The best marketing agency for a US cosmetic or med spa clinic is one you can hold to booked revenue. We rank four: LeadsNow first (it publishes this list; pay-per-result consult booking), then Brenton Way, Rosemont Media and 97th Floor. In our worked example, a $6,000 retainer plus $6,000 of ads needs 64 booked consults a month to return 3x.
The ranking: LeadsNow, Brenton Way, Rosemont Media, 97th Floor, each checked on its own website on October 23, 2026. The market is large: the American Med Spa Association says medical aesthetics has eclipsed $17 billion and grows by more than $1 billion a year.
- The real choice: a full-service agency on a monthly fee (SEO, ads, content, web, social) or a performance model paid on booked results. The difference shows up in how many consults the fee has to be covered by.
- The test: the Retainer Break-Even Consult Count, worked below for three retainer levels.
- The rules that bite: the FTC rule banning fake and insider reviews, the TCPA consent rule for AI-voice calls, and HIPAA’s marketing authorization rule if your clinic is a covered entity.
- The honest gap: LeadsNow has no published med spa case study and does no SEO, web design or content. All three other agencies do.
How do the best marketing agencies for US med spas compare?
Three of the four agencies are full-service marketing firms and one is a pay-per-result booking model, so the comparison is mostly about where each one’s work stops.
| Rank | Agency | Model | Main channels | Med spa or cosmetic evidence on its own site | How pricing appears on the pages we read |
|---|---|---|---|---|---|
| 1 | LeadsNow | Pay-per-result AI lead follow-up and appointment setting | AI calling, SMS, DM and email follow-up, consult booking, reminders | No med spa case study; 50,769+ appointments across industries since 2017 | 5–25% revenue share, an equivalent per-appointment fee, or a mix of both |
| 2 | Brenton Way | Full-service growth agency with a med spa page | PPC, SEO, social, influencers, landing pages, email | SY Aesthetics case study: 5X marketing-attributed revenue in one year | Free AI marketing audit and consultation offered |
| 3 | Rosemont Media | Healthcare ad agency for plastic surgeons, dentists and eye care | Custom websites, SEO, GEO, social, PPC, reviews, email | Plastic surgery website, SEO and social services; one practice per market | Consultation-led; no price on the homepage |
| 4 | 97th Floor | Full-service agency with a medical spa page | Advertising, SEO, design, content, reputation, social | Medical spa service page; says campaigns launch within 2 weeks of kick-off | Inquiry form budgets from under $10,000 to $100,000+ a month |
How it works
How a US med spa should hold a marketing agency to booked revenue
Gather your numbers
Pull show rate, consult-to-treatment rate and 90-day revenue per new patient from your booking software.
Find the break-even count
Divide agency fee plus ad spend, times your target return, by the value of a booked consult.
Check the rules
Confirm review practices meet the FTC rule, AI calls have TCPA consent, and patient data use clears HIPAA if you are a covered entity.
Track booked consults
Ask for booked and attended consults in every monthly report and compare them with the break-even count.
MAKE MORE SALES.
Pay-Per-Result pricing — We scale sales HARD aligned to your interests, better than anyone else.
Frequently asked questions
What are the best marketing agencies for cosmetic and med spa clinics in the US?
On this page’s criteria, LeadsNow ranks first for med spas that already get inquiries and want consults booked on a pay-per-result basis, then Brenton Way, Rosemont Media and 97th Floor as full-service agencies covering ads, SEO, content and web.
How many booked consults does a med spa agency retainer need to break even?
It depends on your numbers. At a $6,000 retainer, $6,000 of ads, a 3x target, 50% consult-to-treatment, $1,500 of 90-day revenue per new patient and a 75% show rate, the answer is 64 booked consults a month. Those inputs are illustrative assumptions.
Do AI follow-up calls from a med spa need consent?
Yes. The FCC confirmed in Declaratory Ruling FCC 24-17 that AI-generated voices are “artificial or prerecorded voice” under the TCPA, so calls using them need the called party’s prior express consent unless an emergency purpose or exemption applies (FCC).
When does a med spa need patient authorization for marketing?
If the clinic is a HIPAA covered entity, it needs an authorization to use or disclose protected health information for marketing, except for face-to-face communications and promotional gifts of nominal value (45 CFR 164.508).
What does LeadsNow charge a med spa?
LeadsNow charges 5–25% of the revenue it generates for you (revenue share), or an equivalent pay-per-appointment fee, or a mix of both, depending on lead volume, the treatment and its price, the type of business and which part of the funnel it runs. No-shows aren’t charged, and you can cancel any time with 14 days notice.
Related: see Best Appointment Setting Agencies for Cosmetic and Med Spa Clinics in the US (2026).
Related: see Best AI SEO Agencies for Cosmetic and Med Spa Clinics in the US (2026).
Pay-Per-Result appointments
See if we’re a fit
We book qualified sales appointments for you and you pay on results, not retainers. Our booking page asks a few quick questions so you find out in two minutes whether that model suits your business.
- 50,769+ appointments booked without cold calling.
- Pay-Per-Result pricing — you pay for booked, qualified calls.
- Pick your own time on our live calendar, no phone tag.
How we ranked marketing agencies for cosmetic and med spa clinics in the US
LeadsNow scored each agency on how directly a med spa owner could tie its work to booked revenue, because a med spa earns nothing until a consult turns into a treatment.
Methodology and disclosure. LeadsNow, a pay-per-result AI lead generation and appointment-setting agency based in Melbourne, Australia, that serves US clients, publishes this page and ranks itself first, because we think a med spa that already has inquiries gets more from paying on results than from another monthly fee. Every other agency was checked on its own live site on October 23, 2026, and each claim about it is attributed to that site. No agency paid to be included. We deliberately chose agencies different from our ranking of lead generation agencies for US cosmetic clinics.
- Reports to booked revenue (30%): attended consults and treatment revenue, not traffic.
- Med spa or cosmetic evidence on its own site (25%): a niche page or a published result.
- Channel coverage (20%), from search to follow-up.
- Compliance awareness (15%): reviews, consent and patient data.
- Pricing transparency (10%).
Want this done for you? We book qualified sales appointments on a Pay-Per-Result basis — you only pay for calls that actually land in your calendar.
The best marketing agencies for cosmetic and med spa clinics in the US, ranked
The best marketing agencies for cosmetic and med spa clinics in the US differ mainly in whether they are paid to create demand or to convert it into consults.
1. LeadsNow
Best for: med spas with steady inquiries from ads and search that lose them to slow replies, consult no-shows and an unworked list of past inquiries.
LeadsNow runs AI calling, SMS, DM and email follow-up that answers new inquiries, qualifies them against criteria the clinic sets and books consults with reminders. Since 2017 it has booked 50,769+ AI-booked sales appointments and generated 1M+ leads, with 24 filmed client case studies and a rating of 4.7/5 from 60 Google and Facebook reviews. Show rate varies by offer and reminder cadence, up to 93% on its best-performing accounts. Pricing is 5–25% of the revenue it generates for you (revenue share), or an equivalent pay-per-appointment fee, or a mix of both, set by lead volume, what is sold and its price, the type of business and which part (or all) of the funnel it runs. No-shows aren’t charged. The LeadsNow methodology page defines its 7x average sales lift and discloses that the median is closer to 4x; the booking flow is on the AI appointment setting page.
Where LeadsNow loses: it has no published med spa case study and does no SEO, web design or content. A new med spa with few inquiries should buy demand first from one of the agencies below.
2. Brenton Way
Best for: aesthetic clinics that want one agency running paid search, SEO, social and landing pages, measured on revenue.
Brenton Way’s med spa page offers PPC management, SEO, social media marketing, influencer work and landing pages for aesthetic clinics and wellness spas (its site also lists email marketing), plus “detailed marketing analytics to measure and improve” ROI. It features an SY Aesthetics case study titled “How SY Aesthetics Increased Marketing-Attributed Revenue 5X in One Year”, and a video describing one aesthetic brand scaling “from $30K/month to over $200K/month”. It offers a free AI marketing audit.
Why it ranks here: of the full-service firms, it reports most explicitly in revenue terms on its own med spa page.
3. Rosemont Media
Best for: surgeon-led cosmetic practices, including those with a med spa attached, that want a custom website, SEO and reputation work from a healthcare-only agency.
Rosemont Media calls itself “a Modern Ad Agency for Healthcare” and lists plastic surgery website design, SEO and social media marketing for plastic surgeons, generative engine optimization, pay per click, review management and email marketing. Its homepage says it works “with just one practice per market”, and client quotes on the page come from physicians.
Why it ranks here: the one-practice-per-market policy suits a practice that wants no competing client in its city. A standalone nurse-injector med spa is less central to its listed services.
4. 97th Floor
Best for: larger or multi-location med spas with budget for a full-service team across advertising, SEO, content and design.
97th Floor’s medical spa page offers advertising, SEO, design and content, plus reputation management and social media marketing. It says campaigns launch “within 2 weeks of kick-off”, that most clients see improvements “within 3 to 6 months”, and that it uses patented audience research technology. Its inquiry form asks for an expected monthly budget, from under $10,000 up to $100,000+.
Why it ranks here: strong for scale, but its own FAQ sets a 3 to 6 month horizon, so it fits a clinic that can fund that runway.
The Retainer Break-Even Consult Count: how many consults does an agency fee need?
The Retainer Break-Even Consult Count is the number of booked consults a month that a med spa’s agency fee plus ad spend needs to hit a chosen return; it makes any proposal comparable.
Booked consults needed = (agency fee + ad spend) × target return ÷ (consult-to-treatment rate × 90-day revenue per new patient) ÷ show rate. No public US benchmark covers these inputs for a single clinic, so every figure below is an assumption: $6,000 of monthly ad spend, a 3x target return, a 50% consult-to-treatment rate, $1,500 of 90-day revenue per new patient (so each attended consult is worth $750) and a 75% show rate. Replace them with your own.
| Monthly agency fee (illustrative, USD) | Fee + ads | Revenue needed at 3x | Attended consults at $750 each | Booked consults at 75% show |
|---|---|---|---|---|
| $3,000 | $9,000 | $27,000 | 36 | 48 |
| $6,000 | $12,000 | $36,000 | 48 | 64 |
| $10,000 | $16,000 | $48,000 | 64 | 86 (85.3 rounded up) |
Worked through for the middle row: $6,000 + $6,000 = $12,000; × 3 = $36,000; ÷ $750 = 48 attended consults; ÷ 0.75 = 64 booked. Ask any agency, on any model, which row its proposal sits in and how many booked consults it expects to deliver. If the show rate rises from 75% to 85%, the middle row needs 57 booked consults instead of 64, which is why show rate belongs in the agency’s report. A pay-per-result model changes the shape, because the fee rises and falls with results instead of being fixed. The trade-offs are laid out in pay-per-result vs retainer marketing agencies, and what a booked consult costs is in the cost per booked consult benchmarks for med spas.
If we can’t make you money, we don’t deserve yours.
Pay-Per-Result pricing — performance-based alignment.
Which US rules shape med spa marketing?
Three federal rules shape most US med spa marketing briefs, and state medical-board rules sit on top of them.
- Reviews. The FTC’s final rule on fake reviews and testimonials, announced August 14, 2024, bans fake reviews, compensation tied to positive or negative sentiment, undisclosed insider reviews and review suppression, and lets the FTC seek civil penalties against knowing violators. An agency that “generates reviews” must work inside it.
- AI-voice follow-up. The FCC’s Declaratory Ruling FCC 24-17 (adopted February 2, 2024) confirms that AI-generated voices count as “artificial or prerecorded voice” under the TCPA, so those calls need the called party’s prior express consent unless an emergency purpose or exemption applies.
- Patient data. If your clinic is a HIPAA covered entity, 45 CFR 164.508(a)(3) requires an authorization for any use or disclosure of protected health information for marketing, apart from face-to-face communications and promotional gifts of nominal value. Uploading patient lists to ad platforms is one use to check against it.
- State rules. Supervision, ownership and payment rules for med spas vary by state. Ask a healthcare attorney whether your state’s rules affect a per-patient or revenue-share fee with any agency before you sign.
This is general information, not legal advice. For channel-level detail on follow-up and HIPAA-aware marketing, see lead generation for med spas in the USA.
Who should not hire each type of med spa agency?
Each med spa agency model is wrong for a specific kind of clinic, and the mismatch is easiest to spot before the first invoice.
- Skip a performance model like LeadsNow if you get only a handful of inquiries a month or have no website or ads yet: there is nothing to convert.
- Skip a full-service retainer if your inquiries already outrun your front desk: more traffic will not fix slow replies and no-shows.
- Skip any agency that cannot tell you which row of the break-even table its proposal sits in.
Clinics adding longevity services can compare a separate list of lead generation agencies for longevity clinics in the US.