic environment (University, Grand rounds, etc.) c. What are the marketing practices of Plastic Surgeons i. Print advertising (magazine, newspaper, billboard, yellow pages) ii. TV advertising iii. Radio iv. Web site or internet v. Networking / Developing additional referring physicians vi. Educational seminars / Q & A sessions for public vii. Community activities or charitable involvement viii. Contact with workers comp case managers ix. Contact with large companies in local area d. Time spent on internet & reading medical journals for professional purposes VII. Plastic Surgeon Attitudes What are plastic surgeons level of agreement with featured product statements (Strongly Disagree) (Disagree) (Slightly Disagree)

Summary:

100 American Medical Association (AMA) board certified plastic surgeons were randomly selected from a list of 6300 surgeons to participate in a self-administered questionnaire (SAQ) featured on the internet. Upon completion of the SAQ, 20 of the participants were selected to participate in a follow-up depth interview conducted via the telephone. The purpose of the study is to provide information on surgical practice characteristics, procedures performed and patient characteristics to be used at face value, as well as in conjunction with other data to segment the market. Marketing, sales, product development and strategic planning efforts should be grounded within the context of what is important to the surgeons. The results of this research are clear in identifying efficacy and patient satisfaction as the most important considerations (safety is assumed). The principle determinant of patient satisfaction is product efficacy, as defined by the magnitude of the treatment effect and the long term duration of the results. The relationship between these considerations indicates that concentrating on efficacy will also satisfy the criteria for patient satisfaction. When there is limited discrimination between competitive products on these considerations the importance of sales reps and customer service becomes paramount. Overall, plastic surgeons perceive sales reps to be valuable to their practices by informing them of new products and as such, allocate time to see them. There are indicators that the frequency of sales rep visits are related to product use, however, this relationship needs to be explored in greater depth. Sales reps are not a preferred source for, and therefore have limited influence in, learning about new methods, techniques or treatments. The frequency of sales reps visits, as well as their perceived value, varies by manufacturer. Many of the industry leaders in various product categories are also the companies’ whose reps are seen most frequently. The perceived value of sales rep visits can be increased by presenting new information to the surgeons. Company sponsored professional education is popular among plastic surgeons and attended by 9 of 10 surgeons. Mentor, Inamed and Allergan events are attended by the greatest number of surgeons and all three are rated near the top in perceived value. The value of professional education events can be improved by integrating information surgeons are seeking, namely marketing and business practices assistance. There are currently a number of leading companies that dominate the various product categories within plastic surgery. In addition to being used by a majority of surgeons, these companies also have the highest satisfaction, highest loyalty and clearly defined positions within plastic surgery. Surgeons effectively discriminate between some companies based on their association with various descriptive terms, while other companies are grouped together. Ethicon is considered “Traditional”, while Inamed and Mentor are considered “Flexible” and “Professional”. Ethicon, Inamed and Mentor share the quality of being considered “Established”. Companies considered “Up & Coming” include: Medicis, Lifecell and Allergan. Byron and Coapt are best described as “Cutting Edge”. Overall, perceptions of companies are positive, although some companies (Mentor, Inamed, Ethicon and Allergan) are clearly seen as superior. Three product areas are used most frequently: injectables, sutures and breast implants. The suture category has a clear leader in Ethicon, but the other two categories are split between two products being used most frequently. The injectable category features the use of Allergan’s Botox, as well as Medicis’ Restylane. The breast implant category features the use of Mentor products, as well as Inamed products. Product switching is rare within these categories, but does occur. Approximately 25% of surgeons have switched products within the implant and wound closure categories, compared to 5% within the injectable category. Clearly, the number of competitive alternative products within a category contributes to the switching dynamics. The motivation for switching is based on the factors previously identified as important in determining product preferences, including efficacy, cost and patient satisfaction. Loyalty and satisfaction are clearly related to product use. The leaders in loyalty are the same products used most frequently within the various product categories, including: Allergan’s Botox, Ethicon’s sutures, Medicis’ Restylane, Byron’s liposuction equipment and Inamed’s implants. While reported loyalty is relatively high, there are opportunities for companies to increase product loyalty. Many of these opportunities are based on a financial incentive or reward.

Companies Mentioned

-Allergan -Bard / Davol -BioForm -Byron Medical -Candela -Ethicon -Implantech -Inamed -Integra -Medicis -Mentor -Spectrum -Thermage -Tyco