Miami Plastic Surgery & Med Spa Practice, 24-Year Operation

$4.1M

Revenue

$1.5M

SDE

1.4x

Multiple

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Full Editorial Writeup

This is an established cosmetic surgery and aesthetic medicine practice in Miami, one of the most competitive and lucrative markets for elective procedures in the country. Operating since the early 2000s, the practice runs out of a 5,800 square foot fully integrated facility with two Quad A certified operating rooms and an operational Med Spa, giving it both high-ticket surgical revenue and recurring aesthetic service revenue under one roof. It generates roughly $4.06M in annual collections with $1.45M in seller's discretionary earnings, a rich 36 percent SDE margin that reflects the pricing power of elective cosmetic work.

The practice bundles $1,000,000 in fixtures, furniture, and equipment plus inventory into the $1,995,000 asking price, meaning a buyer is acquiring a turnkey clinical and surgical plant, not just a patient list. The building itself is owned by the seller and valued at $5,200,000, but it is offered for separate purchase and is NOT part of the asking price, so the operations-only multiple sits near 1.37x SDE. That is cheap on paper, which almost always signals the central risk in these deals: a surgeon-dependent business where much of the goodwill walks out the door with the retiring owner.

The headline growth levers are real and executable: expanding surgical case volume, scaling the Med Spa's recurring aesthetic services, and leasing idle OR time to qualified outside surgeons to monetize fixed capacity. Whoever buys this needs to be, or needs to reliably employ, a licensed plastic surgeon who can carry the surgical caseload, so the true buyer universe is medical professionals or investment groups with a surgeon partner already lined up.

Why we like it

The earnings quality is strong on margin, with $1.45M SDE on $4.06M in collections for a 36 percent margin, driven by high-ticket elective procedures and a Med Spa that adds recurring aesthetic revenue. Cash pay elective medicine means minimal insurance friction and clean collections, which supports the reported numbers if the payment mix checks out in diligence.
The moat is the 24-year reputation and physical plant: two Quad A certified operating rooms, a Med Spa, and $1M in FF&E under one roof in Miami. Reproducing this facility and building the referral base from scratch would cost well north of the asking price, so a buyer is acquiring real replacement-cost value and immediate operating capacity.
Miami is one of the deepest and most durable cosmetic surgery markets in the country, with steady demand for both surgical and non-surgical aesthetics. The dual surgical plus Med Spa model lets an operator capture both the high-margin surgical patient and the recurring lower-ticket aesthetic client, smoothing revenue across cycles.
The operator advantage is obvious and cheap: idle OR time can be leased to outside surgeons to monetize fixed capacity, and the Med Spa can be scaled with additional providers and memberships. At 1.37x SDE the entry multiple leaves meaningful room for a hands-on medical buyer to add value quickly.

How to improve it

Lock in surgical continuity before anything else by recruiting or contracting a replacement plastic surgeon, since the retiring owner is almost certainly the primary rainmaker. Structure the deal so a portion of price is tied to case-volume retention through the transition to protect the downside.
Launch a paid membership or recurring-revenue program for the Med Spa within 90 days, bundling injectables, laser, and skincare into monthly plans. Recurring aesthetic revenue smooths cash flow and raises the resale multiple by converting one-time patients into subscribers.
Monetize idle OR time immediately by leasing the Quad A operating rooms to qualified independent surgeons on a per-block basis. This turns fixed facility cost into a high-margin rental line with almost no incremental labor.
Rebuild the digital front door: modernize the website, invest in local SEO and paid social for high-intent procedure searches, and formalize before-and-after content and review generation. Miami cosmetic patients research heavily online, and paid acquisition here has strong measurable ROI.
Audit and optimize procedure-level pricing and payer mix, pushing toward cash-pay and third-party financing partnerships to lift ticket size and reduce collection risk. Introduce financing options at point of sale to convert consultations that stall on price.
Formalize the mid-level provider bench (nurses, aestheticians, PAs) so revenue is not bottlenecked by a single surgeon's calendar. Delegating consults, follow-ups, and non-surgical services frees surgical capacity for the highest-margin cases.
Negotiate the separately-priced building into a leaseback or option structure rather than paying $5.2M cash upfront. Controlling occupancy cost protects margin while keeping capital deployed into growth instead of real estate.

Diligence notes

Quantify exactly how much of the $1.45M SDE is personally generated by the retiring surgeon versus the Med Spa and staff. If the majority of surgical revenue follows the owner out the door, the true acquirable cash flow is far lower than headline, which explains the low multiple.
Verify the payer and payment mix: how much is cash-pay elective versus insurance, and how clean are collections. Pull three years of collections detail, procedure-level revenue, and aged receivables to confirm the $4.06M is recurring and not concentrated in a few large cases.
Confirm licensing, credentialing, and Quad A certification transferability, and whether the buyer must be a licensed physician to own the practice under Florida law. Corporate practice of medicine rules may require a physician owner or a management-services structure, which reshapes the buyer universe.
Scrutinize malpractice history, outstanding claims, and the tail insurance obligation tied to the departing surgeon. Elective cosmetic surgery carries real liability exposure, and unresolved claims or inadequate tail coverage can become the buyer's problem.
Separate the real estate decision cleanly since the $5.2M building is not in the asking price. Get an independent appraisal and market lease comps so you can decide between buy, leaseback, or lease, and avoid overpaying an owner motivated to offload both.

Source

Originally listed on BizBuySell. View original listing →