The marketing advice given to new aesthetic practices usually assumes a budget. Run ads, hire an agency, build funnels. That advice is useless to the person it is most often aimed at — a clinician who has just left a salaried job, is funding the practice out of their own pocket, and has no patients to generate the revenue that would pay for any of it.
Three Empire faculty members who each built a practice from nothing describe a different method. Between them they have never run a paid search campaign. One of them opened with a marketing budget of literally zero, next door to competitors spending $20,000 a month.
How to Market a Med Spa When You Have No Patients Yet
Dr. Jennifer Thomas-Goering, who opened her Ann Arbor practice in 2017, names it exactly: “My hardest lesson the first year was how to get patients. Getting patients to come through the door.”
Then the sentence that every new owner discovers around month four: “You only have so many friends and family when you first start out.”
She had deliberately constrained herself, and would do it again: “I started out very small, very organically. I didn’t take out any business loans. Everything I was putting into the business was from my pockets, because I didn’t want to buy all the fancy devices right off the bat. I wanted to start slow.”
The trade-off is real and worth naming. Self-funding protects you from debt and forces discipline. It also means that when you finally understand how much marketing matters, you have no money left to do it with.
Med Spa Marketing on Zero Budget, Next Door to $25,000 a Month
Melissa Pulcini-Buttine PA opened her Greenwich, Connecticut practice immediately before the COVID shutdowns — roughly the worst possible timing available.
“My marketing budget was zero, because I had no patients coming in,” she said. “So I had to get very creative. And the marketing was me.”
Her method was to identify her own strongest asset and lead with it rather than with her service list: “I said to myself, what’s my strong point? And that’s education. So I used Instagram and social media, which was free at the time. And I was the marketing. I thought to myself, okay — there are no patients, no income coming in, I just started my own practice by myself, and I would not give up. Every day I would just market myself and what I knew, and educate. That’s how I built my practice from the start.”
The competitive context makes the point sharper than any theory would: “I was next to people that spend twenty to twenty-five thousand dollars a month, med spas locally, on marketing. And I came in and I had a zero budget, and I grew from there.”
What she was actually doing has a name. She was publishing expertise rather than promotions — the same reason a practice’s educational content outperforms its special offers over any timeframe longer than a week.
Three Med Spa Owners, No Google Ads Between Them
Maritza Mejia FNP, founder of Long Island Beauty Bar, is blunt about it: “I never paid for a Google Ad in my life, to be very honest.”
Her reasoning is not that paid search does not work. It is that she did not want the patients it brought: “I feel like referrals is the best way for me to go. I’m afraid to do Google Ads and get the wrong patients. It sounds almost like a Groupon type of thing.”
That is a legitimate strategic position rather than a budget excuse. A discount-motivated patient acquired through paid search behaves differently from one referred by a friend — different price sensitivity, different retention, different expectations about outcome. A practice built on the first kind is harder to price properly later.
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Dr. Thomas-Goering made the same observation about what social media replaced: “That ability of just using social media, where you don’t have to do the Google Ads, you don’t have to do the Facebook ads.”
If you would rather be taught the whole system than assemble it, Empire runs Med Spa Patient Marketing and Practical Marketing Strategies for website, email, SMS and social.
Word of Mouth and Google Reviews: the Two Channels They Credit
1. Word of mouth
“That’s your best marketing,” Melissa Pulcini-Buttine said, “and that’s all on a low budget.”
Maritza Mejia describes how it arrives at her practice: patients coming through “their own families — the mom, the aunt.” Not a campaign. A family.
2. Google reviews
This is the channel most under-invested in relative to its effect, and it is free.
“Google reviews, it’s a big one,” Mejia said. “We have a lot of clients that come and say, oh, we found you, one of my friends — and then I start googling. We see that you have so many Google reviews.”
Note the sequence she describes, because it is how referral and search actually interact. The friend supplies the name. The search supplies the confidence. A referral that hits a thin review profile stalls at exactly the moment it should convert.
And she is explicit that none of it is bought: “Honestly, we don’t even pay for them to do a Google review.”
The newest piece of this is generative search, which is changing how patients find a practice at all. That is the subject of the AI Marketing Masterclass for Practice Growth.
What This Means for Your Med Spa Marketing
Strip away the individual stories and the method is consistent:
- Lead with the thing you are genuinely best at. For Pulcini-Buttine that was teaching. It will be something different for you, but it should be real, because you have to produce it every week without a budget behind it.
- Publish education, not offers. Offers require repetition to work. Education compounds.
- Treat reviews as infrastructure. They are the verification step in every referral you will ever receive.
- Be deliberate about which patients you attract. The cheapest acquisition channel that brings the wrong patient is more expensive than the slow one that brings the right one.
- Accept that it is slow at the start. Thomas-Goering’s practice “started out quite slow” in 2017 and then, she said, “when COVID opened up, I was slammed.” The content she had published through the shutdown was what made that possible.
Marketing is one section of a larger plan: see how to open a med spa and the med spa business plan.
You Do Not Need a Med Spa Marketing Budget to Start
“I don’t want people to feel discouraged that they don’t have a big marketing budget in the beginning,” Melissa Pulcini-Buttine said, “because look at all these great tools that you can use to grow.”
She is not speaking theoretically. She opened with nothing, next to competitors spending a quarter of a million dollars a year, in the worst month of the last decade to open a business that requires people to come indoors and sit close to you.
“If I could do it, I know that all our students and everyone starting off can do it as well.”
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