Most med spa owners make their biggest mistake before they ever see their first patient.
It’s not the equipment they buy. It’s not their service menu. It’s the location they choose and how they choose it.
Todd Stanley recently joined the Aesthetic AF podcast to break down what actually matters when selecting a med spa location. Here’s what every practice owner needs to know.
The “Med Spa Row” Problem
Drive down Bee Cave Road in Austin, Texas. You’ll count 13 med spas on a single 10-mile stretch.
“It’s turned into Med Spa row,” Todd explains. “Very affluent area, people want to get work done.”
Sounds like the perfect spot, right?
Wrong.
Unless you’re offering something truly differentiated, planting yourself in the middle of that cluster is a recipe for margin compression and patient acquisition headaches.
“My advice would be not to go right in the middle of that,” Todd says. “Let’s go to the outer edge where we have very affluent people as well, but it’s not just right on that one road.”
How the Best Locations Actually Get Selected
Most med spa owners pick locations based on gut feel. They drive around, see a nice spot, and sign a lease.
The data tells a different story.
PRG’s approach starts with demographic and competition reports that analyze three-mile radii around potential locations. These reports show:
- Median household income
- Education levels
- Population density
- Actual med spa competition (hand-verified, not just database pulls)
“We don’t want to just say ‘let’s go to Katy, Texas’ and go anywhere there,” Todd explains. “We’re trying to run a business here, so we need to make sure exactly where we’re going to go.”
The competition analysis matters more than most people realize. PRG verifies every single med spa in the search area one by one to calculate actual competition ratios.
Because databases lie. Site visits don’t.
What Your Build-Out Actually Costs (Not What You Think)
Shell space build-out for a med spa: $175-$200 per square foot. Minimum.
That’s for HVAC, lighting, flooring, walls, millwork, and everything except your lasers and supplies.
The standard landlord offer? The TI allowance is equal to one year of base rent. If you’re paying $30/square foot, they’ll offer $30/square foot in improvements.
“My job on a shell space, on a 10-year lease, is to get it to $60,” Todd explains. “Double.”
That extra $30/square foot covers a significant chunk of your actual build-out costs. It’s the difference between starting profitable and starting underwater.
The Triple Net Reality Check
Base rent isn’t your total rent.
Add another $10+ per square foot for triple net expenses: property taxes, insurance, and common area maintenance (CAM).
“That number will fluctuate,” Todd warns, “mostly because of property taxes, especially in Texas.”
In Austin’s market, expect 3% annual escalations on base rent. That $30/square foot becomes $30.90 next year, $31.83 the year after.
Over 10 years? You’re looking at real money.
Retail vs. Medical Office: The Trade-Off Nobody Explains
You have three options for med spa locations:
Retail strip centers: High foot traffic, great visibility, premium pricing. You’ll get drive-by discovery, but you’ll pay for it.
Medical office buildings: Lower rent, medical-focused environment, but no spontaneous walk-ins. “Not very many people will find a space based on walking by or driving by,” Todd notes.
Traditional office buildings: Cheapest option, but requires landlord approval and potentially expensive plumbing modifications. “Med spas require a lot more water in and around the space.”
The counter-argument to retail’s foot traffic advantage? Google.
“The way people find things in this day and age: ‘med spa near me,’ ‘injector near me,'” Todd explains. “That’s the counterargument to having retail versus going into a medical office building.”
Timeline: The 60-Day Delusion
Every practice owner asks the same question: “How fast can I open?”
The answer depends on what you’re starting with.
Second-generation med spa space (fully built-out, ready to go): 3-4 months from search to opening. Maybe. These are “needle in a haystack” rare—Todd finds maybe one or two per year.
Shell space build-out: 10-12 months minimum.
- 3-4 months: Finding space, LOI, lease negotiations
- 6-8 months: Build-out
“If you’re doing a ground-up shell build-out, plan a year,” Todd advises. “That way, you have plenty of time to get all your ducks in a row.”
Starting without that buffer? You’ll open with half-finished details, stressed staff, and operational chaos.
Expansion: Same Process, Different Considerations
Opening your second (or third, or fourth) location?
The process stays the same: demographic reports, competition analysis, multiple LOIs, and aggressive TI negotiation.
What changes: you need to be realistic about geographic coverage.
“Where is too far for you as an owner to jump around all over the city?” Todd asks.
Houston med spa owners often target Katy, Sugar Land, and Spring. But the buildout costs vary wildly.
“If you’re going to move into River Oaks, it’s going to change things,” Todd notes. Premium areas command premium rents—but they don’t always deliver premium patients for your specialty.
The Bottom Line
Location decisions compound.
Choose well, and you’re operating from a position of strength: the right demographics, manageable competition, favorable lease terms.
Choose poorly, and you’re fighting uphill for every patient, every dollar, every year of your lease.
The difference isn’t luck. It’s data, negotiation leverage, and knowing what questions to ask before you sign.
Todd Stanley is Senior Vice President at Practice Real Estate Group, where he specializes in helping healthcare practitioners, from plastic surgeons to dentists to med spa owners, find and negotiate locations positioned for success. With 20 years of experience in the outpatient surgery industry before transitioning to commercial real estate, Todd brings a unique understanding of healthcare business operations to every deal.
This article is based on Todd’s appearance on the Aesthetic AF podcast hosted by Sam Varner. Listen to the full episode for more insights on med spa location strategy.
