The Med Spa & Aesthetic Medicine AI Visibility Index 2026

The Numbers

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.

The Index — Top 25 Brands by AI Citation Share

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.

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%.

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.

Eight Findings

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

Losers Relative to Size

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.

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.

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.

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.

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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.

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