If you are a plastic surgeon, chances are you are spending thousands of dollars every month on your website, plastic surgery SEO and digital marketing.
SEO is just one part of a complete plastic surgery practice growth strategy.
But do you really know what your SEO company is doing?
Most surgeons don’t.
When I consult with plastic surgery practices, I first look at the website from the perspective of a prospective cosmetic patient.
Is it easy to understand what the surgeon specializes in?
Does the surgeon look credible?
Are the before and after photos compelling?
Is it easy to take the next step?
Does the website give the patient enough confidence to call, inquire or schedule?
But then I want to see the real data rather than rely on anecdotal assumptions.
That means looking at Google Analytics, Google Search Console, Ahrefs and other available data to understand what is actually happening.
Google Analytics can show where website traffic is coming from and what visitors do once they arrive. Google Search Console provides actual Google search data including queries, impressions, clicks and average positions. Ahrefs adds another layer by showing estimated keyword rankings, competitor visibility and backlinks. (Google Help)
Mini Case Study
I recently reviewed a practice whose organic traffic looked healthy on the surface. But when we dug deeper, much of the visibility was coming from educational searches outside the surgeon’s local market. Meanwhile, competitors were outranking the practice for the local procedure searches most likely to generate consultations. Traffic wasn’t necessarily the problem. The quality and intent of the traffic was.
“You would rather attract 300 prospective rhinoplasty patients in your market than 3,000 visitors from around the world who will never become patients.”
Together, they help answer a much more important question:
Is your SEO helping grow your plastic surgery practice, or are you simply getting more website traffic?
The Problem: Plastic Surgeons Are Often at the Mercy of Their SEO Company
SEO is complicated.
Most surgeons have neither the time nor the interest to understand what is happening behind the scenes.
So they rely on their internet company to tell them:
“We’re improving your rankings.”
“Traffic is up.”
“We’re building backlinks.”
“We’re creating content.”
“We’re optimizing the website.”
That may all be true.
But when the schedule suddenly slows down, the surgeon often concludes:
“My internet company isn’t working anymore.”
Sometimes they are right.
Sometimes they aren’t.
A slowdown in consultations does not automatically mean your SEO company has failed.
The problem could be traffic.
But it could also be lead response, phone skills, consultation conversion, pricing, competition, reputation, seasonality or poor follow up.
Before blaming SEO, review your broader plastic surgery marketing strategies to identify where the breakdown is actually happening.
That is why I never want to look at SEO in a vacuum.
Before You Fire Your SEO Company, Look at the Data
When I dig deeper into a practice using tools such as Ahrefs, Google Analytics, Search Console and ChatGPT to help analyze the reports, problems often become much easier to see.
I might discover that:
- Important procedure keywords have dropped from positions 3 or 4 to page two.
- Organic traffic is growing, but it is coming from irrelevant searches.
- The practice ranks nationally for educational content but poorly for local procedure searches.
- Blog traffic is increasing while consultation inquiries are decreasing.
- Strong pages have lost visibility.
- Competitors have developed much deeper content around an important procedure.
- Backlinks have increased dramatically, but many are low quality or irrelevant.
- The website is attracting patients researching other surgeons rather than patients considering the practice.
- The SEO company is reporting traffic while nobody is measuring how many consultations or surgical bookings that traffic produces.
As search continues to evolve, it is also important to understand how AI and plastic surgery marketing are changing the way prospective patients discover and evaluate practices.
Ahrefs can be particularly useful for comparing keyword rankings, competitors, backlinks and the pages attracting organic traffic. (Ahrefs)
Now the conversation becomes much more productive.
Instead of:
“I don’t think my SEO is working.”
You can ask:
“Why did we lose visibility for these specific procedures and what are you doing about it?”
That is a very different discussion.
Even a Good SEO Company Can Change
There is another issue surgeons often overlook.
You may have hired an excellent SEO company five years ago.
That doesn’t necessarily mean it is the same company today.
Their strongest SEO strategist may have left.
The partners may have split up.
The company may have been sold.
Your account may have moved from a senior strategist to a junior employee.
The company may have taken on too many clients.
Or their strategy simply may not have kept up with changes in search.
This is why I don’t believe you should blindly stay with an SEO company forever.
But I also don’t believe you should jump from company to company every time your schedule slows down.
A ranking decline should trigger an investigation, not an immediate firing.
What to Watch for if Your Plastic Surgery SEO Rankings Are Falling
1. Your Most Valuable Keywords.
Don’t just ask how many keywords you rank for. Ask: Which keywords are bringing prospective cosmetic patients? There is a huge difference between ranking for: “What happens after rhinoplasty?” and: “rhinoplasty surgeon Philadelphia.” One may generate information seekers. The other may generate a prospective surgical patient. The same principle applies to my own website. I would rather attract 300 plastic surgeons searching for help growing their practices than thousands of consumers researching the plastic surgeons I interview.2. Google Search Visibility
Watch:- Impressions
- Clicks
- Search queries
- Average rankings
- Pages gaining visibility
- Pages losing visibility
3. Qualified Organic Leads
This is where many SEO reports fall apart. Traffic is not the end goal. You want to know:Scheduled
Completed
Booked
An SEO company can legitimately increase organic traffic without increasing surgical revenue.
That doesn’t necessarily mean the SEO is bad.
It means you need to understand what kind of traffic they are attracting.
These are the practice performance metrics that help you determine whether your SEO and marketing efforts are actually contributing to practice growth.
4. Your Competitors
If you lose rankings, determine who gained them.
Then ask why.
Did the competitor build stronger procedure content?
Add case studies?
Develop better local relevance?
Earn stronger backlinks?
Improve their site architecture?
This is where competitive tools such as Ahrefs can help uncover gaps instead of relying on guesswork. (Ahrefs)
Questions to Ask Your Current SEO Company
If performance is slipping, I would ask these questions before you consider replacing them:
▸ What specifically has changed in our organic search performance during the past six months?
▸Which of our highest value keywords have gained or lost rankings?
▸Which pages have lost organic traffic?
▸Which competitors are gaining visibility against us and why?
▸What SEO work have you completed during the past 90 days?
▸What content have you added or improved?
▸What new quality backlinks have we earned, where did they come from and why do they matter?
▸Are there technical problems affecting crawling or indexing?
▸What is your plan for the next 90 days?
▸How are you measuring whether SEO traffic becomes consultations and booked procedures?
And one of my favorites:
▸Who is actually working on my account?
You may be surprised by the answer.
How to Interview a New Plastic Surgery SEO Company
If you decide it is time to look elsewhere, don’t simply ask:
“Can you get me to number one?”
Instead ask:
▸Show Me What You See
Give them access to enough data to analyze your current situation and ask:
“What do you believe is working, what isn’t working and what would you change?”
Then compare the answers.
You will learn a lot.
▸Ask Who Will Actually Do the Work
Who is your SEO strategist?
How experienced are they?
How many accounts do they manage?
Who takes over if they leave?
Don’t evaluate only the salesperson who closes you.
Evaluate the people who will actually work on your account.
▸Ask What Happens to Your Existing Website
This is a big one.
I frequently hear:
“We want to rebuild your website from scratch on our platform and we’ll transfer the copy.”
Be careful.
You may have spent years building authority, pages, backlinks, internal links and rankings.
Your SEO strategy should also support your overall plastic surgery branding and authority, helping strengthen your expertise, reputation and positioning.
A website migration can absolutely be done correctly, but it should have a detailed migration plan. Google specifically recommends mapping old URLs to appropriate new URLs and using permanent redirects when URLs change so users and Google understand where the content moved. (Google for Developers)
Before agreeing to rebuild anything, ask:
Why does the site need to be rebuilt?
Which existing URLs are ranking?
Which pages have valuable backlinks?
Will existing URLs remain the same whenever possible?
What is your redirect plan?
Show me exactly how you would protect our existing rankings and SEO equity if you rebuild or migrate our website.”
How will you monitor rankings before and after the migration?
Who owns the website if we stop working together?
Don’t throw away years of SEO equity simply because a new company prefers its own platform.
Don't Forget What Happens After SEO Generates the Lead
This may be the most important part.
Your SEO company can do a terrific job and your practice can still struggle.
Why?
Because SEO’s job is to get the right prospective patient to raise their hand.
That starts with making sure your SEO is actually attracting more cosmetic patients who are genuinely interested in your procedures, not just increasing traffic volume
Someone still has to convert that person.
That means:
If leads are coming in and nobody calls them promptly, SEO isn’t the problem.
If patients call and the phones are handled poorly, SEO isn’t the problem.
If consultations happen but very few patients book, SEO isn’t the problem.
This is why I strongly prefer practices to have a robust CRM and lead management system.
If your website or marketing company also offers a strong CRM component, that can be very helpful because you can follow the entire patient journey rather than stopping at website traffic.
However, I would not choose an inferior SEO company simply because it has its own CRM.
A strong SEO company that integrates properly with the CRM you already use can be just as effective.
Ideally, your marketing company either offers a robust CRM and lead management system or integrates seamlessly with the one you already use.
The important thing is that somebody can follow the lead from the moment it enters the practice through consultation and ultimately to booked revenue.
Stop Playing Musical Chairs with SEO Companies
Switching SEO companies repeatedly can make a confusing situation even worse.
The new company blames the old company.
The old company blames Google.
The surgeon doesn’t know whom to believe.
Then another company recommends rebuilding everything again.
Instead, establish your baseline.
Know:
- Where your traffic is coming from
- Which keywords matter
- Which pages rank
- Which pages generate leads
- Who your true online competitors are
- How many organic leads become consultations
- How many consultations become surgery
Then judge your SEO company using evidence rather than frustration.
Because the goal of plastic surgery SEO isn’t to win a traffic contest.
The goal is to attract the right cosmetic patients and turn enough of them into profitable, happy patients who help grow your practice.
And that requires looking at the entire patient acquisition and conversion process, not simply where your website ranks on Google.
Conclusion
Before you fire your SEO company or sign with a new one, know your numbers. Understand which rankings matter, where your qualified traffic is coming from, what happens to those leads once they contact your practice and whether that activity is ultimately turning into booked surgery.
Then meet with your SEO company regularly, ask intelligent questions and hold them accountable to an agreed upon strategy.
The goal isn’t more traffic. The goal is more qualified cosmetic patients who become booked surgery.
Not sure whether your marketing problem is traffic, lead handling or conversion? That’s exactly what I uncover in a Practice Performance Audit.
