Botox owns the syringe. RealSelf owns the answer. LaserAway owns the location.
↓ Download the Full PDFThe Med Spa & Aesthetic Medicine AI Visibility Index 2026 ranks the top 25 brands in U.S. aesthetic medicine: toxins, fillers, devices, body contouring, national chains, dermatology groups, and marketplaces. Rankings are by citation share across the five major AI answer engines.
Top 25 brands control 95% of all AI citation share in U.S. aesthetic medicine. The remaining 11,500 facilities — 96% of every med spa in America — split the leftover 5%. AI did not create that compression. AI exposed it.
Citation share scores out of 100. Higher score = higher citation frequency across the five engines on category-defining patient-intent prompts. Composite of citation frequency (40%), cross-engine breadth (20%), query-type breadth (20%), source-authority weight (15%), and crawl-access (5%).
Brand universe: 92 candidate brands evaluated. The final 25 were selected by ranked composite score across the full candidate universe.
Color key: red — independent / marketplace / challenger brands; black — pharma-backed and PE-backed brands.
Strip out the chains, marketplaces, and dermatology groups. Look only at the drug and device brands inside the Index. Four parent companies hold every citation. Two of them hold 80%.
| Company | Brands | Citation Share |
|---|---|---|
| AbbVie / Allergan | Botox, Juvederm, CoolSculpting, Kybella | |
| Galderma | Dysport, Restylane, Sculptra | |
| Merz Aesthetics | Xeomin, Belotero | |
| Revance | Daxxify |
AbbVie/Allergan controls 47% of all drug and device AI citation share in aesthetic medicine. Galderma controls 33%. Together: 80%. Merz and Revance split the remaining 20%.
Every med spa in America books patients using one of four companies' molecules. AI engines reflect that concentration cleanly. The brand wars play out one tier above the clinic.
Local SEO does not equal AI visibility.
Some brands punch above their revenue. Others punch dramatically below it. The gap is the story.
| Brand | AI Citation | Revenue / Scale | Verdict |
|---|---|---|---|
| RealSelf | #3, Score 86 | ~$50M est. private | Smaller business. Owns the gateway. |
| Daxxify (Revance) | #9, Score 65 | Launched 2023 | 24-month newcomer beat 14-year incumbent. |
| AEDIT | #16, Score 44 | <$20M est. private | Sub-$20M marketplace beat $500M public companies. |
| Schweiger Dermatology | #18, Score 35 | ~$150M est. regional | MD authority > national chain footprint. |
| Alchemy 43 | #19, Score 33 | ~$30M est. boutique | Premium founder-driven press beat scale chains. |
| Brand | AI Citation | Revenue / Scale | Verdict |
|---|---|---|---|
| Hydrafacial (SKIN) | Outside top 25 | ~$300M+ public | Public company. 10,000 spas globally. Invisible to AI. |
| InMode (Morpheus8) | Outside top 25 | ~$500M public | Best-selling device line. Lost the patient query. |
| Cutera | Outside top 25 | ~$200M public | Deep device portfolio. No consumer brand presence. |
| Emsculpt (BTL) | Outside top 25 | Category creator | NFL endorsements. Outrun by outcome-language queries. |
| Milan Laser | #13, Score 54 | 350+ locations | Largest hair-removal chain. Cited less than RealSelf. |
| Ideal Image | #10, Score 62 | 150+ locations | Decade of TV ad spend. Cited below RealSelf, below Daxxify. |
The pattern: smaller companies that invested in earned media, schema, and third-party authority outrank larger companies that invested in TV, ad spend, and location count. Revenue scale built the first generation of aesthetic medicine winners. Citation share will build the next.
Heavy ad spend, NFL endorsements, body-sculpting category creator. Did not break top 25. Patients ask AI about "non-surgical butt lift" and "build muscle without exercise," not Emsculpt. Treatment brand beat the equipment brand.
Public company. Ticker SKIN. $300M+ revenue. In roughly 10,000 spas globally. Did not break the top 25 in AI citation share. The earned-media playbook never ran. The Wikipedia entry is thin. The schema is missing. A category brand functionally invisible to LLMs.
Public company. ~$500M revenue. Patients ask for the outcome: skin tightening, radiofrequency microneedling. Not the device. InMode dominates clinician marketing and lost AI patient discovery.
AbbVie's owned loyalty platform and proprietary clinic network. Massive consumer presence at the point of injection. Functionally invisible at the AI-discovery layer. The parent owns the molecule; the network does not own the answer.
Telehealth giant moving into aesthetics. The Hims/Hers parent is a highly visible DTC health brand. The aesthetics line has not yet earned independent AI citation share. Watchlist for 2027.
Botox 95 · Dysport 78 · Daxxify 65 · Xeomin 56
Juvederm 83 · Restylane 77 · Sculptra 69 · Belotero 15
CoolSculpting 87 · Kybella 58 · Sono Bello 47
LaserAway 72 · Ideal Image 62 · Milan Laser 54 · SEV Laser 29
SkinSpirit 49 · Ever/Body 38 · Alchemy 43 33 · AIRE Aesthetics 25 · Skinney Medspa 17
Schweiger Dermatology 35 · U.S. Dermatology Partners 23 · Forefront Dermatology 20
RealSelf 86 · AEDIT 44
Aesthetic medicine is the most regional category in healthcare-adjacent consumer discovery. Patients do not fly for Botox. They drive 12 miles. The national ranking represents national citation share. The moment a patient adds a city, the answer changes.
Seven metros account for over 60% of all U.S. aesthetic medicine spend. AI engines surface a different leaderboard in each. Phase 2 will publish per-metro measured citation share.
| Metro | Regional Citation Leaders |
|---|---|
| South Florida | Riverchase Dermatology, Spa Botanica, Allure MedSpa |
| LA / Beverly Hills | Alchemy 43, SEV Laser, Epione, BH Rejuvenation Center |
| New York Metro | Skinney Medspa, Ever/Body, Smooth Synergy, Tribeca MedSpa |
| Dallas / Fort Worth | Advanced Skin Fitness, Aesthetica, MD Aesthetics |
| Phoenix / Scottsdale | BodyBeautiful, Spa Bella, Skin Phoenix |
| Atlanta | SkinMedic, Buckhead Plastic Surgery, Ageless MD |
| Houston | Houston Aesthetic Center, DermSurgery Associates, Memorial Aesthetics |
The Index is the first defensible measurement of who is winning that race today. The data will change quarter to quarter. The structure will not. Two companies own the answer. One marketplace owns the gateway. Twelve thousand facilities compete for what's left.
Citation share is the new market share. In aesthetic medicine, it is also the new patient pipeline.
"Botox didn't just win the AI category. It became the category. One word. Fifty years of earned authority. Every clinician blog post, every Reddit thread, every WebMD entry anchors the molecule to the outcome. That's the playbook. The brands that can't say what Botox can say — in a sentence, on a source AI actually reads — don't have a citation problem. They have a relevance problem."
ChatGPT (OpenAI), Claude (Anthropic), Perplexity, Gemini (Google DeepMind), Google AI Overviews.
65 verbatim patient-intent queries spanning toxins, fillers, devices, body contouring, hair removal, skin treatments, location search, safety, cost, and provider selection.
92 candidate brands evaluated. The final 25 were selected by ranked composite score across the full candidate universe.
Citation frequency 40% · Cross-engine breadth 20% · Query-type breadth 20% · Source-authority weight 15% · Crawl-access 5%.
Phase 1 establishes the citation baseline. Phase 2 expands the dataset and validates findings across a larger prompt universe, including per-metro measured citation share for the top 7 U.S. markets. Refresh cadence: quarterly.
[1] American Med Spa Association (AmSpa) State of the Medical Spa Industry Annual Report 2024–2025; IBISWorld Medical Spas in the U.S. Market Research Report 2025; Allied Market Research U.S. Medical Spa Market Analysis 2025–2030.
[2] American Med Spa Association (AmSpa) Annual Industry Survey; Grand View Research U.S. Medical Spa Market Size Report 2025.
Brand revenue and footprint figures sourced from public 10-K filings, S-1 filings, private-equity portfolio disclosures, and trade press coverage in 2025–2026. Private-company revenue figures are estimates.
5W measures and builds AI citation share for brands in aesthetic medicine and beyond. Request a citation audit or brief the team on your category.
Download the PDF Report Request a Citation AuditRonn Torossian is the founder and chairman of 5W AI Communications, the AI Communications Firm. He is the publisher of Everything-PR and the author of two best-selling editions of For Immediate Release.
5W is the AI Communications Firm, building brand authority across the platforms where decisions now happen: ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews, alongside earned media, digital, and influencer channels. 5W combines public relations, digital marketing, Generative Engine Optimization (GEO), and proprietary AI visibility research to help clients measure and grow their presence in AI-driven buyer research. Founded in 2003. Learn more at 5wpr.com.