The ability to pivot may be a boon for founders, but for Pat Phelan, his last pivot was into what seemed like unknown territory.
A serial entrepreneur, the Cork man had established himself in the tech sector, growing Cubic Telecom before going on to found fraud prevention start-up Trustev with Chris Kennedy. The latter was bought by TransUnion in a deal worth $44 million, with the US-based consumer credit-rating company integrating the anti-fraud technology into its business.
But it wasn’t the first time that Phelan had made a major change. He originally trained as a butcher and as a chef in Cork, before striking out into the world of entrepreneurship. Reinvention, it seems, is in his DNA.
So two years after the Trustev deal was done, and Phelan had left the company, a new venture wasn’t exactly out of character, even if the industry was a new departure for him.
Sisu was formed in 2018 when Phelan teamed up with doctors – and brothers – Brian and James Cotter. The company's idea was a simple one: doctor-led aesthetic treatments that were non invasive, effective and safe.
"I remember saying it at the very start, like we're going to build a Starbucks of this," says Phelan, who is chief executive of Sisu.
Botox and beauty treatments may be a long way from online fraud, but Phelan has managed to bring some of his previous skills to the new business: strong growth and a decent tech platform behind it to help support that expansion.
“The business is highly software enabled. People get geofenced messages as they enter clinics. They get geofenced messages as they leave clinics,” said Phelan, adding that it’s the trusted playbook of having the best people around you.
“There’s also that identity for fundraising. We’re substantially funded by people like Bullpen, Greycroft . . . I have that kind of global network for that space as well. So it’s probably funding, tech and scaling will be my skills now.”
It has served him well. Sisu has raised $11 million to date, with a $5.5 million round to support its US expansion.
At the time of its launch, Phelan also had a target in mind: 100 locations open within three years. But that was before Covid and its associated shutdowns, although the company has been opening up new clinics at a fast pace.
“We’re getting there,” he says. “Probably Covid held us; we signed one of these American leases during Covid.”
Ireland has served as the testbed for Sisu. It has 14 clinics currently open throughout the island, including one in Belfast, and there are three more in the works. In its most recent report to shareholders, the company said it grew 104 per cent versus its performance in 2021, with almost 5,000 new patients signed up over the year.
Since it opened its doors, the company has also refined its offering. “When we started, you know, in Cork, we tried to be all things to all people: lasers, huge clinics, two-and-a-half thousand square feet,” Phelan says.
In contrast, its Terenure clinic in Dublin has three rooms and does injectables. “It was that laser-focused about what can we remove to make ourselves better for our patients and that can be applied to any technical stack.”
Sisu has already begun the expansion of the brand outside the country, with the structures it put in place in Ireland replicated overseas. It is this expansion we are here to talk about - or rather, one half of the conversation is taking place here in Ireland, while the other is in Miami, where the growth of Sisu is underway.
Phelan and Brian Cotter, Sisu's global medical director, have temporarily relocated to the US as they tackle the market there. The last few weeks has been a whirlwind of activity as the duo scouted new locations and lined up leases from Florida to Texas to New York. Deals have been agreed for Brooklyn and New York's Upper East Side, and Florida is also in the bag.
Sisu has also appointed a US vice-president of operations to help deliver on that promise, with Drybar's fomer vice president of operations Cristina Kennedy tapped for the role. One of the recent additions to the board is Kimberly Nemser of designer eyewear brand Warby Parker.
The group is targeting the title of largest aesthetic group on the planet by the end of the year – and it has already made serious inroads. As well as the clinics it has already signed leases for, the company is opening a clinic opposite Soho Grande, another lease in Chelsea, and another planned for the Upper West Side in New York.
Phelan says the company intends to end the year with about 32 clinics worldwide, with possibly 25 more opening in the US next year.
You would think that the US is saturated with aesthetic clinics, but Sisu has identified a definite gap in the market: the white space between the high-cost plastic surgeons and dermatologists, and lower-end medical spas. Medical retail with a fashion element, Cotter describes it. “That appeals to people entering the space for the first time,” he says.
In the US, the premises have been carefully chosen, playing to the company’s target market. In Florida, the future Sisu clinics will be nestled alongside Lululemon, Whole Foods stores and high-end fashion brands. “That’s the kind of people we want to be near,” said Phelan.
The beauty industry is a huge market, and one that is growing. Sisu is heading right for the accessible middle ground. It's an approach that has worked well for other brands, such as Warby Parker and dental company Smiles.
“The ambitions for here are massive. It’s a huge market – the global market for this space is $90 billion,” says Cotter. “I feel that’s radically underestimated because the interesting thing about it is that the addressable market is changing continuously. It’s probably a shift in the social paradigm in terms of how people are viewing themselves and this is probably moving into more of a wellness space.”
Another element to the business is the development of the brand – not just for the clinics but for Sisu in general. Cultivating trust with its clients is an important part of the proposition, and Phelan says Sisu doesn’t provide treatments that have no proof points.
“When you actually maintain that core ethos structure, what happens is that business grows. People want efficacy, they want results, they want quality,” says Cotter. “You’ve got a patient cohort or consumer that’s more educated, more learned. The market itself has shifted. And I think by having a full 360-degree spectrum of products and services that Sisu was is supplying, I think it just brings something totally different to the market.”
It’s a good approach for a market that has its share of grey areas. Fillers have become a commonplace beauty treatment, available everywhere from clinics and dental surgeries to high-street beauticians.
But the ubiquity can bring its own problems. While some areas of the business are highly regulated – Botox is only available through prescription in Ireland, and leally should only be administered by a medical practitioner or dentist - fillers have no such restrictions on who can administer them.
Sisu's cofounders have been outspoken about the risk of unregulated treatments, with Brian and James writing an open letter to Minister for Health Stephen Donnelly about it.
“Dermal fillers are a grey area. We have patients walk through the door who have had complications from non-medical providers – some quite shocking actually–-where the product has been bought online, in China, on the internet, got a CE mark from somewhere in Europe. And you have non medically-trained people injecting dermal fillers into people’s faces. Dermal fillers are much more dangerous than Botox because they can cause a lot of damage if they’re in the hands of people who don’t know what they’re doing,” says Cotter.
“It’s something we keep pushing for the HPRA [Health Products Regulatory Authority] and via the minister. Unfortunately, we haven’t had much response, but we’ll keep pushing, and our focus with Sisu here as well is that we will become large enough that we set the industry standard.”
The future looks bright for the homegrown company. Cotter says the company’s trajectory is putting it on track to become the largest non surgical injectable brand on the planet.
"We're further along than I ever was with Cubic and Trustev. We're highly profitable. I think people just don't get it unless they follow me on Instagram how big we actually are. We've a huge business that we've taken from Cork and we're now taking globally. We have interests in other territories and other countries," Phelan says.
“We’re intent on this being 200-250 clinic groups globally and building a global brand out of Ireland.”