Case study · Med spa & aesthetics
Med Spa Local SEO Case Study
A single-location med spa in Wisconsin's Fox Valley saw Business Profile calls rise 47.2% and direction requests rise 84.6% year on year, while its top-three map coverage for “botox appleton” went from 6% of the grid to 60%.
Results at a glance
Calls And Visits First, Rankings Second
Business Profile figures compare March to July 2026 against March to July 2025, five months against five months. Grid figures compare the first capture of 2026 against the latest in August. The 2025 figures are worked back from the year-on-year percentages Google reports, so they are shown as approximate.
| Metric | Baseline | Latest | Change |
|---|---|---|---|
| Calls from the Business Profile, Mar to Jul | About 144 (2025) | 212 (2026) | +47.2%, about 68 more |
| Direction requests, Mar to Jul | About 267 (2025) | 493 (2026) | +84.6%, about 226 more |
| Grid pins in the top 3, "botox appleton" | 6% (27 Jan) | 60% (30 Aug) | +54 points |
| Grid pins in the top 3, "lip filler appleton wi" | 1% (17 Feb) | 56% (30 Aug) | +55 points |
| Average grid rank, "botox appleton" | 6.72 | 4.98 | 1.75 positions better |
| Average grid rank, "lip filler appleton wi" | 7.03 | 5.24 | 1.78 positions better |
The work ran alongside the clinic's own promotions, referrals and seasonal demand, so these are results observed after the work shipped rather than isolated causes.
The client
One Clinic, Four Cities Of Demand
A single-location med spa on the north shore of Lake Winnebago, offering injectables (botox, lip filler, masseter botox) alongside general aesthetic treatments.
Market
The clinic sits between Neenah and Menasha, but most treatment searches are typed as “appleton”, the larger city to the north. Ranking well near the front door is not the same as ranking where the searches come from.
Measurement
Local Dominator geo-grids at 1.6 km spacing over a 5 mile radius on Google Maps, one keyword per treatment. Business Profile performance from Google's own report, and Semrush for organic and AI visibility.
Starting Position
Strong on “masseter botox near me”, where it already held the top three on 76% of the grid. Weak on the two highest-volume injectable terms: top three on 6% of the grid for botox and 1% for lip filler, with most pins sitting in fourth to tenth.
What the audit found
Visible Nearby, Stuck Just Off The Pack
For botox and lip filler, 86% and 94% of the grid ranked the clinic between fourth and tenth. That is the most frustrating place a med spa can sit: Google clearly considers it relevant, but the map pack only shows three.
1. Treatment Signals Were Thin
The clinic won a niche treatment (masseter botox) and lost the head treatments. The profile and site were not giving Google enough treatment-level relevance for the terms with the most demand.
2. The Appleton Gap
The north of every grid, toward downtown Appleton and Grand Chute, ranked 9 to 15. That is where the bigger competitor cluster sits and where “appleton” searches carry the most weight.
3. Low Domain Authority
Semrush scores the site's authority at 9, which is low even for a local business. Proximity and relevance had to do most of the lifting.
4. Root Cause
The account ranked for what made it different, not for what most patients search for. The fix was to make the clinic as clearly relevant for botox and lip filler as it already was for masseter botox.
The strategy
Win The Head Treatments, Protect The Niche
Four bets, in the order they were placed.
1. Profile And Proximity In Month One
With most botox and lip filler pins already in fourth to tenth, the fastest return was moving existing visibility up. Month one went into profile optimization, treatment-level services and descriptions, map citations, driving-direction assets and a geo network: the levers that move every pin on the grid at once.
2. Cost Content For The Head Treatments
Patients research price before they book injectables, and most local clinics do not publish it. From month two the site published cost content for exactly the two treatments the clinic was losing: botox and lip filler, later rewritten for the clinic's own town.
3. Treatments On The Profile Itself
From month three, treatments were added to the Business Profile as products, alongside four to six posts a month. It gives Google treatment-level relevance directly on the listing that ranks in the map pack.
4. A Steady Authority Rate
Foundational links, local citations, brand profiles and geo Web 2.0 properties added most months, from a low starting authority score of 9. A steady rate also makes the grid easier to read month to month.
Masseter botox was already a strength, so it got no dedicated content. The goal there was to hold it.
How the work was done
Six Months, Task By Task
Work started in February 2026, and the first grid scan on each keyword is the baseline. This is what shipped each month, taken from the fulfillment log. Planned items that did not ship are listed as such.
| Month | Focus | Shipped |
|---|---|---|
| Month 1 (Feb) | Audit and foundation | Keyword, competitor and geo analysis. Profile, competitor, citation, website and existing-page audits, plus a new-page plan. Profile optimization including services and service descriptions. 4 profile posts and 2 photo or video uploads. 50 foundational links, 30 local citations, 12 G-stacks, 20 brand profiles, map citations, driving-direction assets, iframe stacking and a geo Web 2.0 network. |
| Month 2 (Mar) | Cost content and reputation | 2 cost posts, one for botox and one for lip filler. Blog topic research. Review management started. Spam competitors reported. Schema audit and fixes. 4 profile posts, 2 photo or video uploads. 50 foundational links, 30 local citations, 5 geo Web 2.0 properties, brand profiles, G-stack content and content marketing. |
| Month 3 (Apr) | Pricing pages and entity signals | 2 pricing pages published: membership against non-membership pricing, and tox cost in the clinic's own town. Treatments added to the profile as products. 6 profile posts, new photos. A three-month topic plan. Entity stacking, 20 brand profiles, a location-based Web 2.0 property, site mirroring, monthly citations and content marketing. |
| Month 4 (May) | Profile products and links | Profile posts and further product uploads. Brand profiles, location-based Web 2.0 content, Google stacking and content marketing. Planned new content and photo uploads did not ship this month. |
| Month 5 (Jun) | Town-specific cost pages | Cost pages for botox, lip filler and facial filler written for the clinic's town, plus a town-specific version of the membership pricing page. Profile posts and products. 30 local citations, 20 brand profiles, 4 geo-relevance Web 2.0 properties and content marketing. |
| Month 6 (Jul) | Competitor link gap | Profile posts and products, content marketing, competitor backlinks replicated and a new HQ Web 2.0 property. Two microneedling cost posts were planned and are not yet published. |
Page and post titles are described rather than linked, to keep the client anonymous. The geo-grid was captured on the same keywords throughout.
Geo-grid
What Moved On The Map
Top three coverage is the number that matters for a med spa, because the map pack shows three clinics and patients rarely scroll past it. On the two head injectable terms, coverage went from almost nothing to more than half the grid.
| Keyword | Baseline | Latest | Avg. rank | Top 3 coverage | Rank 11 to 20 | Outside top 20 |
|---|---|---|---|---|---|---|
| botox appleton | 27 Jan, 80 pins | 30 Aug, 95 pins | 6.72 to 4.98 | 6% to 60% | 8% to 12% | none |
| lip filler appleton wi | 17 Feb, 80 pins | 30 Aug, 95 pins | 7.03 to 5.24 | 1% to 56% | 5% to 13% | none |
| med spa near me | 17 Feb, 80 pins | 24 Aug, 95 pins | 5.08 to 4.70 | 56% to 65% | 4% to 3% | 6% to 9% |
| masseter botox near me | 26 Jan, 80 pins | 20 Aug, 80 pins | 3.26 to 2.98 | 76% to 79% | 4% to 4% | none |
Top 3 is Local Dominator's High tier, rank 4 to 10 is Medium, 11 to 20 is Low, and Out means not found in the top 20. Three keywords were captured with 95 pins in August against 80 pins in the baseline, at the same spacing and radius, so their percentages are shares of different pin counts. Masseter botox used 80 pins on both dates.
Botox, Seven Months Apart
In January the grid was almost entirely yellow and orange: relevant everywhere, top three almost nowhere. By the end of August the whole south and west of the grid, from Neenah out to the western edge, is green, with first-place stars around the clinic. The north edge toward Appleton is still red, ranking 10 to 20.
Lip Filler Followed The Same Pattern
From 1% top three coverage on 17 February to 56% on 30 August, with average rank improving from 7.03 to 5.24. The shape of the gain matches botox almost pin for pin, which is what you expect when the same treatment-level signals are strengthened across the profile and site.
The Category Term
“med spa near me” started healthier at 56% top three and finished at 65%, with a cluster of first-place pins forming in the centre of the grid. It also contains the clearest weak spot in the account, covered below.
The Niche Treatment Held
Masseter botox was already the clinic's strongest term. It held and improved slightly, 3.26 to 2.98 average rank and 76% to 79% top three, on an identical 80-pin grid.
Google Business Profile
More Calls, Far More Visits
Between March and July 2026 the profile produced 212 calls and 493 direction requests, against roughly 144 and 267 over the same months of 2025.
| Business Profile metric, Mar to Jul | 2025 | 2026 | Change |
|---|---|---|---|
| Calls made from the profile | About 144 | 212 | +47.2% |
| Direction requests | About 267 | 493 | +84.6% |
| All profile interactions | About 3,497 | 3,612 | +3.3% |
The Mix Shifted Toward Intent
Total profile interactions rose only 3.3%, from about 3,497 to 3,612. Calls and direction requests together went from about 411 to 705. In other words, the profile was not simply seen more. A bigger share of the people who saw it picked up the phone or drove over.
Direction Requests Matter Most Here
A med spa sells an in-person appointment. A direction request is a patient planning the trip, and it is the profile action closest to a booked treatment. It is also the one that grew fastest, up 84.6%.
Organic and AI search
Traffic Up, AI Answers Starting
Semrush estimates the site's organic traffic at 281 visits a month in late August, up from roughly 170 at the start of the six month window, with the rise coming in steps rather than one spike.
AI Visibility
The clinic is already being named in AI answers: 16 mentions and 15 cited pages across ChatGPT, Google AI Mode and Gemini, for an AI visibility score of 35. ChatGPT cites the most pages. Google AI Overviews do not mention it yet.
| AI platform (Semrush, Aug 2026) | Mentions | Cited pages |
|---|---|---|
| ChatGPT | 6 | 11 |
| Google AI Mode | 5 | 4 |
| Gemini | 5 | 4 |
| Google AI Overviews | 0 | 0 |
| Total | 16 | 15 |
Semrush figures are third-party estimates, not the client's own analytics. Search Console and GA4 exports were not part of this write-up.
What actually made the difference
The Content Followed The Keywords That Moved
Without Search Console data in this write-up we cannot tie a ranking gain to a single page. What we can do is line up what shipped against which grids moved.
1. Cost Content On The Two Gainers
The only treatments with dedicated cost content were botox and lip filler: posts in month two, rewritten for the clinic's town in month five. Those are the two keywords where top three coverage jumped by more than 50 points. Masseter botox, with no dedicated content, moved 3 points.
2. Treatments On The Listing
Product uploads from month three onward put treatment names and pricing on the profile itself. The grid gains were widest close to the clinic, which is where profile relevance matters most against proximity.
3. A Month-One Foundation
Profile optimization, map citations, driving directions and a geo network all shipped in month one, before any content. That is the base every later piece sat on.
What did not work
Four Things We Are Still Fixing
Every case study we publish names what underperformed. On this account there are four.
1. The Appleton Edge
On botox and lip filler, the north edge of the grid still ranks 10 to 20, and the share of pins in that band grew (8% to 12% for botox, 5% to 13% for lip filler) as the grid widened. Two location pages a month were planned from month four and none have shipped yet, so nothing on the site speaks to Appleton directly. That is the first job for the next quarter.
2. The Lakeshore Gap
On “med spa near me”, a block of pins along the lakeshore in the south east now shows outside the top 20, taking that tier from 6% to 9%. Top three coverage rose overall, but this patch went the wrong way.
3. An August Dip In Calls
The profile logged 237 calls from March to August, which puts August at 25, against roughly 44 in July. One month is not a trend, but we are not going to hide it.
4. Organic Keywords Down 18%
Semrush shows organic keywords down 18% to 335, even while estimated traffic rose. The site is ranking for fewer terms that bring more visits, which is a fair trade, but it is not growth in reach.
The takeaway
Fourth Place Is The Cheapest Win
A med spa ranking fourth to tenth across most of its grid is closer to the map pack than it looks. Google already considers it relevant. Moving those pins into the top three is a smaller job than building visibility from nothing, and it is where this account's biggest gains came from.
The second lesson is to track every treatment separately. A clinic can own its niche treatment and still be invisible for the two treatments that drive most of its bookings. One “med spa near me” grid would never have shown that.
And judge the profile by calls and direction requests, not total interactions. Here interactions rose 3.3% while the actions that turn into appointments rose by half or more.
Methodology
How To Read These Numbers
Business Profile periods: March to July 2026 against March to July 2025, equal length. The 2025 figures are calculated from Google's reported year-on-year change and are approximate. The August call figure is the March to August total minus the March to July total.
Geo-grids: Local Dominator, Google Maps, 1.6 km spacing, 5 mile radius. The first scan on each keyword is the baseline: 26 and 27 January 2026 for masseter botox and botox, before work started in February, and 17 February for lip filler and med spa near me, in the first weeks of the work. Latest captures are from 20 to 30 August 2026. Three of the four keywords moved from 80 to 95 pins between captures.
Business Profile calls are taps on the call button, not answered calls. No call tracking was installed, so there is no verified booking or revenue figure, and we have not estimated one. Results vary by market and are not a guarantee.
FAQ
Med Spa Case Study Questions
Is this a real client?
Where do the numbers come from?
Why do some grids have 80 pins and others 95?
Are Business Profile calls answered calls?
What did not work?
Do you do local SEO for med spas through agencies?
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