Let’s have an honest conversation about where the aesthetic and wellness industry stands right now because what worked from 2020 to 2023 is simply not the playbook anymore.
Our team works with hundreds of medical aesthetic practices all over the world, and the pattern we are seeing right now is consistent: practices that rode the post-pandemic wave without investing in their infrastructure are hitting a wall. Revenue has plateaued.
New patients are harder to come by. And the team that was busy enough to coast is now being asked to perform at a level they were never trained for.
The good news? Every single one of these challenges is fixable. But you have to be willing to look at your business clearly and make changes with intention. That starts with understanding what the market is actually telling you.
The Boom Years Are in the Rearview Mirror
The numbers speak for themselves. According to the QSight 2025 report, U.S. non-surgical patient spending jumped from $12.1 billion in 2021 to $20.4 billion in 2024. That’s a 24% leap in a single year, driven by pent-up demand and a consumer base that was ready to invest in themselves after two years of putting life on hold.
By 2025, the market grew again to $21.0 billion, but at just 3%. The total U.S. aesthetics market, surgical and non-surgical, now sits at $28.5 billion.
That is still a massive, growing industry. But the pace has shifted, and practices that were growing effortlessly are now having to work for it.
The ones that are pulling ahead are doing so because they built something real: systems, trained teams, and a patient experience that drives loyalty.
Surgical practices have reason to feel encouraged: U.S. surgical spend grew 9% in 2025, the strongest growth since 2022, reaching $7.5 billion. Procedures like facelifts, brow lifts, and fat grafting are trending upward. But even with strong procedure demand, the practices winning in this environment are the ones investing in the business side as much as the clinical side.
Today’s Patient Is a Different Buyer
One of the biggest shifts we are seeing across all practice types, from med spas to surgical practices to wellness centers, is how differently patients are making decisions compared to three years ago.
They are taking longer to commit. They are comparison shopping across multiple providers. They are reading every review, scrolling your Instagram, and forming opinions about your practice before they ever pick up the phone. And when they do call, if your front desk or patient care coordinator is not trained to handle that conversation with confidence and skill, you are losing them before they ever walk in the door.
Add to this a tighter consumer financing environment. Approval rates have become more restrictive, and patients who might have said yes easily in 2022 are now hesitating when the monthly payment comes up. If your team cannot navigate the financial investment conversation with clarity and confidence, presenting options, addressing concerns, and guiding a patient toward a decision, that hesitation becomes a lost booking.
This is one of the core areas where our team works with practices. Sales training is not about being pushy. It is about equipping your team with the language, the process, and the confidence to serve patients well and move them to action. When your providers or patient care coordinators know how to handle objections, present treatment plans, talk about financing naturally, and follow up with leads consistently, your conversion rates go up and so does your revenue.
You Are Competing for Attention in a Crowded Market
According to Qsight, there are approximately 33,000 medical aesthetics practices operating across the United States today. Integrative wellness and regenerative medicine practices are entering the aesthetics space at a rapid pace, nearly 20% of practices now mention “regenerative” services on their website, and over 6,000 reference “longevity” programming. Medical spa locations alone grew 17% in 2023, according to AmSpa’s State of the Industry Report.
The result of all this growth is showing up in patient acquisition data. The average practice acquired 496 new patients in 2025, down 6% from the prior year, marking the second consecutive year of decline. New patients are harder to attract, and the cost of acquiring them has gone up. Paid digital advertising is more expensive. Organic social reach requires more effort and consistency than ever before.
This does not mean marketing doesn’t work. It means marketing alone is not enough. You need a team that can convert the leads your marketing generates. You need a consultation process that moves patients from interest to commitment. And you need a patient experience that earns referrals and repeat visits without you having to chase them.
Where Revenue Is Being Lost
Most practice owners are spending more on marketing when the real opportunity is sitting right inside their four walls in how their team converts leads, closes consultations, and brings patients back.
On conversion, our TRC-recommended benchmarks are clear. Surgical consult-to-close rates should be running 60 to 70%, with top performers above 70%. Non-surgical should sit between 70 and 85%. Show rates for paid surgical consultations should exceed 90%.
If your numbers are below these, you have a team training and process issue and that is something we can fix.
On retention, the data is equally sobering. The average aesthetic practice retains only 52% of its non-surgical patients year over year. For plastic surgery practices specifically, that number drops to 48%. The bottom 25% of plastic surgery practices retain just 23% of first-time patients.
That means nearly eight out of ten new patients never come back.
When you compare practices enrolled in manufacturer rewards programs against those that are not, the gap is striking. Enrolled patients return at a 68% rate. Non-enrolled patients return at 42%).
The difference is structured touchpoints, consistent communication, and a reason to come back. Our TRC retention benchmark for a healthy aesthetic practice is 65%. For practices seeking private equity investment, Skytale Group sets the bar above 70%.
Your existing patient database is one of your most valuable and most underutilized assets. Building a strategy around reactivating dormant patients, creating treatment plans, and implementing membership or loyalty programs can generate significant revenue without spending a dollar on new patient acquisition.
New Services Are Bringing New Patients
One of the most exciting opportunities in the current market is the expansion of services into adjacent wellness categories, and the new patient demographics those services are attracting.
According to Qsight, GLP-1 and medical weight loss programs are a prime example. Quarterly spending in this category went from $53 million in early 2021 to nearly $493 million at its peak in 2025.
More importantly, 40% of GLP-1 patients were brand new to the practices that offered them. For med spas and wellness practices that added weight loss programming, this became a meaningful new patient acquisition channel.
Beyond weight loss, categories like exosomal therapies, hair restoration, polynucleotides, regenerative skincare, IV therapy, hormone balancing, and longevity programming are growing rapidly, both in patient demand and practice adoption. Hair restoration is now offered by 42% of practices, up from 19% in 2017.
Exosomal therapies are offered by 28% of practices, up from zero just eight years ago. Consumer awareness of these emerging treatments is high. 60% of aesthetic patients are already aware of exosomal therapies, and 52% say they intend to try them.
If your practice has not evaluated how your service mix aligns with where patient demand is heading, that strategic conversation is overdue.
Uncover Hidden Revenue, Increase EBITDA, and Build a More Valuable Practice
This is exactly the work our team does every day at Terri Ross Consulting.
Most practice owners know they have opportunities for growth, but very few know exactly where they are losing revenue, what those gaps are costing them, or how to fix them.
Our Business Evaluation is an intensive, data-driven deep dive into every critical area of your business, including financial performance, provider productivity, pricing strategy, patient acquisition, conversion rates, retention, team effectiveness, operational efficiency, capacity utilization, and overall profitability.
We analyze your practice the same way a private equity firm, strategic buyer, or sophisticated investor would.
Our goal is to uncover the hidden opportunities, inefficiencies, and profit leaks that are preventing you from reaching your full potential.
The result is a comprehensive Formal Business Report that goes far beyond identifying problems. We provide clear, actionable recommendations prioritized by impact, along with financial projections that quantify the opportunity. In other words, we don’t just tell you what’s broken, we show you exactly how to fix it, what to do first, and what the potential return could be if implemented successfully.
Many practices discover hundreds of thousands of dollars in unrealized revenue, hidden EBITDA, pricing opportunities, operational inefficiencies, or provider capacity that was previously overlooked.
For practices seeking transformational growth, increased profitability, improved valuation, or preparation for a future exit, our consulting engagements provide the accountability, expertise, and implementation support necessary to turn strategy into measurable results. We work alongside your leadership team to execute the roadmap, align your people, optimize performance, and create a business that is not only more profitable today, but significantly more valuable tomorrow.
Whether you operate a single-location med spa, a plastic surgery practice, or a multi-site enterprise, we help you understand where you are, define where you want to go, and build the strategic plan to get there.
Increase Revenue Without Adding Providers, Devices, or Marketing Spend
For practices looking to increase revenue without adding additional providers, devices, or square footage, sales training is often the single highest-return investment they can make.
The reality is that most practices do not have a lead problem; they have a conversion problem. Opportunities are being lost every day through missed calls, weak consultation skills, inconsistent treatment plan presentations, poor follow-up, and teams that lack the confidence to discuss financial investment with patients.
Our industry-leading Sales Training Program is specifically designed for aesthetic, wellness, regenerative, and surgical practices. This is not generic sales training borrowed from another industry. It is built around the unique psychology of elective healthcare, where patients are making highly emotional decisions that require trust, education, confidence, and connection before they commit.
We train each role based on its specific responsibility, influence, and revenue-driving KPIs.
Front Desk Coordinators & Patient Care Coordinators
Your front desk team controls the first impression and often determines whether a lead ever becomes a patient. We train teams to effectively answer phones, build rapport, qualify inquiries, overcome objections, communicate your Unique Value Proposition, schedule consultations, reduce no-shows, and execute consistent follow-up.
Key Performance Indicators:
- Call-to-consultation conversion rate
- Lead response time
- Consultation show rate
- Lead follow-up compliance
- New patient acquisition
- Cost per acquisition (CPA)
Patient Care Coordinators (PCCs) & Surgical Coordinators
Your PCCs are often responsible for the most important financial conversation in the patient journey. We train them to confidently present treatment plans, package recommendations, discuss financing options, overcome objections, create urgency, and guide patients toward a decision without pressure or discounting.
Key Performance Indicators:
- Consultation-to-procedure conversion rate
- Average treatment plan acceptance
- Revenue per consultation
- Financing utilization
- Treatment plan compliance
- Surgical booking rate
Providers (Injectors, Aestheticians, NPs, PAs, Physicians, Surgeons)
Providers have the greatest influence on patient trust and lifetime value. We train providers to conduct consultations that uncover patient motivations, present comprehensive treatment plans, educate effectively, increase patient commitment, recommend appropriate products and services, and create long-term treatment pathways rather than one-time transactions.
Key Performance Indicators:
- Revenue per hour
- Average patient spend
- Treatment plan utilization
- Internal referral generation
- Patient retention
- Frequency of visit
- Provider productivity
- Lifetime patient value
Our training combines proven sales psychology, consultation frameworks, communication techniques, objection handling, personality profiling, treatment plan presentation strategies, and patient journey optimization. Most importantly, we provide teams with practical systems and scripts they can implement immediately.
The result is higher conversion rates, increased revenue per patient, improved provider productivity, stronger retention, and measurable growth that often generates a return far exceeding the investment in training itself.
Simply put, when your team communicates more effectively, patients say “yes” more often and every key metric in the business improves.
The practices that are growing in this environment are not necessarily the ones with the biggest marketing budgets or the most Instagram followers. They are the ones with trained teams, clear processes, and a leadership mindset that treats the business with the same rigor they bring to clinical care.
The Market Has Changed. Have You?
The aesthetic and wellness industry is not in decline. Far from it. Long-term growth projections remain strong, and the consumer appetite for looking and feeling better is as powerful as ever. But the era of effortless growth is behind us, and the practices that will define the next chapter are the ones building real businesses, not just busy practices.
If you are ready to take a hard look at your numbers, invest in your team, and build the infrastructure to grow with intention, we would love to be part of that journey.
The next era belongs to practices that are ready for it. Let’s make sure yours is one of them.
