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Operator
Welcome to the InMode Third Quarter 2019 Earnings Conference Call. (Operator Instructions) Please note, this event is being recorded.
I would now like to turn the conference over to Miri Segal of MS-IR. Please go ahead.
Miri Segal-Scharia - CEO
Thank you, operator, and good day to everybody. I would like to welcome all of you to InMode's Third Quarter 2019 Financial Results Conference Call. With us on the line today are Mr. Moshe Mizrahy, Chairman of the Board and CEO; Mr. Yair Malca, CFO; and Michael Kreindel, CTO.
Before we begin, may I remind our listeners that certain information provided on this call may contain forward-looking statements, and the safe harbor statement outlined in today's earnings release also pertains to this call. If you have not received a copy of the release, please view it in the Investor Relations section of the company's website.
Changes in business, competitive, technological, regulatory and other factors could cause actual results to differ materially from those expressed by the forward-looking statements made today. Our historical results are not necessarily indicative of future performance. As such, we can give no assurance as to the accuracy of our forward-looking statements and assume no obligation to update them except as required by law.
Moshe will begin the call with the business update followed by Yair with an overview of the financials. We will then open the call for the question-and-answer session.
I'll now hand over the call to Mr. Moshe Mizrahy, InMode's CEO. Moshe, please go ahead.
Moshe Mizrahy - Chairman & CEO
Thank you, Miri, and thanks to all of you for joining our third quarter financial results conference call. I would like to welcome everyone to our first quarterly earnings call as a public company since our IPO on -- which took place on August 8 of this year. I'm sure that many of you are already familiar with the InMode story from our road show presentation and from meetings with some of you. And for those of you who will hear the story for the first time today, I hope that we will communicate the message clearly.
Before I start, I want to present the team here around the table in our office in Israel. With me, of course, Dr. Michael Kreindel, Co-Founder, our CTO and also a member of the Board; Yair Malca, our CFO; Raffy Lickerman, our VP, Finance.
I will start by updating you with the major developments that have positively affected our company since the IPO. As to first one, as presented in the road show, we launched the Evolve platform to the U.S. market. Evolve is the first hands-free platform with 3 treatment modalities: skin tightening, fat destruction and muscle stimulation, what we call EMS. Although the launch was only in the United States, but it was very successful in the fourth quarter.
Second, as part of our global expansion strategy, we have established 2 fully owned sales and marketing subsidiaries, 1 in India and 1 in Australia. We have already hired salespeople and management team in each of those 2 subsidiaries. This initiative will help us to sell our product portfolio directly to the doctor and not through distributors.
Third, we established business plan and contacts in 2 other countries in Europe and Asia for establishing 2 additionally fully owned subsidiaries for marketing and sales in 2020. By the end of 2020, we would like to have full direct operation in 8 territories: the United States, Canada, Spain, the U.K., India, Australia and 2 more countries, as I said, 1 in Europe and 1 in Asia.
Sales. We are continuing to receive regulatory approval for our unique product line. We recently received approval in Canada, and we reported that for the Morpheus8, our second-generation fractional RF device and for our RFAL, radio frequency assisted lipolysis technology, which cover all the BodyTite, FaceTite, AccuTite application. We also received CE Mark approval in Europe for Morpheus8 and also for the Forma V for women's health application. In addition to that, we are currently managing 5 regulatory processes around the world: in Taiwan, TFDA; in Korea, KFDA; in Brazil, ANVISA; in China, CFDA; and in Singapore. And all this is in addition to 2 filings that we made recently with the FDA and additional 2 filings with the CE in Europe. So altogether, we have right now pending something close to at least 10 to 12 new approvals, which we expect to get from all regulatory bodies around the world. Hopefully, all of them will be in effect in 2020, okay? We are continuing to grow worldwide. As of September 30, our total employee was 232 people, excluding manufacturing, out of which 107 are direct salespeople.
Before we continue to update you with the financial results for Q3, I would like to reemphasize InMode's core business and competitive advantage. These competitive advantages help us to maintain our leadership position and momentum for years to go. InMode is a leading global provider of innovating minimally invasive surgical aesthetic and medical treatment solution. Our proprietary products are designed to address: first, face and body contouring; medical aesthetic and women's health using minimally invasive bipolar radio frequency energy. Minimally invasive bipolar RF energy represents a paradigm shift in the aesthetic surgery market, offering an alternative to conventional surgery while significantly minimizing risk of scarring, downtime, anesthesia, pain and other complications that are typical in surgical procedures. In addition, we design differentiated noninvasive medical aesthetics products as well that includes fat killing and skin tightening simultaneously, permanent hair reduction using our innovative dual-wavelength technology and other treatments targeting skin appearance and texture through our high-power intense pulse light technology.
Our competitive advantage is based on 6 competitive elements, which we will maintain as long as we are keeping the momentum. The first one is our IP. We believe that we have a very strong IP on all of our base technologies, which have been registered in several countries. So far, no one has tried to copy these technologies since we believe that everyone knows that our IP cover the technology very well. To summarize, we believe that our minimally invasive RF bipolar IP will provide us with the protection and advantage over years to come.
The second competitive advantage is our know-how. During the last 10 years, we have developed knowledge and know-how with regard to how to design minimally invasive bipolar RF devices for aesthetic surgery and other surgical procedures. This know-how -- this knowledge covers hardware, software and mechanical engineering.
The third element is our clinical base. Since our initial introduction to the market, we have published over 40 peer-reviewed articles in the best magazines on this technology and -- on our technologies and indications. We are the lead -- the leaders of the research of minimally invasive bipolar RF clinical science.
The fourth element -- the fourth competitive element is our luminary base. We have developed a group of luminaries and opinion-leading doctors, who are also surgeons, that conduct our study, and they are a great supporter of our technology. It will be very difficult for anyone in our -- of our competitors to develop such unique group of luminaries and opinion-leading doctors.
The fifth competitive advantage element is the regulatory approval. We passed all the regulatory approval processes in many countries. This process take years since the regulatory bodies around the world ask for long follow-ups. We believe that this is a significant barrier to entry to other competitors.
The sixth element is our branding. We own the brands BodyTite, FaceTite, NeckTite, AccuTite, Morpheus8 and others, which are becoming increasingly well-known brand names. We have already sold 4,400 systems worldwide. We are definitely considered a pioneer in the industry with a strong marketing and brand position.
In the third quarter of 2019, InMode generated record revenue of $40 million, a 57% increase from the same period in 2018, reflecting our continued growth and the increased adoption of our minimally invasive bipolar RF technology around the world. Net income increased by 87% to over -- year-over-year to $16.2 million in the third quarter, up from $8.6 million in the same period in 2018. We are focusing on profitable growth and are successfully pursuing our goal of international expansion driven largely by Europe and Asia Pacific. We're increasing this expansion effort with our subsidiaries established in India and Australia and more to come, which both offer a large target market seeking minimally invasive technology that address the need of plastic surgery, cosmetic surgery and women's health.
Having boots on the ground provide us with direct contact with our customers, ensuring understanding of their need and how to effectively address them, and I mean the doctors. We have a diversified product portfolio. Most of our revenue in the quarter was generated from our BodyTite, Embrace, Optimas and Votiva, so we are not dependent on any individual product.
Now let me hand over the call to Yair. He will review and give you more detail on our financial results. And after that, we will open it to Q&A. Please, Yair.
Yair Malca - CFO
Thanks, Moshe. Good day, everyone. Total revenue in the third quarter of 2019 grew 57% to $40 million with gross margin of 87%. Operating expenses in the quarter totaled approximately $19 million, a 42% increase from the previous year. The increase is due largely to our expenditures and marketing efforts. Operating margin in the quarter was 40% compared to 33% for the same period in 2018. Earnings per share in the quarter were $0.42 per diluted share compared to $0.26 in the previous year, an increase of 62%.
We completed the third quarter with a strong balance sheet. As of September 30, 2019, the company had cash and cash equivalents, marketable securities and deposits of $166.3 million, out of which $70 million are net proceeds raised at the recent IPO. On the cash flow front, across the first 9 months of 2019, the company generated $34.8 million from operating activities.
With that, I will turn the call back to Moshe.
Moshe Mizrahy - Chairman & CEO
Okay. Thank you, Yair. Now we are pleased to open to questions. Miri, do you want to handle this session?
Operator
(Operator Instructions) The first question comes from Jack Meehan of Barclays.
Jack Meehan - VP & Senior Research Analyst
Congrats on the first quarter out of the gate. Just as my first question, the revenue came in better than we were expecting. I heard the update where you stood at August in terms of the commercial hiring. But I was wondering, as you look forward in the U.S., what are your expectations for additional sales hires? In terms of the numbers, where do you expect to end 2019? And what's a good run rate into 2020? And then internationally, could you just give us some color on the -- on what some of the efforts you put in, in Europe and Asia to drive growth?
Moshe Mizrahy - Chairman & CEO
Yes. Thank you, Jeff. Thank you. Yes, I will answer your questions. Currently, in North America, we have 96 direct sales reps. Our plan for 2020 is to grow to 115 -- between 110 and 115. Our direct salespeople in the rest of the world right now is about 11 people. And we would like to grow in 2020 by a least another 12 by opening more subsidiaries. As regard to 2019, our target revenue was between $146 million to $148 million. We are now raising the target to $150 million to $152 million. As regard to 2020, we will give the target in the next conference call.
Jack Meehan - VP & Senior Research Analyst
Great. That's helpful. And then maybe could you just give us some color on where you're seeing traction with the BodyTite family? Just in the quarter, could you give us a sense for how many systems you placed and where you were seeing demand from a customer perspective? And then finally, just how is the AccuTite launch contributing to that? Has that been a driver of the BodyTite placements?
Moshe Mizrahy - Chairman & CEO
The answer, yes, absolutely. As we add more handpieces to the BodyTite Embrace platforms, we sell upgrades to existing customers and we sell the new platforms with the new handpieces. As you know, we do not want to release and reveal the numbers of platforms that we're selling every quarter by names or by category. The only thing I can tell is that we continue to sell across 3 segments of our business, which is minimally invasive, which includes the BodyTite, FaceTite, NeckTite, AccuTite, Embrace and Morpheus8, all the ablative products; and the second segment is the aesthetic, which is the noninvasive RF, IPL laser for more, I would say, conventional aesthetic treatment; and the third part of our -- or the third segment is women's health, which we introduced to the market a few new indications using the AccuTite for labiaplasty and others. Other than that, I don't think we want to reveal the numbers of individual platforms. But again, as I said in my presentation, we do not depend on one product. We are selling across the line.
Jack Meehan - VP & Senior Research Analyst
Great. Last question. The gross margins at 87.4% came in above what we were looking for in the quarter. What do you attribute the leverage on that line to? And what's a good run rate moving forward? Was there anything outsized, which contributed to the upside in the quarter?
Moshe Mizrahy - Chairman & CEO
Okay. First, before I answer your question, I want to say something so everybody will understand. Gross margin of above 85% for InMode, it's a must. It's not nice to have. What does it mean? It means that every time that we go back to the drawing board to design the next platform and we're designing at least 2 new platforms every year, on the drawing board, we have all kinds of formulation to calculate that the systems that we're designing will have 85% gross margin. Otherwise, we do not start. Unless we have 85% to 87% gross margin, we will never be able to invest 45% in marketing, in R&D and others and have a nice profit, which is the most important objective of the firm, I would say. Therefore, we will continue to maintain this level. Either it will be 85%, 86% to 87%, it depends on the mix of the product that we manufacture. If the mix is more RF-based, then it's 87%. If the mix is more laser and IPL, it's 85%. If we sell more on the international market where we recognize only the transfer price and not the full value of the system, then gross margin go a little bit below 85%. But on average, we will keep at least 85% gross margin on any combination product or any portfolio that we will have in the future. Does that answer your question?
Jack Meehan - VP & Senior Research Analyst
It did. So -- but also -- and I really appreciate that feedback. Just in the quarter itself, was there any -- because it obviously did a lot better in the quarter, was there anything that contributed -- should we expect it kind of drops closer to 85% in the fourth quarter? Or what are you thinking?
Moshe Mizrahy - Chairman & CEO
You mean on the fourth quarter?
Jack Meehan - VP & Senior Research Analyst
Yes. And just going forward, is this a good run rate? Or should we just assume 85% is the...
Moshe Mizrahy - Chairman & CEO
Yes. It's going to be a good -- the answer is yes. It will be probably the same as the third, plus or minus 1%. You never calculate it by a fraction of a percentage.
Operator
The next question comes from Matt Taylor of UBS.
Matthew Charles Taylor - Equity Research Analyst of Medical Supplies & Devices
Congrats on a good quarter. So I just wanted to ask a little bit more about the pipeline. Can you talk about the platforms that you're planning to launch here in the second half of the year, first, noninvasive hands-free devices for body and face and also the CelluTite application? And how are those rolling out? What's the reception been like? Any other color that you can provide would be great.
Moshe Mizrahy - Chairman & CEO
Okay. Okay, I will. Thank you, Matt. Yes, the Evoke -- first of all, the Evolve, we launched the Evolve the U.S. in the last month -- in the last quarter, and we continue in the fourth quarter. We will launch it in the rest of the world in the first quarter of 2020. We're still waiting for the final approval by the CE for Europe of the Evolve, which is the body hands-free device. But it will come. It's coming. We're almost at the end. Right now, regulatory becomes a bottleneck. You need to spend more money and attention to get it, but we know how to do it. We have a good regulatory department here that actually files worldwide with some assistance from consultants. So this is the Evolve.
The Evoke, the hands-free face treatment platform, is pending FDA approval. Hopefully, it will come soon. The system is almost ready. We are waiting for the approval, and we're even starting to manufacture some pieces in order to launch it once we have the approval. I believe it will come either at the end of this quarter or the first of next quarter. I'm sure you understand that the FDA is more sensitive with the face, and they ask many questions to make sure that it's safe and the efficacy is according to what we said. We have done all kinds of in vivo and animal testing to show them the study -- to show them the safety. And hopefully, it will come soon.
The same with CelluTite, the CelluTite right now is already FDA approved, but we are waiting to see the results from the study that we are making from the United States to finalize the protocol. So these 2 platforms, as we promised in the road show, we either enter the market towards the end of this quarter. But I believe it would be better to do it right and to launch those 2 products sometime in the first quarter of 2019 -- 2020, excuse me. Other -- we have other products in the pipeline like the EMS and -- the EMS device and some new Morpheus tips. But these are in the engineering phase, and it will come sometime in 2020. Did I answer your question?
Matthew Charles Taylor - Equity Research Analyst of Medical Supplies & Devices
Yes, you did. I just had one follow-up based on that. So firstly, I just was wondering, given you had Evolve launched early last quarter, can you talked about the early uptake of that? How are customers responding to it? Was there actually material sales in Q3?
Moshe Mizrahy - Chairman & CEO
Material sales, yes, it will -- what I can say is it was a successful launch. We sold quite a few in Q3. And we have some backlog, which we're basically supplying in Q4. We increased manufacturing capacity of the Evolve recently, and now we're producing about 25 every week. So it's coming, and it's going to be successful worldwide.
Matthew Charles Taylor - Equity Research Analyst of Medical Supplies & Devices
And then just one follow-up on that. So I guess with the Evoke coming a quarter or 2 later, I mean, obviously, the results in Q3 were very strong despite not having any sales of that. I know you don't want to talk about the specific numbers of boxes, but is there 1 or 2 areas this quarter that were very strong that you saw an acceleration in demand? Is there any high-level color that you can provide to help us understand how different areas of the business are performing?
Moshe Mizrahy - Chairman & CEO
Well, the Evolve, the hands-free device, was actually sold only in the U.S. And it was 9% on our business in the fourth quarter, close to $3.7 million, if I -- to be precise. So that was the nice contribution to Q3, and it will continue to contribute in Q4 and in 2020 as well.
Operator
The next question comes from Kyle Rose of Canaccord Genuity.
Kyle William Rose - Senior Analyst
Congrats on a strong quarter. So a lot has been asked, but I guess I just wanted to talk -- you put up a press release, I think, back in late August, early September, just about a user meeting. Maybe you can help us understand kind of the feedback from the user meeting, maybe kind of how that helps inform your view of the product development and kind of the market opportunity for some of these new products. And then when you think about 2020, opening up 2 markets, it sounds like 1 in Europe, 1 in Asia Pacific, maybe just help us understand the potential for the size and the investments that need to happen to open up those opportunities. Is that something that happens in the first half? Do we see the revenue growth in the second half? Just kind of flesh that out for us.
Moshe Mizrahy - Chairman & CEO
Okay. First, I will start with your second question, okay? The country in Europe that we're talking about, and you can guess, is one of the big -- biggest countries. I'm not talking about Belgium. We are not opening a fully owned or a joint venture controlled by us in a country that will contribute a few million dollars a year, we would like -- or a few hundred thousand dollars a year, we would like to open it in a country where the investments will pay off. And of course, it will be one of the biggest countries.
In Asia, I can tell you, we are talking about China. We are trying to open something in China. We have a small company in Guangzhou. And once we get the CFDA approval, we will start operating commercially in China, direct and through some distributor. In China, you cannot go just direct, you have to combine because China is big territories. Sometimes, there's a different mentality. We are learning it right now, doing some homework in order to be prepared for the time that the CFDA will allow us to start. We're in the process of getting CFDA for the InMode RF, the minimally invasive, and also for the InMode.
As far as your first question regarding the user meeting, the user meeting was the first time we did -- was the first time that InMode actually did such a meeting. And it was just good for the doctors to share information. We had something like, I don't know, 6 to 8 lectures every day. It was for 2 days. Attendance was about 600 people, which is very unique for the first user meeting. We intend to continue to do it. Some doctors shared some of the experience. Some doctors asked questions about the adverse effect. They tried to share protocols and to understand which protocol was better. I think it's good, especially for doctors. It's a community. It's a community like the family of InMode, and we will continue to do it. We are learning for the first time. And the next time, we'll be organized, I believe, even better with some experience that we have from the first time. But it was quite successful.
Kyle William Rose - Senior Analyst
Great. And then just one follow-up for me. Just you've got a nice war chest of cash piling up, both from the recent financing in the IPO but then also from just cash flow from operations. I guess how should we think about deployment of capital on a go-forward basis? I mean your expectations for product development and gross margins are very clear. But should we expect you to be acquisitive on a go-forward basis? Just how do you view your cash utilization moving forward?
Moshe Mizrahy - Chairman & CEO
Well, we have close to $170 million. And I will not tell you today that we have -- we know how to deploy $170 million, no. But we have 3 areas where we will invest heavily. First, when you establish a subsidiary, you need millions of dollars. You hire people. You have real estate. You need training. You need to give them demos. You need to keep inventory, working capital. It's an investment. And this is coming from the same source.
Second, if the opportunity will present itself and we will be able to acquire a complementing technology that will enable us to design something which will complement our product line, we will do it, licensing or buying technology. And there are some technologies that we are considering right now. We are checking. We have some people coming to us with, call it, technologies that relate to wellness, aesthetic, et cetera. So this is also something that we might consider.
All the rest is, well, increasing our capacity of manufacturing, and that costs money. I will not say it costs $170 million, but it costs money. And we are now establishing a few more lines. Probably, we will increase our production capacity by 1/3 next year. And we are doing it right now. And this is also -- we are deploying money on all kinds of manufacturing facilities, all kinds of testing equipment, all kind of fixtures and having -- and buying inventory of components. This is also another. But at the end of the day, we're generating -- you can see that we're generating about $16 million to $18 million every quarter, which is a lot of money. Basically, it's our net profit. And so I assume that the money will continue to accumulate until we have some good reason to invest tens of millions of dollars. Right now, we do not have.
Operator
(Operator Instructions) The next question comes from Jeff Johnson of Baird.
Jeffrey D. Johnson - Senior Research Analyst
Just a couple of follow-up questions for me. First, Moshe, did I hear you correctly, I joined the call a little late, that you do have EMS indications approved on Evolve? And then on Evoke, I know you're talking about an approval late this year or early next. We did just see an FDA approval on a product called EmFace, E-M, face. Just wondering what that product is. We thought that might be Evoke, but it sounds like it must not have been.
Moshe Mizrahy - Chairman & CEO
Yes. The EmFace, it's a preliminary on the Evoke. We got the approval on one indication. We're waiting for the second one. So we will launch them together. You are right, this is the product. As we go to the EMS on the Evolve, it is not yet FDA approved. Once it will be approved, we will be able to launch it to the market on the Evolve. But the EMS will be also be launched on the Votiva and other platforms as well.
Jeffrey D. Johnson - Senior Research Analyst
All right. That's helpful. And then on the women's health care platform, obviously, there's just been a lot of noise in the past year on there. And you seem to be sitting well compared to some of your competitors in that area. So any color you can provide on that part of the business this quarter, what it grew, how to think about the women's health care business over the next several quarters.
Moshe Mizrahy - Chairman & CEO
Yes. The woman health business, you know that all the industry had a problem in the middle of last year in 2018 when everybody received the letter from the FDA. Several companies left the market like Lumenis and Cynosure and others. Those companies have used laser to do ablation in the vaginal wall. Since we are using RF, which is nonablative and noninvasive technology, the FDA received our answer to the letter, and we are well cleared by the FDA to continue to sell it. So actually, this market, after the FDA letter, went down significantly. And we are picking up again. Right now, it's about 16% of our business. But by adding more indications to the same platform, we hope that, that will grow again to the level of 20% and above -- 20% and above.
Jeffrey D. Johnson - Senior Research Analyst
Great. That's helpful. And the last question for me, just on the new relationships in India and Australia. Was there any contribution from inventory load into those dealers in the third quarter? Or can we use this kind of $9 million international revenue number for the third quarter as a good jumping-off point to think about how we grow that number over the next several quarters?
Moshe Mizrahy - Chairman & CEO
Yes. In Australia, there is none. We just hired the general manager and 2 more people. So their contribution to the third quarter was not -- would not exist. The India was the first quarter that we're actually selling, and the revenue in India was around $280,000 to $300,000.
Operator
And we have a follow-up from Matt Taylor of UBS.
Matthew Charles Taylor - Equity Research Analyst of Medical Supplies & Devices
I just wanted to ask about margins longer term. So you had really strong margins this quarter, and you talked about your commitment to 85%-plus gross margin products. I guess given the high-margin number that we saw in Q3, does that give you more confidence in your gross margin trajectory over the next couple of years? Can we actually see gross margins expand? Can you talk a little bit about those dynamics?
Moshe Mizrahy - Chairman & CEO
Now I think we're in some kind of a balance. I think to grow above 85% to 87% will be very difficult, and we don't want to jeopardize the quality of the system. Of course, we can buy cheaper components and try to do it cheaper, but I don't think it's necessarily having 85% to 87%. I do believe that we will continue to maintain the -- this gross margin level between 85% to 87%, depends on the platform, depends on the territory, depends on the end-user price. I don't think it will go up to above that.
Operator
This concludes our question-and-answer session. I would like to turn the conference back over to Moshe Mizrahy, Chairman and CEO, for any closing remarks.
Moshe Mizrahy - Chairman & CEO
Okay. Again, thank you, everybody, for joining us. We will welcome you again within 3 months in our end-of-year earnings call. And have a good day. Thank you very much. Bye-bye.
Operator
The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.