Every year the med spa marketing surveys come out, and every year they say roughly the same thing. Cost per lead: €30-80. A "good" return on ad spend: 3 to 5 times. Conversion rates that sound like a rounding error. Owners read them, feel reassured they're "about average," and keep doing exactly what produced the average.
Here's a number from a real campaign we ran for a med spa: 71× ROAS. €3.21 cost per lead. On about €620 of ad spend.
Same industry. Same platforms. Same €200 laser package everyone else sells.
The gap between the survey and that campaign isn't luck, and it isn't a bigger budget — €620 is a small budget. The gap is that industry averages are averages of mostly broken setups. And once you see what they're made of, "average" stops being a comfort and starts being a warning.
What do the med spa benchmarks actually measure?
They measure what most med spas actually do. Which is the problem.
A benchmark report averages thousands of advertisers together. The overwhelming majority of them are running one of a few broken plays: boosting Instagram posts, running ads with no conversion tracking, or paying an agency that reports impressions. So when a survey says "average cost per lead is €50," it's not describing a target. It's describing the price of doing what everyone does.
Ask a sharper question and the picture flips: what are the top performers in that same dataset doing? Because the median and the top of any benchmark are worlds apart. The survey averages them into one soft number that makes everyone feel normal.
Building your med spa's marketing to hit the benchmark is building it to be average. And the average, by definition, is mostly the people struggling.
The real numbers, in full
Let me give you the whole campaign, not the highlight.
A med spa in Nice we work with ran paid ads for six weeks. Here's what happened, start to finish:
| Metric | Result | Industry survey | |---|---|---| | Ad spend | ~€620 | — | | Leads | 193 | — | | Cost per lead | €3.21 | €30-80 | | Appointments | 111 | — | | Clients closed | 88 | — | | Revenue | ~€44,000 | — | | ROAS | 71× | 3-5× "good" | | Time to first lead | 1h27 after launch | — |
No before-and-after shock ads. No €10,000 budget. A clear offer built around a consultation, tight targeting, instant follow-up on every lead, and revenue tracked back to the ad — not likes, not reach. Revenue.
That's the flex. Now the honest part: this isn't magic, and it isn't repeatable for everyone overnight. It's what happens when the four things the average is made of get fixed. Here they are.
Why is the average so low? Four broken pieces
The benchmark is low because four specific things drag it down. Each one is fixable.
1. Boosting instead of advertising. Most med spas hit the blue "boost" button. That optimizes for likes, not booked consultations. It can't target intent, can't track a booking, can't retarget a no-show. A room full of boosted posts is most of what drags the average CPL to €50. Real conversion campaigns are a different product entirely.
2. No follow-up. The lead comes in and sits. Nobody calls for hours, or ever. Across the field, a huge share of med spas have no automated follow-up at all — so leads they paid for go cold in an inbox. Speed and persistence are most of the difference between €3.21 that converts and €50 that doesn't.
3. Tracking likes instead of revenue. If you can't tell which ad produced which paying client, you can't cut what's wasting money or scale what's working. Most setups track impressions and reach — vanity numbers that feel like progress and hide the leak. The 71× campaign existed because every euro was traced to revenue.
4. Renting your account from an agency. When an agency owns your ad account, pixel, and data, you can't see your true numbers and you can't leave without losing everything. That opacity is where "we're about average" hides. Own the account, and the real performance — good or bad — finally becomes visible.
Fix those four and you're no longer the median med spa in the survey. You're the outlier the survey quietly averages away.
Doesn't a small budget explain the huge ROAS?
Fair pushback — and partly yes. A €620 spend can post a dramatic multiple that a €50,000 spend can't hold as it scales. ROAS usually compresses as budget grows, because you exhaust the cheapest audiences first.
But that cuts the other way too. The survey's "3-5× is good" is measured across every budget size, including tiny ones. If small budgets naturally show high ROAS, the average being stuck at 3-5× means the small-budget advertisers in the data are also doing badly. They have every structural advantage — cheap first audiences, low spend — and still land on the average. That's not a budget story. That's a setup story.
The point of the 71× isn't "you'll get 71×." It's that the ceiling is nowhere near where the benchmark tells you to relax. If you're sitting at a comfortable 4× because a report said that's good, a free audit will usually find the money you left on the table.
The 30-second audit
Three honest questions about your med spa's ads:
- Do you know your real return on ad spend — revenue divided by ad spend — or just your cost per lead?
- Is every new lead contacted within minutes, automatically, or does it wait for someone to notice?
- Who owns your ad account and pixel — you, or your agency?
If any answer was fuzzy, book a free audit. We'll pull your actual numbers and show you where you sit versus what's really possible — even if you never work with us.
The survey says you're average. That's not a compliment. It's the gap.