Q3 2020 Establishment Labs Holdings Inc Earnings Call
Good afternoon, and welcome to establishment Labs third quarter 2020 earnings conference call.
At this time all participants lines are in a listen only mode. After the speakers presentation. There will be a question and answer session and to ask a question during the session, we need to press star one or telephone.
Please be advised that todays conference is being recorded Nic report any further assistance. Please press Star then zero.
At the end the conference over to your Speaker today, David Erickson, Vice President of Investor Relations. Please go ahead.
Thank you operator, and thank you everyone for joining us.
With me today are Juan Jose Chicago Heroes, our Chief Executive Officer, and Renagel Yetter, our Chief Financial Officer.
Following their prepared remarks, we'll take your questions.
Before we begin I would like to remind you that comments made by management. During this call will include forward looking statements within the meaning of federal Securities laws.
These include statements on establishment labs financial outlook, and the company's plans and timing for product development and sales.
These forward looking statements involve material risks and uncertainties and the company's actual results may differ materially.
For a discussion of risk factors I encourage you to review our quarterly report on form 10-Q that we filed with the FCC today and is available on our website at establishment labs Dot com.
The content of this conference call contains time sensitive information accurate only as of the date of this live broadcast November 920 20.
Except as required by law establishment labs undertakes no obligation to revise or otherwise update any statement to reflect events or circumstances. After the date of this call.
With that it's my pleasure to turn the call over to our CEO Juan Jose.
Thank you David and good afternoon, everyone I Hope and we went is healthy and continues to be safe.
As we guided to in October Preannouncement total revenue in the third quarter was $22.8 million, which is comparable to the 22.9 million reported in the third quarter Twinkie 90 in may.
More than double the sales reported for the second quarter this year.
A strong recovery from it and Danny well underway, we are comfortable issuing full year 2020 revenue guidance of $80 million to $82 million.
Well, we are now back toward 2019 revenue levels. We believe we are actually recovering faster than our global industry. Our success and we turn to Prefund demick levels is actually indicative of continued market share gains, which can be attribute it not only to the superior static and safety profile.
Well other implants, but also in our digital efforts have amplifying, how we communicate with both patients and doctors. In addition to strong topline sales this quarter or focus on lowering expenses and driving efficiencies led to continued decrease in our operating cash burn.
During the third quarter, our cash burn was $3 million given us the cash position at September thirtyth of $81.4 million East.
East Kip says.
In a strong financial position and affords us the flexibility to continue managing our business for continued growth in market share gains.
Importantly in the quarter, we continued to advance technologies in our R&D pipeline and will contribute to sales growth in 2020 one equal.
Equally important our submission timeline to gain regulatory approval and entered the U.S. market remains on track.
Like most of the world our business and industry has not yet returned to normal but we are in the clear path towards doing so.
Of course, we are seeing country to country volatility that's could beat 19 flares up in some places but sales in more than 80 countries has given us some stability to manage our business throughout this period as of today plastic surgeons are operating even where government restrictions have limited other activities.
It certainly helps that the majority of breast enhancement procedures are not performing hospitals, putting private clinics, which are generally owned or controlled by plastic surgeons.
Well not all countries are performing procedures at prefund debt levels all countries in which we operate are open in performing procedures.
Our Q3 sales in Europe in Asia were at or above levels reported in the third quarter last year Matt.
Latin America appears to have seen the worst of things and finished October fully reopened with continuing improvement across the region, including Brazil most.
Most importantly, we have seen continued month over month improvement since the lows of April and this has continued into the fourth quarter.
Third quarter direct sales, which continue to be the most reliable indicator of real time trends, we're back to the levels of direct sales in the first quarter of Twentytwenty, which except for the final two weeks of March were mostly on affected by could beat shutdowns distributor sales which are.
Best viewed as an indicator of future demand showed stronger sequential gains than direct sales.
The most important take away from our third quarter results is this.
Patient demand is strong.
Across our many geographies, we consistently hear from surgeons that they have never been busier as they work through their backlogs in that new patients are interested in using this time to recover at home from a static procedures.
One of the interesting and unexpected outcomes of the pandemic is that with the increased time at home patients are eager to invest in themselves both plastic surgeons and patients have become much more adapt and comfortable with online tools for education and initial comes from patients.
As we noted last quarter the level of optimism and business outlook, among our plastic surgeon customers remains quite positive.
Turning to some recent events I would like to recap some of the data we announced that are 10 year Motiva Symposium a few weeks ago at that event. We were pleased to report 10 year post market surveillance data from a variety of sources, demonstrating an unmatched device related complication.
Rate of less than 1% for the key safety endpoints of capsular contracture in implant rupture.
These are two of the most important safety metrics when evaluating the success of breast augmentation procedures.
Of all the data sets that we discussed at our symposium I would like to highlight one in particular, our warranty data from the past five years.
Approximately 12500 woman purchasing extended warranty coverage only nine of them just zero point, 73% required coverage for re operations.
This data is incredibly compelling.
Patients and doctors are economically incentivized to let us know about every complication and yet the reported number remained below 1%.
It continued study support these findings it will represent a dramatic improvement over the historical published numbers of our industry.
This data speaks to something beyond a competitive advantage however, it.
It could change how women receive the CTO of breast augmentation procedures in general your perception of the industry improves along with widely reported new safety data the total addressable market could grow substantially.
While we would like to focus on the data that we are generating regarding or improve safety profile, even more important is improved patient experiences.
The mouth and online forums are an important component of our growth into superior performance and results of our product is at the heart of our success.
As first hand experiences are the driving force behind our business. The second part of the symposium featured a panel of leading plastic surgeons, who discussed the important technological differences between motiva and other implants and shared the real world experiences with our products.
Their belief and Motiva and the growing body of evidence supporting our unmatched clinical results are why nearly 1.3 million Motiva implants had been placed worldwide over the last 10 years.
If you did not get a chance to catch the symposium, we have archive it on our website and I hope you find time to do so.
Surgeons are taking time to listen to their peers.
Our digital platform a few edge offers online training programs and seminars and attract both new and existing surgeons interested in education and the latest innovations in breast implant technology. So far this year. The total audience for online would be bad scientific events has been more than 19000 plastics.
Surgeons and other medical professionals.
Now for an update on our product pipeline.
We have a number of exciting and innovative new technologies several of which represent potential growth drivers in 2020 one.
Beginning with our Motiva floor tissue expander, we are continuing to collect early patient experience in advance of our broad commercial launch in Europe early next year.
We believe the market would be receptive to the advancements offered my flora, including proprietary integrated RF by the board in North Smoots heal by engineered surface.
Eight sites that have used floor. So far feedback has been very encouraging with surgeons, commenting on its ease of use in patients reporting overall satisfaction and comfort.
Well door with Eva implants are already used in breast reconstruction procedures in Europe, the ability to pair them with one of the most advanced tissue expanders available means that we will be able to fully axis. This important market segment.
Flora in the U.S., we now expect to submit our five 10-K in the first half of Twentytwenty one once.
Once cleared by the FDA, we will be able to access the largest portion of the 225 million dollar global tissue expander market.
We expect receipt of the CE Mark in Europe for Motiva ergonomics to implant in the fourth quarter.
Economics to build upon our successful ergonomics implant, which has become our best selling and most premium offering in many markets, including Europe and Asia Pacific.
Tiers of this innovative new product, including enhanced mechanical properties advanced chemistry in improved ergonomics should result in even greater patient satisfaction as it is so feature rich we expect ergonomics due to command a premium price over ergonomics plastic surgeons.
Familiar with their economics should be able to switch easily ergonomics, too, which will be available in a wide range of sizes throughout Europe.
Turning to achieve EMEA, our minimally invasive breast augmentation program, we are continuing to make good progress as we fine tune the surgical technique during the quarter, we received irve approval to begin patient series in Thailand.
Broaden our experience even further we are also planning to initiate patient series in Latin America by the end of the year.
EMEA is a very promising technology and we are excited by the opportunity to expand the addressable market for breast aesthetics by creating a new product category. We are confident of the large number of women who would be interested in a less invasive breast procedure would seek in a static outcomes similar to.
Current multi mine plant.
He is successful it would contribute meaningfully to our growth and further differentiate us in the market.
Motiva is already the implant of choice for many surgeons and patients around the world and we are eager to introduce innovative product portfolio to do a large Chinese in U.S. market.
Continuing to make progress with our regulatory submission in China, and we expect approval during the first half Twentytwenty two as previously discussed customers in this market our active digital users for product information breast enhancement indication and scheduling a plastic surgeon consultations and displays.
Very well to our strong digital capabilities, United States represents the single largest breast implant market in the world and we are continuing to pursue approval to offer motiva two women and plastic surgeons in this geography study.
Study follow up visits are continuing for all patients have a U.S. IB clinical trial in follow up compliance is high even during the more challenging and dynamic environment approximately half of the patients in the US day cohorts have reached a two year anniversary date and all study related.
These remain on track for FDA requirements, we are very eager to demonstrate the advantages of motiva in an F.D.A. clinical trial.
You will recall, we successfully completed enrollment in the revision reconstruction so cohort during the second quarter enrollment in a remaining reconstruction cohorts, which was delayed by the pandemic still continues and we are making steady progress.
With that I'd like to turn the call over to Renee to discuss the financials in detail running.
Thank you Juan Jose.
Not only did we see strong sequential growth in sales this quarter, we aggressively controlled operating expenses and I'd like to thank the team for helping to keep establishment labs in a very solid financial position you can find additional details about our third quarter financials in our earnings press release, and our form 10-Q, which we filed today.
Total revenue for the quarter was $22.8 million direct sales were approximately 40% of the total while distributor sales, which can fluctuate based on changes in inventory levels and the timing of Reorders made up the balance.
Our direct distributor sales mix. This quarter has returned to a more typical pattern I was similar to the same period a year ago.
From a regional perspective sales in Europe comprised approximately 45% of global sales.
Asia Pacific Middle East was approximately 35% and Latin American made up the balance.
Brazil, which is our single largest market globally accounted for approximately 10% of total quarterly sales, even though the Brazilian real has depreciated approximately 40% this year as.
As Juan Jose mentioned, both direct and distributor sales in Latin America were down year over year as the region continued to recover by comparison year over year growth was strongest in Asia Pacific and Europe as those regions recovered more quickly our reported gross profit for the third quarter was $15.1 million.
Or 66.6% of revenues compared to $14.2 million or 62.3% of revenues for the same period in 2018.
The year over year increase was due to the benefit of geographic mix greater operating efficiencies and enhanced manufacturing planning capabilities.
Total operating expenses for the third quarter was $17.7 million, a decrease of $5.3 million or 23% compared to $23 million in the same period a year ago.
C N a expenses for the third quarter declined $4.2 million or 21.9% to $15 million compared to $19.2 million in the third quarter of 2018 the.
The majority of this decrease resulted from our commitment to preserve cash by controlling expenses, including lowering consulting fees lower sales and marketing expenses and the reduction of other discretionary expense categories.
Our research and development expenses for the third quarter decreased $1.1 million from the same quarter, a year ago to $2.7 million.
Most of the reduction was due to the timing of clinical trial expenses and the reprioritization of certain projects strengthening our product portfolio to drive future growth remains a top priority and we will continue to invest in research and development with discipline and focus.
Net loss from operations for the third quarter was $2.6 million compared to net loss of $8.8 million in the year ago period. During the third quarter, we used $3 million to fund operations compared to $6.1 million in the second quarter of 2020 and $10.9 million.
For the third quarter of 2018 this.
This demonstrates our ability to restrict cash burn when circumstances require it and invest when warranted all while driving growth.
From a balance sheet perspective, our cash position remains strong at $81.4 million as of September thirtyth compared to $86.4 million on June Thirtyth to help you with some modeling we expect to see fourth quarter expenses similar to what was reported in the third quarter.
And we plan to provide more specific 2021 guidance next year.
Overall, we believe our company is in a strong competitive position the business fundamentals are sound and we remain very optimistic about the potential for our new products to contribute to our growth in 2021.
And while the covert pandemic still presents a degree of uncertainty I am confident we have the flexibility to respond quickly to changes in our business and we will continue to remain diligent as we progress towards cash flow breakeven and profitability.
I will now turn the call back over to Juan Jose for some concluding remarks.
Thanks Renee.
Before we open it up for questions I'd like to express my gratitude to our plastic surgeons and business partners for their ongoing commitment to establishment labs.
I also want to acknowledge and thank the employees of establishment labs for their tremendous effort and resilience, which has enabled us to successfully navigate a challenging year, while meeting our operating and financial commitment.
Salish maps has a very bright future and we are excited about our ability to grow and create value for our shareholders. As we look to 2021, we have truly differentiated technologies coming that will expand our comprehensive portfolio we.
We expect continued market share gains both from expanding our presence in breast reconstruction and also developing new product categories like minimally invasive augmentation piece.
These will help support for growth next year and for many years to come we continue to plan for entry into the U.S. in Chinese markets, well staying committed to controlling expenses and increasing our efficiency to maintain strong financial position.
Finally in honor of breast cancer and breast reconstruction awareness month in October as part of our global campaign establishment lapse was privileged to partner with plastic surgeons medical personnel in Brazil volunteered their time to perform more than 60 reconstruction surgeries for breast cancer survivors.
Many of these women have been waiting for a long time for their surgeries in being able to help them in their journey is an important and powerful reminder of our commitment to women's health and wellbeing.
We thank you for your support as we continue to transform this industry, while improving women's health with that I will turn the call over to the operator for Q.
Thank you.
And as a reminder to ask a question, ladies and gentlemen, we need to press star one of your telephone.
I will draw your question. Please press the pound key please standby opportunity Ross.
And our first question comes from a lot of Chris Cooley Stephens. Your line is now.
Good afternoon, everyone.
Thank you taking the questions can you hear me okay.
Yes, we can hear you.
Thank you.
Congratulations on the very impressive results in light of an extremely challenging environment, maybe just two quick ones for me first when we think about it.
Just what you saw in the third quarter and the exit rates here as we're going into 2021.
Curious what you anticipate seeing most.
Most most specifically.
In the European Theater.
In terms of growth here in the fourth calendar quarter do you think.
See additional spikes in that that's kind of what what we need to bake in or is it.
An environment now that can manage through any flare ups or.
That you're seeing there just curious you know again, a little bit more about.
What's built into the expectations for the fourth quarter from a top line perspective, and then similarly, if I could maybe just for my follow on with Rene in terms of your cash flow breakeven commentary.
Could you just update US again, when you expect to achieve those levels I mean, clearly you're getting much better leverage now.
Then a great job of expense management just curious.
You plan to spend some of those savings or that initial target on cash flow breakeven could be pulled forward somewhat thank you.
Hi, Chris Thanks for the questions and thanks for joining US today, certainly you know as we went through the third quarter. We saw strong performance in Asia Pacific and Europe, and you know why those countries responded well to the PMIC and came back online in Latin America.
Well, certainly behind that but we've seen improvements as well as well in sort of month over month improvement here as we think about the guidance that we gave for the fourth quarter and full year you know we're factoring in a variety of.
You know things there were juggling at the moment in fact that we're in over 80 countries. You know our guidance represents our best estimate for Q4 based on everything that we presently now and we're obviously actively monitoring the situation in Europe.
It's nice to see that most of the governments that are providing restrictions and they aren't doing full locked down and so weve continued as of today to to continue to see procedures and continue to operate but you know as your question implies we're watching it closely and we'll have to see how the rest of the quarter plays out.
And as you know in your second question asked about cash burn you know I'm very happy with the team's response to this year and everything that we've been juggling and it's great to see that we can restrict cash burn when needed, but we also fully appreciate that you know we will want to.
We continue to invest in research and development and new product innovation and said that we can continue to bring amazing product to this industry. So you know I'm not going to specifically comment on when I think the cash burn it is quite I'm going to turn profitable or are you know turn positive, but I am extremely excited with what we've done this year and look.
Forward to getting there.
Thank you.
Thank you. Our next question comes from the line of Matt Taylor with UBI, Yes. Your line is now open.
Hi, Thank you for taking the question. So they maybe one for you I was wondering.
The Q4 guidance.
Help us understand.
Between Q3 and Q4, how much stocking do you think there was for some of your distributors did that help you in Q3 and are you expecting a similar more or less benefit in Q4.
You know, we you know our Q3 results most of our distributors are are ordering based on sales forecast for future quarters, I would not indicate that the their worst restocking and or punishments. There I think we're very happy to see the activity that's coming from our distributors and we're talking with them on a monthly basis.
So you know when I look back at Q3 and look back at it in comparison to the prior year Q3, and you know sort of gave some commentary where we're really seeing it sort of return to normal both not only the balance of direct versus distributor. But then also some of the geographic stuff. So I was happy to see a business returning not.
Okay.
Okay, and can you speak a little bit to the outlook for surgical schedules have you talk to your customers you have any bead on how things are looking early into next year relative to the pre tovey baseline.
Yeah, Matt what we are seeing is that the business continues to progress well and while we continuously have seen as well these flare ups in different areas of the world.
You know what we have found is that surgeons have gotten really good at adapting to the situation. So the way. They are can you know conducting.
Online consultations the way they are providing very safe protocols for patients to come in when they need to.
You know everything they are doing around providing safe protocols for the surgery procedures take place. So all of that is going on so the situation is very different from last spring and what we are seeing now in Europe. We have seen in other places at different times. So I think by now the plastic surgery community is well aware.
Aptitude and situation. So of course, we're monitoring things you know literally week to week over those 80 countries, but we feel confident of where we are in terms of patient demand and you know the online search activity.
Supports that confidence.
Great. Thank you.
Thank you.
Our next question comes from the line of Raj as noise with Jefferies. Your line is now open.
Great. Thank you good evening.
Wonder if maybe why does it start with you on on Flora Rolling out I guess CE Mark or later this year, but you know this year and in the U.S. at some point next year.
Maybe you could give us some of your thoughts around how quickly. This this could start to take share in that 225 million dollar market opportunity described what would be a reasonable expectation for you over the next say call. It 12 to 18 months.
Yes, Thank you Raj.
Well look.
We are of course Super happy that we got the CE Mark for Motiva Flora earlier. This year, we are conducting pre marketing activities and we're doing that are you know.
Preparation of a broader commercial launch in 2021.
What we have seen so far in the different centers, where they are using motiva flora is that youre, commenting on its ease of use and patients reporting overall satisfaction and comfort with the device now we need to educate surgeons about the unique features of flora including.
What does five engineers surface means if you pair that surface indices, you expand or ahead of the use of our you.
What t. by implants, and then also there's you know that integrated RF I'd port that is MRI compatible. So we're doing a lot of good work to measure the benefits because of course, what we want to be able is to bring to market.
Once we fully launch this at the right price point, so I think that.
You know we're not in a hurry to do this I think.
When when we.
When we see the sales of.
In the past that we've had a breast implants in reconstruction, it's been very low for us because we have been focused mostly on acetic, but the plan is next year that as we start you know bringing to market. This multiple flora. We're also going to be bringing to market. The ergonomics implants for instance for breast reconstruction not remember.
Most of you.
The most of the countries in Europe for reconstruction, you're talking about government contracts hospital contracts and that takes time. So although you know we may do a broad launch in the first half of next year do you remember that we have to go through the process of how contracting takes place.
That's helpful.
Maybe just also on Europe, maybe I could follow up there you know there was a report which I'm sure I think you guys actually sort of round out of European Commission recently on I get on textured implants, and their association with the LCL a you.
It's not something that seems to be getting a lot of focus it's not as much as they used to get that maybe you can describe a bit about what you're hearing on the ground in terms of how much.
Are these issues with textured implant still pushing surgeons to move towards Motiva. You know is that still a very active process, you think or what.
Sort of through the worst of that in the sense that that people are sort of already voted where they want to be in terms of their implant choice and and these reports are really just sort of a nothing.
Nothing new and maybe positions lines.
Yeah as you well know we were the company that you know saw this coming a decade ago and Thats why we.
We created that proprietary by ingenious engineers surface.
What I would say is that what do we have seen last month is more of the same what we are talking is about regulators, placing another set of restriction. So first we saw earlier.
Last month, the TJ in Australia, taking out of the market too, Matt protection devices, and polyurethane implants completely out of the market in Australia and then this comedian report the sheer committee, which is basically a committee of the European Commission that looks at safety issues, what they are highlighting Andrew.
What's particularly interesting there is that they are calling out on the association between textured implant in LTL.
And as you know according to ISO 14, six of seven we are a smooth surface. So we do think that this purge of unsafe devices is good for the industry is going to bring us closer to the patients and closer to woman who were worried about these devices.
And you know just like we've done over the last few years, we will continue to push the message of safety and trying to gain as much market share that we can because of that superiority.
That's helpful. Thank you.
Thank you.
And our next question comes from the line of Josh Jennings with Cowen Your line is now.
Hi, good evening, thanks for taking the questions.
Just two questions first on the FDD trial, I think with your symposium and.
Stellar data that was presented there.
[noise] catalyze some questions from investors around when we could see data from the.
Augment patient cohort cynics cohort.
To your follow up should be completed by next August should we be expecting the initial look at that fermentation cohort data before the end of 2021 or could it come sooner. Just wondering if you could help investors think about timing of when we could see the initial data from the trial.
Yep. Thank.
Thank you Josh.
One of the really good things in terms of the progress is the fact that half of the patients India steady cohorts have now reached their two year anniversary of you know do surgery. So that shows you know the progress that we're making.
No.
We are of course, we're looking very much forward to showing our data because we believe that data will be consistent with what we have seen outside of the United States. However, you know all of these things are ongoing.
Deep conversations with the FDA are part of that and we do plan to you know too.
So our progress as soon as it is possible, but those conversations keep on going with the FDA. We'll let you know as soon as we know some of the.
The I would say clear images regarding this.
Understood understood. Thanks for that and then just thinking about China, I mean huge market opportunity you're going to unlock it.
Was hoping you could just share with us what's left in the regulatory process for China FDA approvals. That's the path, where you guys are taking it should be expecting approvals in China, when they happen for ergonomics to me and Florida or what what will be the initial implants.
Devices that will be approved with heads that initial opening up of the China gate. Thanks, a lot for taking the questions.
Yes, Thank you and of course for us the opportunity in China is super exciting.
You know already.
Many patients fly from China to places like South Korea, Japan, or Vietnam to get Motiva implants at least that we're doing so before the pandemic.
And you know out of those in countries like South Korea, 25% of patients used to come from China. So we know that our technology is going to fit very well into that market, which is set to be the fastest growing breast aesthetic market in the world and the one with the highest average selling prices.
So we just fast or latest round of testing earlier in last quarter, and we continue to make progress we.
We are going to continue working on that product testing that is coming and then complete the remaining regulatory steps, we're expecting approval in the first half of 2022.
Those are for ergonomics in round Smoot silk implants, but we are planning all of the work.
That we are on that we are doing now with the Chinese late regulators to allow us to build on that so that we can bring of course, ergonomics too and specially motiva EMEA because.
We do believe that Motiva, EMEA is particularly well suited for the Chinese market and some of the early experience work that we're doing.
You know with ergonomics to and some of the patient series that we're planning with me a deal.
They all will be you know in that same mind to eventually use that information for the Chinese market.
Oh, that's great. Thanks for those details I appreciate it.
Thank you and our next question comes from the line of Marine.
BP RG your line is now.
Hi, Good evening. Thank you for the question the question.
I'll ask one here recalling the symposium, we hosted last month in that excellent 10 year data.
That I wanted to share some of the feedback weve been hearing from industry and on a related note any detail you can tell us about establishment labs ability to pick up new surgeon during kobin.
Yes of course so.
I think.
You know Weve talked about this before is that for many years, our competitors spoke about but.
Steve I am plans not having been on the market for long enough to really measure the safety profile of our devices and because the FDA establishes.
The studies as a 10 year study then surgeons tend to look at that 10 year Mark very.
Very carefully so of course, we have recede very good.
Feedback from the plastic surgery community, but also from patients.
That have had this devices now for 10 years. So we are very happy to show in that symposium for instance, the results of patients who have had the devices for that that long. So thats definitely very helpful for us and it also allows us to really go into our medical education platform into Motiva edge.
With that message of 10 years in the market would that amazing safety data and just to remind everyone. You know so far this year, we've had aboard 19000 plastic surgeons.
Trained using motiva edge and out of those thousands of new accounts. So I think that of course, we want to get those new accounts to start using motiva as quickly as possible.
We are working towards that but it does show that there is a strong connection between the safety data our ability to conduct online education and eventually turning that into new accounts.
That's great. Thank you for that and wanted to ask a follow up on the T. rania good to hear that you'll be expanding into you know patient series in Latin America, but I wondered where this is taking up in terms of sort of the timeline for motiva EMEA when might we see kind of data from that patient series.
And then what is the plan for I guess formal trials and the regulatory process.
Yeah.
Yeah. Thank you and we want to be able to do with these patients series is to not only expand the number of patients who have received motiva EMEA, but also look at different geography. So we started the series in you know in Asia with some patients.
As being you know.
Getting motiva EMEA in Japan in the plan now is to turn those series also to Latin America. So that we can learn how fast can plastic surgeons begin doing this procedure because in a way, it's a simpler procedure, but it's different so.
So we want to learn about that how can we make this procedure replicable, because we're setting a new standard for minimally invasive breast augmentation and of course, we do plan to expand our series in Asia to Thailand. So that we can also see in another market in Asia, how does that relationship but.
I mean, you know the education the standard can take place in a way that we can capture as much value with me now because this technology. So promising we are being patient and we are being patient because we want to get it right. There was also a strong direct to consumer.
Part of this that we are also working very hard on and this is going to be perhaps the other building block that we're going to begin talking about more and more which is how can we get woman who are currently using pad abroad, but not thinking about a breast augmentation because that's not what they want to eventually see this.
As an option and I think thats one of the key things in this whole equation and one that we are working on very hard so.
I would say Murray is you know we will show data.
As soon as we can but most importantly, we already have you know the safety data of the surface. We are talking about implants manufacturer under the same conditions as the rest of our products. So we are fairly confident on that side. It is mostly about you know getting.
Into the final details of the surgical procedure and then how do we teach this two surgeons all over the world.
Makes sense. Thank you.
Thank you our last question comes from the line to meet her zones with Goldman Sachs. Your line is now.
Hi, everyone. This is Phil on for me. Thanks, So much for taking the question I thought I'd start maybe four Renee it's of course from our own cost controls and the great job you guys have done with Opex. So far this year.
I'm wondering how durable some of those cost savings might be as we look out the 2021.
Maybe how those are going to be related to a resumption and procedures and a ramping backup of sales next year.
Yeah. Thanks, Phil Yeah, I mean, we've been very pleased with this year and how the team has worked diligently across all organising all departments of the organization thinking about different ways to do things differently I think not unlike many other companies you sort of reevaluating, how we do business in the most efficient manner.
And yet while still delivering on our growth targets on our innovation pipeline. So you know we will obviously you know cost will come back in as growth continues to ramp, but I think we've learned a big lesson this year and I'm hopeful that some of those are going to stick.
Some of the cost controls. They came in you have to keep in perspective that they are volume based so they will just automatically come back and when revenue continues to grow but again, I think things like travel or events or again, just different ways of working with our vendors our consulting.
And I'm really pleased to see that the sort of new culture that we've adopted.
That's great color I appreciate it I think the second one looked.
Looking forward to it certainly appreciate the conservatism you guys are taking given given all the question marks I had him I'm wondering if a 30% growth number on 21 right now from the street is an appropriate place to start as you guys think about the recovery and the visibility that you have maybe in light of some of the developments today. Thanks.
Thanks, a lot.
Yeah. It's a good question and I totally appreciate it I think you know we're still finalizing our 2021 annual operating plan, which includes no real time assessment of business conditions in all the countries that we operate and how the pandemic is is happening and flowing through.
So you know at this stage I'm not going to be able to give too much more color to that but we're trying to be really thoughtful in this process and we're just excited with the results that we've seen today.
All right. Thanks, a lot.
Thank you and this.
It does conclude todays question and answer session now, let's turn the call back to management for any further remarks.
Yes.
Thank you for joining us on today's call. We look forward to providing our next quarterly update early next year have a very good rest of the day and please stay healthy.
Ladies and gentlemen, this concludes today's conference call. Thank you for participating you may now disconnect.
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