Buying Your New Face

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Dozens of new kinds of injections, light therapies, laser resurfacing devices and innovative skin creams are available or about to hit the market. The newest selling point: shorter recovery periods, fewer visible aftereffects and, in many cases, near immediate results. "The better the techniques, the more people want them," says New York City and Miami cosmetic dermatologist Dr. Frederic Brandt. The machines used by professionals are expensive, but for dermatologists the payoff is huge: cash up front and no insurance bureaucracy to engage. "If you're really good at what you do," says La Jolla dermatologist Dr. Richard Fitzpatrick, "you've got the potential to charge a premium, which you can't in the medical arena. And you get paid immediately."

That incentive isn't lost on other M.D.s. Many obstetricians, gynecologists and otolaryngologists now offer laser treatments and injections to their patients. Dr. George Shapiro, a cardiologist in Scarsdale, N.Y., is even shifting his practice to what he calls age management. "What I do is offer my patients everything in one place so they can be beautiful and healthy." The man is going to coin money. Here's how the battle is shaping up:

• INJECTABLES: Dueling Syringes

The idea that we could buy a new face without getting a face-lift got its start with Botox, a purified form of botulinum toxin that eases the appearance of wrinkles by essentially paralyzing facial muscles temporarily. Annual regimens for Botox or fillers can cost around $2,000, since the results last three to six months.

Little wonder, then, that Allergan and Medicis are aiming new products at each others' best sellers. The battle started last spring when Medicis was set to pay $3.2 billion for Inamed, a medical aesthetics firm with a promising product pipeline that included potential Restylane competitor Juvéderm and the U.S. rights to distribute Dysport (a Botox-like muscle relaxant that will be marketed here as Reloxin). Weeks before the deal was to close, Allergan, based in Irvine, Calif., swooped in and outbid Medicis by $200 million and also had to fork over $90 million to Medicis as a termination fee. "At first it was a somewhat defensive move," admits Allergan CEO Pyott. "But then I had a 'wow' moment. It was like playing poker when you know you have a winning hand."

Allergan's triumph was short-lived, though. The Federal Trade Commission challenged the company's Botox monopoly and ruled that it couldn't retain Reloxin. Guess who got the spoils? Medicis. "We lost the battle but got the product we wanted anyway," says Manny Kapur, Medicis' business director in Canada. "And we got to buy it with their money," adds Jonah Shacknai, chairman and CEO of Medicis.

For the moment, though, Allergan has the competitive edge. Juvéderm will roll out in January. Medicis' Perlane won't be available until the middle of next year; Reloxin isn't expected until early 2008. Shacknai isn't too worried. He expects that market leader Restylane will hold on to its share of the filler segment and its near 90% profit margins. "We're the leading filler and have lots of pioneering products coming to market," he says. "Eventually, we will be able to meet every need for filling the face."