Let's TalkLet's TalkPatient acquisition for dermatology and aesthetics, where the cash-pay side funds the practice and the imagery that sells it is the imagery the ad platforms restrict.
Dermatology practices usually market the practice and wonder why the high-value procedures do not fill. We will map your cash-pay procedures against what is actually being searched in your market, show you which ones have demand you are not addressing, and tell you what each consult should cost you.
Four failures we see repeatedly in this vertical, and what each one actually costs.
A patient searching for a mole check and a patient researching injectables share a specialty and nothing else - different urgency, different price sensitivity, different decision length. Practices that run one campaign for dermatology get the low-value medical enquiries cheaply and never fill the aesthetic calendar.
Before-and-after photographs are the most persuasive asset an aesthetics practice owns and they are restricted on Meta. Practices either run them and collect restrictions, or abandon visual proof entirely. Neither is necessary: demonstration, technique and result-in-context creative performs once the angles are built properly.
Mixing insurance-billed dermatology and cash-pay aesthetics in one report produces an average that describes neither. The cash-pay side is where cost per consult can be tied to treatment revenue, so it has to be measured on its own or the budget decisions are guesswork.
Aesthetic consults are often scheduled two or three weeks ahead, which is long enough for the patient to lose momentum or book elsewhere. Without a nurture sequence between booking and appointment, the show-rate quietly decides the return on the whole programme.
Business outcomes rather than dashboard metrics. None of these is a guaranteed number - where we do guarantee something, it is written into the offer above.
The real deliverables, not a list written to make a proposal look thicker.
Not the general agency pitch. The reasons that only apply to this kind of business.
In most practices the constraint is not enquiries but who can deliver what. A cosmetic campaign that fills the dermatologist's diary with treatments an aesthetician could perform crowds out higher-value work and medical patients who have waited months. We plan each campaign around which provider actually delivers the service, and push demand toward the hours that have room.
Insurance-based medical dermatology is rarely short of patients - waiting lists are common, and paying to acquire more medical demand only lengthens them. Where that is the position, we say so and put the budget on cosmetic services instead. It is less work for us to manage and it is almost always the right allocation.
Patients choose a dermatology practice partly because it is not a spa. Flash sales, countdown timers and discount codes borrowed from the aesthetics chains erode the clinical credibility that justifies charging more for the same treatment. We keep the tone of a medical practice, which converts better with the patients worth having and costs you nothing in price.
Your cash-pay procedures ranked against what is actually searched in your market. This routinely finds a treatment with real local demand and no page addressing it.
Two funnels, two conversion definitions, two reports. Until this exists, no number about the practice means very much.
Demonstration, technique and result-in-context angles, plus a board and platform compliance pass before anything runs. Planned around the restriction rather than discovered by rejection.
Sub-minute response on every enquiry, then a sequence between booking and appointment so the consult still arrives three weeks later.
Budget follows cost per consult against treatment value, procedure by procedure, rather than a single practice-level target.
The parts of this that come from having run it in this industry before rather than from running it well in general.
Offering a defined skin assessment as the entry point - rather than a list of individual treatments - turns a browser into a patient with a plan. It also plays directly to the one thing a dermatology practice has that a med spa does not: a clinician who can tell what is going on with the skin before anything is treated.
Many practices sell professional skincare and treat it as a counter sale. Handled deliberately - recommended at assessment, replenished on a sensible cycle - it keeps the practice present in the patient's routine between appointments and becomes a steady revenue line that needs no acquisition spend.
Medical dermatology demand arrives largely through referrals from primary care and other specialists. The marketing for that half of the practice is the referral relationship itself - how easy you are to refer to, how quickly referred patients are seen, and whether the referrer hears back. It is invisible on an ad report and it is where medical growth comes from.
Blending medical and cosmetic numbers produces a practice-wide cost per patient that describes neither. Medical success looks like access and referral flow; cosmetic success looks like consults, treatments and revenue per patient. Reporting them apart is what lets a practice owner see which half is actually growing.
The clinic group below came to us running one campaign across every service line in three states, with a cost per lead that made expansion unaffordable. Splitting demand by service line and moving the conversion to the booked consult cut cost per lead 57% within two weeks. That reduction is what funded the next nine states - by eighteen months the group was running in twelve states at 500+ leads a day.
Read the full case studySeparating the medical enquiries from the aesthetic ones was the whole thing. We had been celebrating cheap leads that were never going to book a treatment.
They built creative that worked without before-and-afters. Two agencies before them told me it was impossible.
The nurture between booking and appointment lifted our show-rate more than any ad change did.
Yes, and you largely have to on Meta, where before-and-after imagery is restricted and enforcement is routine. The alternatives that perform are demonstration of the procedure itself, technique and equipment, practitioner-led explanation, and result-in-context rather than side-by-side comparison. Where your state board permits results imagery, it still has a place on your own site and in organic content - it is the paid channel that constrains it.
Almost always. The two patients differ in urgency, price sensitivity and decision length, and a shared campaign optimises toward whichever converts cheapest - which is the medical enquiry, and which does not fill the aesthetic calendar. Separating them costs a little more in management and is usually the single biggest improvement available to a dermatology practice.
They differ by state, and they matter more than most practices expect - what qualifies as a testimonial, whether results imagery is permitted, what disclaimer must accompany a claim, and how a practitioner's credentials may be described. We check your state's rules before creative is built rather than after something has run, because the board is a slower and more serious problem than an ad platform.
It comes from your treatment values rather than from a benchmark. A practice where the average aesthetic treatment is $4,000 can afford a materially higher cost per consult than one at $600, and the useful target is a fraction of treatment value rather than a number borrowed from another practice. Working that out is the first thing in the free teardown.
We handle the response and the booking route, and we integrate with your calendar. The consultation conversation stays with your team, though we review call recordings monthly and feed back what is losing bookings. In aesthetics that feedback is often worth more than a media change, because the enquiry is rarely the constraint.
Usually, yes - it depends on cash-pay volume rather than on locations. A single practice with a strong aesthetic offering and capacity to fill has better economics than a multi-location group doing mostly insurance-billed work. On a smaller budget there is not enough signal to optimise every procedure at once, so we concentrate on the one with the best value and the most capacity, and put the early effort into consult response and attendance, which need no extra spend.
The board that governs your advertising depends on the licence you hold and the region you hold it in. These are the states we have written up.
Written for owners weighing this up, whether or not they work with us.
This is one part of a bigger service. Here is the whole of it, and the closest neighbours.
No pitch deck, no discovery call you have to sit through. Tell us the situation and we will tell you whether we can help.