What It Really Takes to Build a Medspa Empire From Scratch

What It Really Takes to Build a Medspa Empire From Scratch

She started injecting Botox out of the front seat of her car, reclining patients onto her lap at gas stations between Encino and Laguna Beach, back when almost no one knew what Botox even was.  Today that one-woman operation is a multi-location medical spa group across Orange County and Los Angeles. How does a burned-out nurse with $4,000 in her checking account turn pure instinct into a brand? Erin Alonso, Founder & CEO of DermFx, takes Bill Walker through every location she has opened and the decision behind each one — from the upstairs four-room space a landlord didn’t want to rent her, to the first building she bought with an SBA loan she couldn’t believe got approved. She is candid about having no business plan, no MBA, and no strategy beyond a gut that kept telling her which buildings were DermFx buildings. The real throughline is not real estate — it is people. Alonso explains why she hires for one trait above all others, why she sends her strongest team into every new location instead of keeping them close, and how handwritten thank-you cards twice a year to more than 130 staff became a retention strategy she built without ever calling it one. Her rule on integrity is just as blunt: she would rather earn millions less than put anything fake in a patient. For any operator weighing a second, third, or fourth location, this is a field guide to growing without losing what made the first one work. Questions answered by this episode: 1. 1. How much does it cost to open a medspa? 2. How do you start a medical spa business? 3. Is owning a medspa profitable? 4. How do you grow a medspa to multiple locations? 5. How do you get an SBA loan to buy a building for an aesthetic practice? 6. How do you hire and keep good aesthetic nurses? 7. What makes a medspa successful? 8. How do you keep your brand and culture consistent across multiple locations? 9. What should you look for when hiring medspa staff?10. What mistakes should you avoid when opening a new medspa location? Learn more about DermFx [https://www.dermfx.com/] GUEST Erin Alonso Founder & CEO, DermFx Erin Alonso is the Founder & CEO of DermFx, a Southern California medical spa group she built from a mobile Botox practice into multiple locations across Orange County and Los Angeles. A Family Nurse Practitioner with 25 years in aesthetic medicine, she was an early pioneer of non-surgical facial rejuvenation, injecting neurotoxin before most physicians had heard of it. She now trains top providers for brands including Allergan, Galderma, Merz, and Revance, and is known across the industry for her energy, her hands-on work with her team, and her drive to make aesthetics affordable for everyone. She is also a dedicated philanthropist, funding an orphanage in Mexicali through The Forgotten Foundation, which she supports entirely through events and in-store sales at DermFx. Connect with Erin on LinkedIn [https://www.linkedin.com/in/erin-alonso-2872113b/] Follow DermFx on Instagram @dermfx [https://www.instagram.com/dermfx/] About Aesthetic Appeal Aesthetic Appeal is where Aesthetic Brokers brings you the latest insights straight from Southern California. We break down what’s happening in the medical aesthetics world—especially when it comes to private equity and transactions with mergers and acquisitions that matter to you as a practice owner. Learn more about Aesthetic Brokers [https://www.aestheticbrokers.com/] Follow Aesthetic Brokers on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/] Theme music: Blinding, Cushy

The Service Mix That Decides What Your Practice is Worth

Most owners add a new service because they're personally excited about it. Jessica Hunter has a harder test: before you spend a dollar on a device or a drug, can you prove that 40% of your current patients would actually try it? That one number is the difference between a home run and an expensive mistake. Jessica and Bill Walker get into how to add GLP-1s, hormone therapy, and peptides without blowing up your liability or your margins. They cover why every service needs its own consent, how often to revisit your intake forms, and why one client spent twelve months asking every patient the same question before buying a device that now averages $40,000 a month. Bill explains why a practice with 80% of its revenue in GLP-1s is over-leveraged in a buyer's eyes, where the old guard and the newer wellness platforms draw the line on weight-loss revenue, and why doing a few complementary services well beats chasing seventeen. He also makes the case that a $5 million practice growing 30% a year is exactly the one you should be selling. Listen for the 40% rule, the EMR feature most owners are already paying for and never use, and why a rural owner needs to start planning the exit two and a half years out. Questions answered by this episode: 1. What is my medical spa worth? 2. When is the best time to sell a medical spa? 3. Should I offer GLP-1s in my med spa? 4. How do I add hormone replacement therapy to my practice? 5. What do private equity buyers look for in a med spa? 6. How do I decide which new services to add to my practice? 7. How much of my revenue should come from GLP-1s? 8. How do I market new services to my existing patients? 9. How often should I update patient intake and consent forms? 10. How far in advance should I plan my practice exit? HOST Bill Walker Founder & CEO, Aesthetic Brokers Bill Walker is the Founder & CEO of Aesthetic Brokers, where he leads transaction advisory for medical spas, cosmetic dermatology practices, and plastic surgery centers. Prior to founding Aesthetic Brokers, Bill led mergers & acquisitions for a large private equity-backed healthcare services organization, where he helped doctors unlock hundreds of millions of dollars in generational wealth. He is a nationally recognized speaker and thought leader in healthcare M&A. Bill began his career as a Marine Corps pilot, ultimately serving under two administrations at the Presidential Helicopter Squadron and commanding a squadron in combat. Follow Bill on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/] Connect with Bill on LinkedIn [https://www.linkedin.com/in/bill-walker-usa/] HOST Jessica Hunter Head of Aesthetic Consulting, Aesthetic Brokers Jessica Hunter is the Founder & CEO of Hunter Consulting and Head of Consulting at Aesthetic Brokers, where she helps medical aesthetic clinics grow smarter and stronger. She's partnered with more than 75 clinics across Canada and the U.S., guiding them to boost profits, streamline operations, and build lasting success. Known for her energy, straightforward approach, and genuine care, Jessica believes the best advice comes from truly understanding each business, especially its financial health and unique challenges. Follow Jessica on Instagram @hunterconsulting_ [https://www.instagram.com/hunterconsulting_/] Connect with Jessica on LinkedIn [https://ca.linkedin.com/in/jessica-hunter-mba-bkin-998a46199] About Aesthetic Appeal Aesthetic Appeal is where Aesthetic Brokers brings you the latest insights straight from Southern California. We break down what's happening in the medical aesthetics world—especially when it comes to private equity and transactions with mergers and acquisitions that matter to you as a practice owner. Learn more about Aesthetic Brokers [https://www.aestheticbrokers.com/] Follow Aesthetic Brokers on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/] Theme music: Blinding, Cushy

Where AI Pays Off And Where It Costs You

The same tool that can save hours of admin work in an aesthetic practice can also quietly erode the thing patients are actually paying for. Jessica Hunter explains where to lean in hard, where to pull back, and how to tell the difference before a practice accidentally automates itself out of relevance. Jessica walks through her own daily use as a consultant — sorting financials, templating protocols, summarizing emails — and lays out the specific tasks she would hand off to AI inside a practice: appointment confirmations, post-treatment check-ins, Botox rebook reminders, pre and post care content, and competitive research. She also shares a small branding trick: pasting a client's website into Claude so any new document inherits the tone and look of the brand. The other side of the conversation is sharper. AI-written social posts read as phony from a mile away, and patients are not paying for a generic caption — they came for a face, an expertise, and a portfolio of before-and-afters. The same logic applies to consultations: the moment an AI tool starts telling a patient what their treatment plan should be, the provider has quietly handed over the one thing only they can do. A practical breakdown of which AI tasks free up the day and which ones quietly cost a practice the patient relationship it has spent years building. Questions answered by this episode: 1. How can med spas use AI? 2. What's the best AI tool for small business operations? 3. Should aesthetic practices use AI on social media? 4. How fast should a med spa respond to a new lead? 5. Can AI do a med spa consultation? 6. How do you automate appointment reminders for Botox patients? 7. Why does AI-generated social media content look fake? 8. How do you use AI to write pre and post care instructions? 9. How do you do competitive research with AI? 10. What tasks should practice owners never hand off to AI? HOST Jessica Hunter Head of Aesthetic Consulting, Aesthetic Brokers Jessica Hunter is the Founder & CEO of Hunter Consulting and Head of Consulting at Aesthetic Brokers, where she helps medical aesthetic clinics grow smarter and stronger. She's partnered with more than 75 clinics across Canada and the U.S., guiding them to boost profits, streamline operations, and build lasting success. Known for her energy, straightforward approach, and genuine care, Jessica believes the best advice comes from truly understanding each business, especially its financial health and unique challenges. Follow Jessica on Instagram @hunterconsulting_ [https://www.instagram.com/hunterconsulting_/] Connect with Jessica on LinkedIn [https://ca.linkedin.com/in/jessica-hunter-mba-bkin-998a46199] About Aesthetic Appeal Aesthetic Appeal is where Aesthetic Brokers brings you the latest insights straight from Southern California. We break down what's happening in the medical aesthetics world—especially when it comes to private equity and transactions with mergers and acquisitions that matter to you as a practice owner. Learn more about Aesthetic Brokers [https://www.aestheticbrokers.com/] Follow Aesthetic Brokers on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/] Theme music: Blinding, Cushy

Why Raising Your Prices Is Almost Always the Wrong Move

Most consultants will tell you one thing when revenue stalls: just charge more per unit. Jessica Hunter, Head of Aesthetic Consulting at Aesthetic Brokers, has watched that advice quietly cost practices money for years. Her position is simpler — pricing is a strategic tool, not a number to bump every January. Jessica walks through three distinct pricing levers most owners collapse into one. Acquisition pricing creates urgency for a first visit. Retention pricing rewards a returning patient who books inside the optimal window — for neurotoxin, that's roughly every two-and-a-half to three months. Volume pricing reflects the truth that 10 units and 40 units take about the same chair time, but only one of them pays the room. The metric that drives all of it isn't price per unit. It's average transaction value. Jessica shares the client doing $60K to $70K a month in neurotoxin with a $450 ATV, where the right move was building frequency, not raising the menu. Cost of goods barely moves the math. Provider type and minutes per appointment do. The clearest example sits at the end of the episode. One client's neurotoxin revenue jumped from $18,000 in January to $39,000 in February on three additional patients — same hours, same provider, restructured pricing. Questions answered by this episode: 1. How do you price Botox profitably in a med spa? 2. Should I raise my Botox prices to make more money? 3. What is average transaction value in an aesthetic practice? 4. How do you make neurotoxin services profitable? 5. How long should a Botox appointment take? 6. How do you get Botox patients to come back more often? 7. What is the best pricing strategy for a med spa? 8. How do you price add-on services in aesthetics? 9. Is a lip flip profitable as a standalone service? 10. How does provider type affect neurotoxin profitability? HOST Jessica Hunter Head of Aesthetic Consulting, Aesthetic Brokers Jessica Hunter is the Founder & CEO of Hunter Consulting and Head of Consulting at Aesthetic Brokers, where she helps medical aesthetic clinics grow smarter and stronger. She's partnered with more than 75 clinics across Canada and the U.S., guiding them to boost profits, streamline operations, and build lasting success. Known for her energy, straightforward approach, and genuine care, Jessica believes the best advice comes from truly understanding each business, especially its financial health and unique challenges. Follow Jessica on Instagram @hunterconsulting_ [https://www.instagram.com/hunterconsulting_/] Connect with Jessica on LinkedIn [https://ca.linkedin.com/in/jessica-hunter-mba-bkin-998a46199] About Aesthetic Appeal Aesthetic Appeal is where Aesthetic Brokers brings you the latest insights straight from Southern California. We break down what's happening in the medical aesthetics world—especially when it comes to private equity and transactions with mergers and acquisitions that matter to you as a practice owner. Learn more about Aesthetic Brokers [https://www.aestheticbrokers.com/] Follow Aesthetic Brokers on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/] Theme music: Blinding, Cushy

Why Selling Your Aesthetic Practice Like a House Costs You Millions

A direct buyer reaches out, the number sounds generous, and the temptation to skip a formal process kicks in fast. That’s where most founders quietly leave the biggest check of their career on the table. Bill Walker breaks down what a real M&A engagement looks like next to the “list it like a house” approach most founders default to. He walks through a recent client who came to Aesthetic Brokers with a higher-than-usual direct offer in hand, the analysis that proved the practice was worth millions more, and the eight competitive buyers AB brought to the table — a process that pushed final deal value 62% above the original number. He also takes on the fear most founders carry into a transaction but rarely name out loud — what happens to the team after the sale. The answer separates the parts of that fear that are valid from the parts that aren’t, and explains why heavy-hitter staff often gain a career trajectory they could never have built solo, plus 401k matching and real health benefits a founder typically can’t afford on their own. A clear look at the engagement process, the post-sale realities for the people who built the practice with you, and the founder mistake that quietly costs the most in the two years before exit. Questions answered by this episode: 1. How much is my medical spa worth? 2. How do you sell a medical spa? 3. Should I use a broker to sell my aesthetic practice? 4. Should I accept an off-market offer for my practice? 5. What happens to my staff when I sell my practice? 6. How do private equity firms value an aesthetic practice? 7. What mistakes do practice owners make before selling? 8. How much more can an M&A firm get for my practice? 9. What should I do in the two years before selling my practice? 10. Do employees get better benefits after a practice acquisition? HOST Bill Walker Founder & CEO, Aesthetic Brokers Bill Walker is the Founder & CEO of Aesthetic Brokers, where he leads transaction advisory for medical spas, cosmetic dermatology practices, and plastic surgery centers. Prior to founding Aesthetic Brokers, Bill led mergers & acquisitions for a large private equity-backed healthcare services organization, where he helped doctors unlock hundreds of millions of dollars in generational wealth. He is a nationally recognized speaker and thought leader in healthcare M&A. Bill began his career as a Marine Corps pilot, ultimately serving under two administrations at the Presidential Helicopter Squadron and commanding a squadron in combat. Follow Bill on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/]Connect with Bill on LinkedIn [https://www.linkedin.com/in/bill-walker-usa/] About Aesthetic Appeal Aesthetic Appeal is where Aesthetic Brokers brings you the latest insights straight from Southern California. We break down what’s happening in the medical aesthetics world—especially when it comes to private equity and transactions with mergers and acquisitions that matter to you as a practice owner. Learn more about Aesthetic Brokers [https://www.aestheticbrokers.com/]Follow Aesthetic Brokers on Instagram @aestheticbrokers [https://www.instagram.com/aestheticbrokers/] Theme music: Blinding, Cushy