Learning how to sell a plastic surgery practice usually starts with a question that has nothing to do with multiples. Who will look after my patients? What happens to the team that’s been with me for fifteen years? And how much longer do I actually want to operate?
Those questions matter, because they shape every decision that follows. This guide is written for surgeon-owners of aesthetic and reconstructive plastic surgery practices, from a solo office with an accredited OR to a multi-surgeon group. It covers who’s buying, what drives price, how to prepare, how a sale actually runs and the deal terms that decide what you really keep.
Key takeaways
- Demand is strong. Cosmetic surgical procedures rose 7% in 2025, according to the American Society of Plastic Surgeons.
- Price depends on adjusted EBITDA and on how much of the practice depends on you. Heavy dependence on a single surgeon is one of the biggest discounts buyers apply.
- Most offers mix cash at closing, rollover equity, sometimes an earnout, and a multi-year employment agreement.
- A confidential, competitive process protects your staff, your patients and your price. One unsolicited offer rarely does.
How do you sell a plastic surgery practice?
You decide what you want from the sale, recast your earnings the way a buyer will, reduce your dependence on yourself, and clean up compliance, contracts and facility records. Then you run a confidential process with several qualified buyers, compare offers on total value, negotiate the letter of intent, clear diligence and close.
That’s the short answer to how to sell a plastic surgery practice. The longer answer is the rest of this page, and it matters, because most of the value a surgeon keeps or loses is decided before any buyer sees a number.
Here’s the shape of it:
- Get clear on your goals and timeline
- Rebuild your financials the way a buyer reads them
- Reduce key-surgeon risk
- Get your compliance, facility and contracts in order
- Know your buyer options
- Run a competitive, confidential process
- Negotiate the terms, not just the price
- Clear diligence
- Close and hand over well
Why is 2026 a good time to sell a plastic surgery practice?
Because patient demand is growing, buyers are well funded, and the market is still fragmented enough that platforms need new practices to grow. ASPS reported cosmetic surgical procedures up 7% in 2025, and investment bankers describe steady interest from private equity-backed groups looking for surgeon partners.
The demand picture is encouraging. ASPS said lift procedures led growth, with facelifts up 13% and patients aged 66 and older up 24%, the biggest gain of any age group. That’s a patient base that pays cash, plans ahead and returns for further procedures.
On the buyer side, Physician Growth Partners counted six new plastic surgery platforms formed over a 24-month period, leaving more than twice as many groups looking to consolidate the market as before. It also noted that most plastic surgeons were still independent as of 2023. More buyers chasing a fragmented market is a good setup for a seller.
None of this means you should sell now. It means that if you’re within five years of wanting out, the market is worth understanding before you need it.
Step 1: Get clear on your goals and timeline
Before you call an advisor or answer a buyer, write down what you want. Most surgeons have four goals competing with each other:
- Money. How much cash do you need at closing, and how much risk are you willing to hold in equity?
- Time. Do you want to keep operating for three to five years, or step back quickly?
- Control. How much say do you want over scheduling, marketing, staffing and clinical decisions after the sale?
- Legacy. What matters to you about your name, your team and your patients’ care?
There’s no right mix. A 48-year-old surgeon who wants capital and a growth partner will choose differently from a 64-year-old who wants to operate part-time for two years and then retire. Knowing your answer tells you which buyers to talk to, and which offers to walk away from.
Step 2: Rebuild your financials the way a buyer will read them
Buyers value your practice on adjusted EBITDA: earnings before interest, taxes, depreciation and amortization, adjusted to show what the business earns under new ownership. That means recasting your numbers.
Typical adjustments include:
- Your compensation. Buyers replace what you pay yourself with a market salary for the clinical work you’ll keep doing. This adjustment can move EBITDA in either direction, and it’s often the biggest single change.
- One-time costs. A lawsuit settlement, a one-off equipment repair or a rebrand can be added back if it’s genuinely non-recurring.
- Personal expenses. Cars, travel or family members on payroll who don’t work in the practice come out.
- Rent. If you own your building or surgery center real estate, rent gets reset to market.
Clean monthly financials, prepared on an accrual basis, make this far easier. Buyers also want revenue broken down by surgeon, by procedure category and by source: surgery, injectables, skin care and any reconstructive or insurance work. For how buyers then turn earnings into a price, see our guide to plastic surgery practice valuation.
Step 3: Reduce key-surgeon risk
This is where most plastic surgery practices lose value, and it’s the step surgeons researching how to sell a plastic surgery practice most often skip. If you perform most of the procedures, bring in most of the patients through your name and hold every referral relationship, a buyer sees a business that may walk out the door with you.
FOCUS Investment Banking lists single-surgeon concentration, which it defines as 70% or more of revenue, among the factors that compress valuations. TUSK Practice Sales says buyers consistently worry about “key man risk” and want an associate or partner surgeon who could step in if the founder leaves (PR Newswire).
Ways to reduce that risk over one to three years:
- Hire an associate surgeon and let them build their own caseload
- Add injectors and aestheticians so non-surgical revenue doesn’t depend on you
- Build a practice brand alongside your personal brand
- Put a strong practice manager in place who runs operations without you
- Document patient intake, consultation and follow-up so they don’t live in your head
Step 4: Get your compliance, facility and contracts in order
Buyers will review your licenses, your OR accreditation, your malpractice history, your marketing claims, patient privacy practices, billing for any insurance work, and every contract you’ve signed. Surprises found in diligence cost money or kill deals. Surprises you disclose early are usually just negotiated.
Useful items to gather now:
- Facility accreditation reports and any corrective actions
- Malpractice claims history and insurance policies
- Leases for your office and any surgery center space
- Vendor, equipment and financing agreements
- Employment agreements and non-competes for surgeons and key staff
- Before-and-after photo consent forms and marketing policies
- A HIPAA risk assessment
Ownership rules matter too. Many states limit who can own a medical practice or control clinical decisions, under what’s called the corporate practice of medicine doctrine. DLA Piper notes the rules come from a patchwork of state statutes, case law and board guidance, and that enforcement increased in 2026. Your structure, and the buyer’s, needs to fit your state.
Step 5: Know your buyer options
Plastic surgery practices sell to four broad types of buyer: another surgeon or small group, a management services organization (MSO) backed by private equity, a larger platform buying add-ons, and occasionally a hospital system or multispecialty group for reconstructive-heavy practices. Each pays differently and asks different things of you after closing.
| Buyer type | Typically fits | What they offer | What they ask |
| Surgeon-to-surgeon | Smaller practices, often under $2 million in revenue | Continuity, simpler terms | Cash may be limited; often seller financing |
| PE-backed MSO or platform | Practices with $2 million+ revenue or multiple surgeons | Higher prices, capital, back-office support | Rollover equity, a multi-year employment agreement |
| Platform add-on | Practices near an existing platform | Integration, shared marketing | Adoption of their systems and brand strategy |
| Hospital or multispecialty group | Reconstructive or insurance-heavy practices | Stability, employment | Less upside, more institutional control |
The revenue guides in the table come from TUSK Practice Sales, which describes MSO partnerships as suiting practices with $2 million or more in revenue and doctor-to-doctor sales as common below that. Our guide to who buys plastic surgery practices covers each buyer in depth.
Step 6: Run a competitive, confidential process
If there’s one lesson in how to sell a plastic surgery practice well, it’s that competition sets price. If one buyer knows it’s the only buyer, it sets the terms. A structured process puts your practice in front of several qualified buyers at once, under confidentiality agreements, so you can compare real offers.
A typical process runs like this:
- Your advisor prepares a confidential summary and a detailed information memorandum
- Qualified buyers sign NDAs before learning your name
- Buyers submit indications of interest with a price range
- Selected buyers meet you, usually outside clinic hours
- Buyers submit letters of intent, and you pick one to move forward with
Confidentiality protects your practice. Staff who hear rumors start interviewing, and competitors are happy to tell patients you’re leaving. Most surgeons tell their team only once a deal is close to signing.
How to sell a plastic surgery practice: broker or M&A advisor?
For a small practice selling to another surgeon, a broker can work. For a practice with multiple surgeons, a surgery center, or EBITDA large enough to attract private equity, an advisor who knows healthcare M&A usually earns their fee by bringing in more buyers and negotiating structure, not just price.
A broker lists a practice and waits for inquiries. An M&A advisor approaches buyers directly, runs the competitive process, models rollover equity and earnouts, and coordinates with your attorney and accountant. TUSK, a practice sales firm, says a marketed process typically raises initial offers by 40% to 100%. Treat that as one firm’s claim, but the principle is sound: competing offers reveal value a single offer hides.
When you interview advisors, ask how many plastic surgery or aesthetic practice deals they’ve closed, which buyers they know personally, how they handle confidentiality, and how they’re paid.
Step 7: Negotiate the terms, not just the price
The headline number is only part of the deal. Two offers at the same price can leave you with very different outcomes depending on how much is paid in cash, how much in equity, what you must hit to earn the rest, and what you agree to do afterward.
The main terms to negotiate:
| Term | What it is | Watch for |
| Cash at closing | The guaranteed portion | Working capital adjustments that reduce it |
| Rollover equity | Part of your price reinvested in the buyer’s company | Debt ahead of your equity, the buyer’s exit timeline |
| Earnout | Payments tied to future performance | Targets you can’t control, vague definitions |
| Employment agreement | Your role, pay and term after closing | Compensation formula, call and schedule, termination terms |
| Non-compete | Where and how long you can’t practice | Radius, length, and your state’s rules |
| Escrow and indemnity | Money held back for post-closing claims | Size, length and caps |
TUSK notes that most transactions combine upfront cash, rollover equity and sometimes earnouts, with employment agreements typically in the three-to-five-year range. Rollover equity deserves special care, because it can be the most valuable part of the deal or worth very little. Our guide to plastic surgery rollover equity explains how to evaluate it.
Step 8: Clear diligence
After you sign a letter of intent, the buyer spends several weeks or more verifying everything. Expect a quality of earnings review of your financials, a legal review of contracts and licenses, a compliance review of marketing and any billing, and a look at facility accreditation and safety.
Keep running the practice well during diligence. A dip in consultations or a key staff departure in the middle of the process gives the buyer a reason to renegotiate. Have one person, usually your practice manager, manage document requests so you can keep operating.
Step 9: Close and hand over well
Closing brings the purchase agreement, your employment agreement, any real estate lease, and notices to payers and vendors together. Then the real work starts: telling your team, introducing the new partners, and keeping patients confident that their surgeon and their care aren’t changing overnight.
A good handover plan covers how and when staff hear the news, what changes and what doesn’t, how patients are told, and how marketing and your online reputation carry over. Buyers who have done this many times will have a playbook. Ask to see it before you sign.
How to sell a plastic surgery practice you built from scratch
For many surgeons, the hardest part isn’t the paperwork. It’s letting go of something they built one patient at a time. That’s normal, and it’s worth planning for. Talk with your family and your partners early, decide what role you want in five years, and choose a buyer whose approach to patient care you respect. Surgeons who treat the emotional side as part of the plan tend to negotiate more calmly and regret less afterward.
How long does it take to sell a plastic surgery practice?
Timelines vary widely. Preparation, from recasting financials to hiring an associate, can take a year or more if key-surgeon risk is high. The marketed process and diligence then usually run several months. Surgeons who start preparing early tend to sell on their own schedule rather than a buyer’s.
Succession plans change the timeline too. If your goal is to hand the practice to a younger associate over several years, the plan looks more like a gradual buy-in than a sale, and it should start long before you want to stop operating.
Plastic surgery practice succession planning: sell or transition?
If you’re not ready to sell, succession planning is how you keep options open. Bringing in an associate with a path to partnership, building a practice brand and documenting operations all make an internal transition possible and raise your value to outside buyers if you change your mind.
Many surgeons think of succession and sale as opposites. They aren’t. The same steps that make an associate buy-in work, such as spreading patient relationships across surgeons and running the business on clean numbers, are exactly what private equity buyers pay for. For the market context, see our guide to plastic surgery practice for sale listings and the platform exit wave.
Frequently asked questions
How do I start selling my plastic surgery practice?
Start by deciding what you want from the sale, then have your financials recast to show adjusted EBITDA. Assess how dependent the practice is on you, gather compliance and contract records, and speak with an advisor who knows plastic surgery transactions. Starting a year or more ahead gives you time to fix issues that lower value.
What is my plastic surgery practice worth?
Most practices are valued as a multiple of adjusted EBITDA. FOCUS Investment Banking reported plastic surgery platform deals at 5x to 12x or more EBITDA in 2026, depending on size, with add-on acquisitions at 5x to 9x. Surgeon concentration, growth, payer mix and facility ownership decide where you land.
Should I sell my plastic surgery practice to private equity?
It can make sense if you want a strong price, access to capital and back-office support, and you’re comfortable with rollover equity and a multi-year employment agreement. It may not suit you if control and independence matter most. Compare private equity offers with surgeon-to-surgeon and other options before deciding.
Will I have to keep working after I sell?
Usually, yes. Most buyers, especially private equity-backed groups, want the selling surgeon to stay for a transition period, and TUSK reports employment agreements typically run three to five years. Your role, compensation, schedule and exit terms are all negotiable, so settle them in the letter of intent.
What happens to my staff when I sell my practice?
Most buyers want to keep clinical and front-desk staff, because they hold patient relationships and are costly to replace. Changes are more likely in billing, marketing and administration as the practice joins the buyer’s systems. Ask each buyer about staff pay, benefits and roles, and put key commitments in writing.
How do I keep the sale confidential?
Require every buyer to sign an NDA before learning your practice’s name, share detailed information in stages, and hold meetings outside clinic hours. Tell staff only when a deal is close to signing, and plan the announcement carefully. An experienced advisor manages this process so rumors don’t reach your team, patients or competitors.
How to sell a plastic surgery practice: the bottom line
How to sell a plastic surgery practice comes down to preparation and competition. Know what you want, recast your numbers, reduce your dependence on yourself, and put your practice in front of several qualified buyers. Then negotiate the whole deal, not just the headline price.
| Thinking about selling in the next few years? Get the Plastic Surgery Exit Report newsletter for quarterly deal data, or book a confidential conversation with the plastic surgery team at Olympic M&A. Disclosure: Plastic Surgery Exit Report is published in partnership with Olympic M&A, a healthcare M&A advisory firm. |
