Plastic surgery
More consultations, at a cost you can actually calculate.
Plastic surgery is a slow decision. A patient may research for months, read twenty sources, and book one consultation. Most practices can tell you what they spent on advertising last quarter and how many consultations they held. Very few can tell you the number connecting those two figures.
That number is the whole job. Everything below exists to move it.
You are being compared, and not only to the surgeon down the road.
A prospective patient researching a procedure is reading review platforms, watching recovery videos, and pricing the same operation in Miami, Mexico City and Istanbul. Price alone rarely decides it — but the practice that never appears during those months of research is not in the comparison at all.
Meanwhile the search results themselves have narrowed. Directories, aggregators and review platforms occupy the first screen for most procedure terms, because they publish hundreds of pages per procedure while a practice publishes one. That gap is closeable, by organic search done on procedure pages. It is not closeable by adding a blog.
The practices that win these searches are the ones treating their site as the place a patient does their research, not as a brochure that confirms a decision already made somewhere else.
There is a second problem underneath the first, and it is the one that costs most. The scarce resource in a surgical practice is not leads, it is the surgeon’s consultation hours. An agency that doubles enquiries while halving their quality has made the practice worse and will report it as a win, because enquiries are what it measured. This is why we treat the held consultation as the conversion event and refuse to optimise against anything upstream of it, which takes tracking that reaches the consultation before it takes a campaign. Once that exists, paid search can be priced against it.
What we do
Five things, described as the work.
Pages built around procedures, not around your service menu
A patient searches for the operation, the recovery, and the price. Most practice sites organise around the surgeon's specialties instead, and lose the search to a site that answers the question directly.
Getting you into results the aggregators currently own
For most procedure searches, the first screen is directories and review platforms rather than practices. Those pages are beatable, but not with a site that has one thin page per procedure.
Reviews and the Google profile, treated as ranking surface
For a decision this size, the profile is often the first and last thing a patient looks at. It is also one of the few things a practice can move in weeks rather than quarters.
Tracking where the consultation is the conversion event
Not form fills, not calls of any length — consultations. Everything else is a proxy, and proxies are what let an agency report growth in a quarter when bookings went down.
Paid search run against cost per consultation
Once consultations are tracked properly, the budget question stops being an argument and becomes arithmetic.
The closest thing we have to proof, stated honestly.
We do not have a plastic surgery client. We would rather say that here than have you find out on the call. What we have is a multi-year engagement with a multi-location urgent care group, where the mechanic was the same one described above: a practice invisible in search made visible, with acquisition cost falling as volume rose.
- Cost per booked appointment
- $122.36 → $8.80
- Organic sessions per month
- 17,351 → 62,602
- Top-three keyword rankings
- 736 → 4,743
Twenty-six months, January 2024 to April 2026, SEO and paid search alongside an 88-piece content library. By the end of it search was the group’s biggest source of patients, bought with no extra media. An urgent care visit is not a rhinoplasty and the economics are not identical — but the reason the cost fell was structural, and structure transfers.
And a Manhattan dermatology practice
Closer to the aesthetic side. Between 15 February and 20 May 2026, paid search produced 628 leads on $6,495 of spend at $10.34 each, with cost per lead falling 45% across the period — $19.80 in February to $10.86 in May.
The interesting part is which ad group won. The Spanish-language one clicked through at 9.2% where the English version of the same ads managed 4.3%, and its leads came in cheaper as well. One city, one practice, one budget, and the only variable was which language the ad was written in. If your market has a Spanish-speaking half and your site does not address it, that is the number to look at twice.
One thing to be exact about: leads, and not booked patients. Down-funnel tracking is not connected in that account, so the figure measures media efficiency rather than patient acquisition cost. Nobody there can tell you what a patient cost, and this page will not imply that anybody can.
Both borrowed accounts are told whole, caveats included, on the results page.
How we start
The first thirty days, and no campaigns in them.
We begin with a free analysis: which procedure searches the practice already appears for, who is sitting above it in them, and what is in the way. It is written down and it is yours, hired or not. Specifically, it covers which procedure searches you rank for and which you do not, which competitors and aggregators hold the first screen in your market, what is technically limiting the site, and how your Google profile and reviews compare to the practices outranking you.
If you do, the first month is measurement and structure. We make consultations trackable back to their source, audit the site against how patients actually search for each procedure, and agree the twenty or thirty searches worth competing for in your market. Only then does paid spend make sense. A practice that scales spend before it can measure usually loses the first quarter of the budget finding that out.
To do the arithmetic before that conversation, the ROI calculator works backwards from a consultation target to the spend it implies.