Increasing consumer demand for medical spa services
Changes in consumer attitudes have led to increased demand in cosmetic procedures and treatments that outweigh the current available supply of clinical professionals and medical spa services, with the majority of clinics reporting more interest and bookings than pre-pandemic and longer wait times[v]. The medical spa services industry is expected to achieve double digit growth rates in the medium term[vi], which we believe is due to favorable long-term tailwinds supporting growth, including:
- Demand for medical spa services is high across the board. A recent Mindbody study[vii] found that demand for services and procedures is high for both men and women across multiple age ranges, highlighting an often-underrepresented demographic in this industry: millennial men. With significant buying power and an increased focus in health and wellness, the average man spends more in this category monthly than women ($1,800 USD compared to $1,044 USD)[viii]. Botox procedures for men have tripled between 2000 and 2020.[ix] With something for everyone, it is no surprise that we are seeing an increasing number of consumers interested in what the medical spa service industry has to offer.
- Social media is driving awareness and normalizing aesthetic procedures, with coverage for the ‘fillers’ tag increasing eightfold from 2010 to 2020[x]. Among the Gen-Z consumer, 44% say they learned about cosmetic procedures via social media.[xi] Certified dermatologists are vocal in the online conversation too, becoming a source of information for skincare health and product recommendations – Dr Maneeb Shah, the TikTok ‘Derm Doctor’, boasts 18M followers[xii] who take his advice (and product recommendations) as loyally as one might do from their own doctor[xiii]. As consumers take health matters into their own hands, with nearly 60% researching symptoms and treatments online before contacting a doctor[xiv], we believe the digital marketing potential for this industry is extensive.
- Medical spas are proliferating to keep up with consumer demand. The respondent demographics of the latest American Society of Plastic Surgeons report[xv] prove an interesting snapshot of the current landscape – 76% of respondents identified themselves as solo practitioners and only 2% identified as a multi-specialty group practice. As an increasing number of medical professionals enter the market to provide medical spa services in conjunction with existing offerings, such as dental surgeries, we expect an increase in multi-specialty group practices.[xvi]
- Innovation is driving demand across the board: new treatments like radiofrequency body contouring[xvii], dermo-fillers increasingly used for chin and cheek enhancements, and biostimulators for buttock lifts[xviii]. Medical spa service providers must keep up with this innovation, investing in the technology and training medical professionals. In our view, the high growth potential in this industry remains untapped - the pool of potential consumers in the US is nearly 80 million, defined as Americans aged 25-65 earning >$50,000 USD[xix]. With the relatively low consumer penetration for procedures currently available, who knows which new treatment may attract the rest of the population?
Fragmented market with opportunity for consolidation
There are approximately 2,900 clinics in North America, comprised primarily of smaller scale, independent medical spa operators[xx]: 81% of all medical spas are single location practices, and only 8% are part of a franchise, private equity, or national chain[xxi]. We believe that the medical spa industry will continue to consolidate, as scaled operators benefit from operational efficiencies, including:
- Experienced management teams
- Better infrastructure
- Access to more capital to invest in marketing, technology, compliance, and training; and
- Superior standardization of processes across clinics and patient care, driving referrals and overall patient retention
Consolidation can provide an exciting opportunity for companies to partner with private equity investors to build scale platforms.
A durable investment opportunity for private equity
Despite the consumer discretionary aspects of these services, medical spas have a proven track record of resilience across economic cycles. Firstly, during the 2008 recession, the overall number of medical spa procedures only plateaued for a few short years and robust growth had resumed by 2011[xxii]. More recently as the world reopened following the COVID-induced shut-down, there was a strong rebound in the industry by early 2021[xxiii]. This growth was driven in part by an unanticipated consequence of remote work: the ‘Zoom effect’. As Americans spend an average of 8 hours a week in virtual meetings[xxiv] faced with their on-screen appearance, there was a surge in demand for aesthetic treatments: a study of remote workers in early 2021 found that 40.6% of participants who had not previously undergone facial cosmetic treatments were now planning to thanks to the 'Zoom effect' highlighting appearance concerns[xxv].
Additionally, consumers of medical spa services typically pay for the products and services out-of-pocket, meaning revenue would not be subject to reimbursement risk or insurance payor coverage risk, which is attractive from a risk mitigation perspective.
Medical spa services such as injections and skin rejuvenation services are typically not a one-time customer purchase[xxvi] - patients can incorporate the services into their regular wellness routine and seek out follow up treatments. Additionally, medical spas can utilize multiple product lines to increase and diversify revenue streams, aiming to reduce risk and stay ahead of the competition. Many medical spas are becoming more efficient by developing vertical integrations[xxvii] of service expansions. We believe these factors are showing spas within the medical services industry to be compelling and highly durable businesses for private equity investors.
Private equity interest gaining momentum
Approximately $3.1 billion in private equity capital has been invested across 400 medical spa and aesthetic clinic transactions[xxviii] over the past five years. Recent M&A transactions in this space and reflecting this trend include:
- June 2023: SkinSpirit, a KKR portfolio company, acquired Contempo Aesthetics, a California-based medical spa[xxix]
- April 2023: The Thurston Group, Chicago-based private equity firm, acquired The Esthetics Center, a California-based medical spa and cosmetic surgery services provider[xxx]
- February 2023: MedSpa Partners’, a portfolio company of Persistence Capital Partners, acquired Advanced Skin & Body Solutions, a Washington-based medical spa services provider[xxxi]
- June 2022: Sono Bello, or Body Contour Centers, a leading multi private plastic surgery practice, acquires Body Sculpt International, the nation’s third-largest provider of body contouring surgery[xxxii]
- February 2022: Hidden Harbor Capital Partners acquires Inspire Aesthetics and Garramone Plastic Surgery, two plastic surgery and aesthetic medicine centers in Florida[xxxiii]
Investment in medical spas may be just beginning to gain momentum for private equity, but it could serve as an advantageous pathway to growth and sustainability, especially for independent medical spas seeking to bolster their financial strength and optimally position themselves in today’s ever-changing landscape. We believe the many attributes of the medical spa industry will drive continued private equity interest and investment activity in 2023 and beyond.
To discuss any of the themes explored, get in touch with authors, Hector Torres and Luc-Henry Rousselle, here >
This article has been prepared solely for information purposes and is not intended to function as a “research report.” In particular, this means that it is not intended, nor does it contain sufficient information, to make a recommendation as to the advisability of investment in, or the value of, any security.
Additionally, this article does not constitute or form part of, and should not be construed as, an offer to sell, or a solicitation of any offer to buy, or any recommendation with respect to, any securities. You should not base any investment decision on this article; any investment involves risks, including the risk of loss, and you should not invest without speaking to a financial advisor.
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What to read next
[iii] ‘Medical Aesthetics Is Resilient, Growing, and Attracting Investors’, BCG, May 2023 https://www.bcg.com/publications/2023/medical-aesthetics-industry-growth-attracting-investors
[vi] ‘From extreme, to mainstream: the future of aesthetics injectables’ McKinsey, December 2021 https://www.mckinsey.com/industries/life-sciences/our-insights/from-extreme-to-mainstream-the-future-of-aesthetics-injectables
[vii] ‘Beauty & Wellness Report’, MindBody, September 2022 https://brand.mindbodyonline.com/m/80d2625566e419/original/Beauty-Wellness-Report-2022.pdf
[ix] ‘Inaugural ASPS Insights & Trends Report: Cosmetic Surgery 2022’ June 2022 https://www.plasticsurgery.org/documents/News/Trends/2022/trends-report-cosmetic-surgery-2022.pdf
[x] ‘From extreme, to mainstream: the future of aesthetics injectables’ McKinsey, December 2021 https://www.mckinsey.com/industries/life-sciences/our-insights/from-extreme-to-mainstream-the-future-of-aesthetics-injectables
[xv] ‘Inaugural ASPS Insights and Trends Report: Cosmetic Surgery 2022’, page 4 – 6, June 2022 https://www.plasticsurgery.org/documents/News/Trends/2022/trends-report-cosmetic-surgery-2022.pdf
[xvi] ‘From extreme, to mainstream: the future of aesthetics injectables’ McKinsey, December 2021 https://www.mckinsey.com/industries/life-sciences/our-insights/from-extreme-to-mainstream-the-future-of-aesthetics-injectables
[xviii] ‘From extreme, to mainstream: the future of aesthetics injectables’ McKinsey, December 2021 https://www.mckinsey.com/industries/life-sciences/our-insights/from-extreme-to-mainstream-the-future-of-aesthetics-injectables
[xix] ‘Medical Aesthetics Is Resilient, Growing, and Attracting Investors’, BCG, May 2023 https://www.bcg.com/publications/2023/medical-aesthetics-industry-growth-attracting-investors
[xx] ‘American Med Spa Association 2019-2020 Industry Report’ January 2021 https://americanmedspa.org/news/amspa-releases-results-of-amspa-2020-medical-spa-industry-short-survey-covid-19s-impact
[xxi] ‘American Med Spa 2022 Medical Spa State of the Industry Report’, January 2023 https://americanmedspa.org/blog/the-2022-medical-spa-state-of-the-industry-executive-summary-in-context
[xxii] ‘Medical Aesthetics Is Resilient, Growing, and Attracting Investors’, BCG, May 2023 https://www.bcg.com/publications/2023/medical-aesthetics-industry-growth-attracting-investors
[xxiii] ‘Medical Aesthetics Is Resilient, Growing, and Attracting Investors’, BCG, May 2023 https://www.bcg.com/publications/2023/medical-aesthetics-industry-growth-attracting-investors
[xxviii] ‘From extreme, to mainstream: the future of aesthetics injectables’ McKinsey, December 2021 https://www.mckinsey.com/industries/life-sciences/our-insights/from-extreme-to-mainstream-the-future-of-aesthetics-injectables