Television programs like "Nip/Tuck," "The Swan" and "Extreme Makeover" may sometimes present becoming "beautiful" as a fairly straightforward process, but the fact of the matter is that plastic surgery and even less invasive cosmetic treatments can be painful and leave patients looking anything but beautiful for a period of time. Immediate pain, reddening of the skin, bruising, and swelling are just some of the side-effects that must be endured even with so-called simple procedures but a group of Israelis, once again at the forefront of technology, have found a way to accomplish many of those cosmetic treatments without the undesirable effects. Just as the latest trend toward mechanically enhanced beauty kicked off about two years ago, a group of former employees of Yokneam-based Lumenis spotted this market opportunity and founded Aesthera in January 2004. Expanding upon the explosive growth in the medical aesthetics market since the 1990s, the US-based company developed Photopneumatic Therapy PPx, which reduces both the clinical and financial risks associated with traditional laser and light-based aesthetics. A combination of pneumatic energy (pressure) and broadband light, the PPx therapy is a more hygienic procedure thanks to a personalized single-use disposable tip, which is customized per treatment area. Unlike existing treatment alternatives, patients do not need to undergo time consuming pre-treatment procedures such as applying topical numbing agents or cooling gels. "The industry of the medical aesthetic is expected to grow to the level of $700 million a year in 2009 and Aesthera is aiming to get a market share of 10 percent", said Erez Rozenfeld, vice president and head of European Operations at Aesthera, in an interview with The Jerusalem Post. Today, the start-up boasts a total of 45 employees worldwide with direct sales offices and local distributors in the US, Europe, Japan and Israel. In February 2005, Aesthera raised $6.5m. in its second financing round led by California-based venture capital fund MedVenture Associates L.P. Adam Street Partners, and private investors, who previously invested $2.5m. in Aesthera, also participated. Private investors in Aesthera include Israel Institute of Technology president emeritus Zeev Tadmor; Lumenis director and former CEO Yacha Sutton; and former Lumenis director Thomas G. Hardy. Touted as the first no pain and safer light based therapy to treat sun damaged and aging skin, including brown spots, redness and broken capillaries, as well as unwanted hair and unsightly veins, Aesthera is set to continue the trend of Israeli entrepreneurs and scientists leading the medical aesthetics industry. Israel has been at the forefront of developing the industry in past years with companies such as Lumenis, a world leader in medical lasers and light-based technology and Syneron, the Yokneam-based medical technology company. In Israel, Aesthera has already sold about five PPx devices over the past six months through a local distributor. "We continuously looked for a therapy without pain as some patients would stop aesthetic treatments because of the pain element," said Prof. Ralph-Levi Carasso M.D., a pain specialist who is using Aesthera's PPx device at his Tel Aviv Rejuvenation Integrative Center. "There is no equivalent to the PPx. Higher effectiveness with no pain and reduced treatment times. Treatment takes half the time or a third of the time than with similar devices," added Carasso, who is also head of the neurology department at the Hillel Jaffe Medical Center in Hadera. Clearance of PPx by the US Food & Drug Administration in April 2005 marked a significant milestone for the promotion and distribution of the device. "This market has simply been awaiting an effective, easy-to-acquire device that doesn't require high patient volume for profitability. This opens the door to many other patients who may have been unwilling or apprehensive to try traditional technologies for the treatment of sun damaged and aging skin, hair removal and the removal of unwanted veins," said Rozenfeld. Aesthera's linear business model focuses on developing a portable, user-friendly device at a low end-user price for mass usage. Average prices for aesthetic medical devices range from $50,000 to multi-application systems costing up to $150,000 compared with Aesthera's price of $35,000 for the PPx.