Frequently Asked Questions

About the Med Spa & Aesthetic Medicine AI Visibility Index

What is the Med Spa & Aesthetic Medicine AI Visibility Index 2026?

The Med Spa & Aesthetic Medicine AI Visibility Index 2026 is a ranking of the top 25 brands in U.S. aesthetic medicine based on their citation share across five major AI answer engines: ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews. The Index measures how frequently each brand is cited in response to 65 patient-intent prompts, covering toxins, fillers, devices, body contouring, hair removal, and more. The Index is published by 5W AI Communications and is the first defensible measurement of AI-driven brand authority in this category. Note: The Index does not measure local SEO or traditional web search visibility.

How are brands ranked in the AI Visibility Index?

Brands are ranked by a composite citation share score out of 100, reflecting how often they are cited by AI engines in response to patient-intent queries. The scoring formula is: citation frequency (40%), cross-engine breadth (20%), query-type breadth (20%), source-authority weight (15%), and crawl-access (5%). 92 candidate brands were evaluated, with the top 25 selected for the Index. Note: The Index focuses on national citation share; regional rankings are published separately in Phase 2.

Which AI engines are tracked in the Index?

The Index tracks five major AI engines: ChatGPT (OpenAI), Claude (Anthropic), Perplexity, Gemini (Google DeepMind), and Google AI Overviews. These engines were tested with 65 patient-intent prompts to measure brand citation share. Note: Other AI engines or search platforms are not included in this phase of the Index.

Key Findings & Market Insights

What are the most important findings from the 2026 Index?

Key findings include: (1) AbbVie/Allergan and Galderma control 80% of all drug and device AI citations in aesthetic medicine; (2) Botox is the most cited brand, scoring 95/100; (3) RealSelf, a marketplace, is the highest-cited non-pharma brand; (4) Chains and device brands are often out-cited by smaller, earned-media-driven brands; (5) Independent med spas collectively hold under 5% of AI citation share; (6) Dermatology groups with board-certified MDs outrank most chains; (7) Device brands focused on equipment, not outcomes, are largely invisible to AI; (8) Citation share is now a leading indicator of patient pipeline, not just market share. Note: These findings are based on data as of June 2026 and may change as the market evolves.

How concentrated is AI citation share in the U.S. aesthetic medicine market?

In 2026, the top 25 brands control 95% of all AI citation share in U.S. aesthetic medicine. The remaining 11,500 med spas—96% of all facilities—split the leftover 5%. Among drug and device brands, AbbVie/Allergan holds 47% and Galderma 33% of citation share, with Merz Aesthetics and Revance splitting the remaining 20%. Note: This concentration means most independent clinics are functionally invisible to AI-driven patient research.

Which brands are the top performers in the 2026 Index?

The top five brands by AI citation share are: 1) Botox (95), 2) CoolSculpting (87), 3) RealSelf (86), 4) Juvederm (83), and 5) Dysport (78). These brands are cited most frequently by AI engines in response to patient queries about aesthetic medicine. Note: Rankings are based on composite scores out of 100 as of June 2026.

Why do some large brands have low AI citation share?

Some large brands, such as Hydrafacial (SKIN), InMode (Morpheus8), and Cutera, have low or no AI citation share despite significant revenue and market presence. This is often because AI engines prioritize outcome-focused queries and earned media authority over equipment brands or ad spend. Brands that invested in schema, third-party authority, and earned media tend to outperform those relying on traditional advertising or device branding. Note: Device brands that do not align with patient-outcome language are often invisible to AI-driven research.

Methodology & Data Sources

How was the AI Visibility Index methodology designed?

The methodology involved testing 65 verbatim patient-intent queries across five AI engines. 92 brands were evaluated, with the top 25 selected by composite score. The scoring weighted citation frequency (40%), cross-engine breadth (20%), query-type breadth (20%), source-authority weight (15%), and crawl-access (5%). Data sources include AmSpa, IBISWorld, Allied Market Research, Grand View Research, and public/private company filings from 2025–2026. Note: Private company revenue figures are estimates; public company data is sourced from filings and trade press.

What are the main data sources for the Index?

The main data sources are: 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, Grand View Research U.S. Medical Spa Market Size Report 2025, and company filings (10-K, S-1), private equity disclosures, and trade press (2025–2026). Note: Private company revenue is estimated; public company data is from filings.

How often is the Index updated?

The Index is updated quarterly. Phase 1 establishes the baseline, and Phase 2 will expand the dataset to include per-metro measured citation share for the top 7 U.S. markets. Note: Rankings and findings may change as new data is collected and AI engine algorithms evolve.

Competition & Brand Performance

Which companies dominate AI citation share in aesthetic medicine?

AbbVie/Allergan and Galderma together control 80% of all drug and device AI citations in the Index. AbbVie/Allergan brands (Botox, Juvederm, CoolSculpting, Kybella) hold 47%, while Galderma brands (Dysport, Restylane, Sculptra) hold 33%. Merz Aesthetics (Xeomin, Belotero) and Revance (Daxxify) each hold 10%. Note: Chains, marketplaces, and dermatology groups are tracked separately and do not contribute to this concentration.

Why do some smaller brands outperform larger competitors in AI citation share?

Smaller brands like RealSelf, Daxxify, and AEDIT outperform larger competitors because they invest in earned media, schema markup, and third-party authority, which AI engines prioritize. For example, RealSelf (score 86) is cited more than Milan Laser (350+ locations) and Ideal Image (150+ locations), despite having a smaller revenue base. Note: Brands relying solely on ad spend or location count often underperform in AI-driven discovery.

What are some notable absences from the top 25 Index?

Notable absences include Hydrafacial (SKIN), InMode (Morpheus8, BodyTite), Cutera, Emsculpt (BTL), Allergan Med Spa / Allē Loyalty, and Hims & Hers Aesthetics. Despite large market presence or ad spend, these brands did not break the top 25 in AI citation share, often due to a lack of outcome-focused earned media or schema. Note: Device and loyalty brands are especially vulnerable to being overlooked by AI engines if they do not align with patient-outcome queries.

Use Cases & Practical Implications

How can brands improve their AI citation share?

Brands can improve their AI citation share by investing in earned media, third-party authority, schema markup, and outcome-focused content that aligns with patient queries. The Index shows that brands with strong earned media and schema presence (e.g., RealSelf, Daxxify) outperform those relying on ad spend or device branding. Note: Local SEO does not guarantee AI visibility; brands must optimize for AI-driven patient research specifically.

What is the difference between national and regional AI citation share?

National AI citation share reflects which brands are cited most frequently in generic, non-location-specific queries. Regional citation share measures which brands are cited when a patient adds a city or metro area to their query. Seven metros account for over 60% of U.S. aesthetic medicine spend, and regional leaders can differ significantly from national leaders. Note: Phase 2 of the Index will publish per-metro measured citation share for the top 7 U.S. markets.

Limitations & Transparency

What are the limitations of the AI Visibility Index?

The Index measures AI citation share for national brands in response to 65 patient-intent prompts across five AI engines. It does not measure local SEO, traditional web search, or offline brand presence. Private company revenue figures are estimates, and public company data is based on filings and trade press. The Index is updated quarterly, but AI engine algorithms and market conditions may change between updates. Note: For detailed limitations or methodology questions, contact 5W AI Communications directly.

About 5W AI Communications

What services does 5W AI Communications offer for brands in aesthetic medicine?

5W AI Communications offers AI citation audits, Generative Engine Optimization (GEO), public relations, digital marketing, and proprietary AI visibility research to help brands measure and grow their presence in AI-driven buyer research. The firm works with brands to build authority across ChatGPT, Claude, Perplexity, Gemini, Google AI Overviews, and earned media channels. Founded in 2003, 5W is one of the largest independent PR agencies in the U.S. Note: Detailed service offerings and case studies are available at 5wpr.com.

5W AI Visibility Index · Aesthetic Medicine · June 2026 · Phase 1 of 2

The Med Spa & Aesthetic Medicine
AI Visibility Index 2026

Botox owns the syringe. RealSelf owns the answer. LaserAway owns the location.

By Ronn Torossian · Founder & Chairman, 5W AI Communications · Published June 18, 2026

↓ Download the Full PDF
The Numbers

A $25 billion category.
Twenty-five brands own all of it.

The 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.

$25BU.S. aesthetic medicine market in 2026
15%CAGR — fastest-growing healthcare-adjacent category
12,000Med spas operating across the U.S.
95%AI citation share held by the top 25 brands
5AI engines tracked: ChatGPT, Claude, Perplexity, Gemini, Google AI Overviews
65Patient-intent prompts tested across all 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.

The Index — Top 25 Brands by AI Citation Share

The full ranking.
Scored out of 100.

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.

01Botox
95Toxin · AbbVie / Allergan
02CoolSculpting
87Body Contouring · AbbVie / Allergan
03RealSelf
86Authority Site · Marketplace
04Juvederm
83Filler · AbbVie / Allergan
05Dysport
78Toxin · Galderma
06Restylane
77Filler · Galderma
07LaserAway
72Hair Removal Chain · Independent
08Sculptra
69Filler · Galderma
09Daxxify
65Toxin · Revance
10Ideal Image
62Hair Removal Chain · L Catterton
11Kybella
58Body Contouring · AbbVie / Allergan
12Xeomin
56Toxin · Merz Aesthetics
13Milan Laser
54Hair Removal Chain · Independent
14SkinSpirit
49Premium Chain · Carlyle
15Sono Bello
47Body Contouring Chain · Bain Capital
16AEDIT
44Authority Site · Marketplace
17Ever/Body
38Premium Chain · Private
18Schweiger Dermatology
35Dermatology Group · Private
19Alchemy 43
33Premium Chain · Private
20SEV Laser
29Hair Removal Chain · Private
21AIRE Aesthetics
25Premium Chain · Private
22U.S. Dermatology Partners
23Dermatology Group · ABRY Partners
23Forefront Dermatology
20Dermatology Group · OMERS
24Skinney Medspa
17Premium Chain · Independent
25Belotero
15Filler · Merz Aesthetics

Color key: red — independent / marketplace / challenger brands; black — pharma-backed and PE-backed brands.

AI Citation Power Structure

Two companies own the answer.
Together: 80%.

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.

Eight Findings

What the data actually says.

80% Finding 01 — AbbVie and Galderma control 80% of aesthetic medicine's AI citations. Every patient asking AI about wrinkles, lines, fillers, or fat reduction is being answered through brands those two companies own.
95 Finding 02 — Botox is the only word. AbbVie's Botox scored 95 — the highest in the Index. The drug, the brand, and the category are the same word in every AI answer about wrinkles.
86 Finding 03 — RealSelf is the gatekeeper. Scored 86 — higher than every individual med spa, dermatology group, and device brand. When patients ask AI "is this safe?" the marketplace owns the answer.
100× Finding 04 — The chains are 100x outspent, and 50% less cited. LaserAway: 190+ locations, $200M+ revenue. Cited less than the combined marketing budgets of RealSelf and AEDIT. Location count and ad spend do not translate to AI citation share.
#9 Finding 05 — Daxxify entered the chat. Revance launched Daxxify in 2023. Already ahead of Merz's Xeomin, which has been on the market for over a decade. 24 months of press beat 14 years of market presence.
5% Finding 06 — Independent med spas don't exist to AI. ~11,500 facilities operate below the Index. Combined citation share: under 5%. Independents either consolidate, brand-license, or disappear from AI-mediated patient research.
MD> Finding 07 — Dermatology groups outrank med spa chains. Schweiger (35), USDP (23), Forefront (20) all out-cited 19 of 25 ranked brands. Board-certified MD authority is the citation signal AI engines weight highest in medical categories.
0 Finding 08 — Patients ask for outcomes, not machines. InMode, Cutera, Lutronic, BTL, Solta, Hydrafacial: every device OEM that built a brand around equipment instead of outcomes is invisible. The treatment brand wins. The machine loses.
Winners Above Their Weight · Losers Relative to Size

Citation share is supposed to track market share.
In aesthetic medicine, it doesn't.

Some brands punch above their revenue. Others punch dramatically below it. The gap is the story.

Winners Above Their Weight

BrandAI CitationRevenue / ScaleVerdict
RealSelf#3, Score 86~$50M est. privateSmaller business. Owns the gateway.
Daxxify (Revance)#9, Score 65Launched 202324-month newcomer beat 14-year incumbent.
AEDIT#16, Score 44<$20M est. privateSub-$20M marketplace beat $500M public companies.
Schweiger Dermatology#18, Score 35~$150M est. regionalMD authority > national chain footprint.
Alchemy 43#19, Score 33~$30M est. boutiquePremium founder-driven press beat scale chains.

Losers Relative to Size

BrandAI CitationRevenue / ScaleVerdict
Hydrafacial (SKIN)Outside top 25~$300M+ publicPublic company. 10,000 spas globally. Invisible to AI.
InMode (Morpheus8)Outside top 25~$500M publicBest-selling device line. Lost the patient query.
CuteraOutside top 25~$200M publicDeep device portfolio. No consumer brand presence.
Emsculpt (BTL)Outside top 25Category creatorNFL endorsements. Outrun by outcome-language queries.
Milan Laser#13, Score 54350+ locationsLargest hair-removal chain. Cited less than RealSelf.
Ideal Image#10, Score 62150+ locationsDecade 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.

Notable Absences

Who didn't make the Index.
The more useful story.

Emsculpt (BTL Industries)

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.

Hydrafacial (The Beauty Health Company)

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.

InMode (Morpheus8, BodyTite)

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.

Allergan Med Spa / Allē Loyalty

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.

Hims & Hers Aesthetics

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.

By Sub-Category

Seven categories.
Seven leaderboards.

Toxins

Botox 95 · Dysport 78 · Daxxify 65 · Xeomin 56

Fillers

Juvederm 83 · Restylane 77 · Sculptra 69 · Belotero 15

Body Contouring

CoolSculpting 87 · Kybella 58 · Sono Bello 47

Hair Removal Chains

LaserAway 72 · Ideal Image 62 · Milan Laser 54 · SEV Laser 29

Premium Chains

SkinSpirit 49 · Ever/Body 38 · Alchemy 43 33 · AIRE Aesthetics 25 · Skinney Medspa 17

Dermatology Groups

Schweiger Dermatology 35 · U.S. Dermatology Partners 23 · Forefront Dermatology 20

Authority Sites

RealSelf 86 · AEDIT 44

Appendix A — The Regional Layer

National brands win generic queries.
Regional players win local queries.

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 FloridaRiverchase Dermatology, Spa Botanica, Allure MedSpa
LA / Beverly HillsAlchemy 43, SEV Laser, Epione, BH Rejuvenation Center
New York MetroSkinney Medspa, Ever/Body, Smooth Synergy, Tribeca MedSpa
Dallas / Fort WorthAdvanced Skin Fitness, Aesthetica, MD Aesthetics
Phoenix / ScottsdaleBodyBeautiful, Spa Bella, Skin Phoenix
AtlantaSkinMedic, Buckhead Plastic Surgery, Ageless MD
HoustonHouston Aesthetic Center, DermSurgery Associates, Memorial Aesthetics
The Closing Argument

Three generations.
One race.

  1. The first generation of aesthetic medicine was won by whoever opened the most locations.
  2. The second generation was won by whoever spent the most on Google.
  3. The third generation is being won by whoever gets cited by AI.

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.

From Ronn Torossian, Founder & Chairman, 5W AI Communications
"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."
Ronn TorossianFounder & Chairman · 5W AI Communications
Methodology

65 prompts. 5 engines.
92 brands evaluated.

Engines tracked

ChatGPT (OpenAI), Claude (Anthropic), Perplexity, Gemini (Google DeepMind), Google AI Overviews.

Prompt set

65 verbatim patient-intent queries spanning toxins, fillers, devices, body contouring, hair removal, skin treatments, location search, safety, cost, and provider selection.

Brand universe

92 candidate brands evaluated. The final 25 were selected by ranked composite score across the full candidate universe.

Scoring composite

Citation frequency 40% · Cross-engine breadth 20% · Query-type breadth 20% · Source-authority weight 15% · Crawl-access 5%.

Phase 1 / Phase 2

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.

Sources

[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.

Does your brand have an AI citation problem?

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 Audit

About the Author

Ronn 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.

About 5W

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.