A plastic surgery practice valuation almost never matches the number a surgeon has in mind. Sometimes it’s higher, because buyers pay for a brand, a patient base and a surgical team that took decades to build. More often it’s lower at first, because buyers price the practice without the surgeon’s personal effort and without the parts that depend on one person.
This guide explains how that number gets built. It covers the multiples reported in 2026, how buyers recast your earnings, a worked example, how an owned surgery center changes the picture, the difference between personal and enterprise goodwill, and the seven factors that move your price. It’s written for surgeon-owners of aesthetic and reconstructive practices.
Key takeaways
- Plastic surgery practices are usually valued as a multiple of adjusted EBITDA. FOCUS Investment Banking reported platform deals at 5x to 12x or more in 2026, depending on size (FOCUS).
- Around $3 million of EBITDA, the buyer pool shifts from add-on buyers to platform buyers, and multiples can rise by two to four turns.
- Heavy dependence on one surgeon is one of the most common reasons for a lower multiple.
- How your earnings are recast often matters more than the multiple itself.
What is a plastic surgery practice valuation?
A plastic surgery practice valuation is an estimate of what a buyer would pay for your practice. For most practices it’s calculated as a multiple of adjusted EBITDA, then tested against recent deals, your growth, your payer mix, how much revenue depends on you, and whether you own your surgical facility.
It’s worth separating three different numbers people call “valuation.” A formal appraisal, often used for tax, divorce or partner buy-ins, estimates fair market value under set standards. A market valuation estimates what buyers would actually offer today. And the deal value is what you finally sign, which depends on structure as much as price. This guide focuses on the second, since that’s what matters when you’re thinking about selling.
What is my plastic surgery practice worth in 2026?
Most practices are worth a multiple of adjusted EBITDA, with the multiple rising as the practice grows. FOCUS Investment Banking’s September 2026 benchmarks put platform acquisitions at 5x to 6x EBITDA under $1 million, rising to 9x to 12x or more above $7 million. Add-on acquisitions ranged from 5x to 9x.
Here are the ranges FOCUS reported for plastic surgery practices:
| Adjusted EBITDA | Platform acquisition multiple | Source |
| Under $1 million | 5x to 6x | FOCUS, Sept 2026 |
| $1 million to $3 million | 5x to 9x | FOCUS |
| $3 million to $7 million | 7x to 11x | FOCUS |
| $7 million and above | 9x to 12x or more | FOCUS |
| Add-on acquisitions (any size) | 5x to 9x | FOCUS |
A separate FOCUS review of physician practice multiples from April 2026 put plastic surgery and aesthetics platform deals at 8x to 12x and add-ons at 4x to 8x, noting that smaller single-site practices trade in the low to mid single digits.
Two cautions. First, these ranges come from reported transactions, and private practice sales aren’t public, so treat them as a guide to your neighborhood, not a quote. Second, the jump between size bands matters most. FOCUS calls $3 million of EBITDA “a critical inflection point,” where the buyer pool shifts from local add-on to platform-ready and multiples can increase by two to four turns.
Plastic surgery practice EBITDA multiples: why size matters so much
Bigger practices earn higher multiples because they carry less risk and more room to grow. A practice with several surgeons, multiple locations and professional management is less likely to lose value if one person leaves, and it can serve as the foundation a private equity firm builds on.
That’s why the same dollar of earnings is worth more in a larger practice. A surgeon who grows from $1.5 million to $3.5 million of EBITDA doesn’t just earn more. They often move into a different buyer pool that pays a higher multiple on every dollar. For many practices, growth through an associate surgeon is the most valuable move available before a sale.
How do buyers calculate adjusted EBITDA?
They start with your reported earnings, then add back owner-specific and one-time costs, and replace your compensation with a market salary for the clinical work you’ll keep doing after the sale. The result, adjusted EBITDA, shows what the practice earns under new ownership. It’s the number the multiple is applied to.
Every buyer rebuilds your earnings this way. It’s called a recast, and it’s where a plastic surgery practice valuation is really won or lost. Common adjustments:
- Surgeon compensation. In a private equity deal, you typically agree to a post-sale compensation formula. The difference between what you take today and that new formula flows straight into EBITDA. Higher post-sale pay means lower EBITDA and a lower price, which is the central trade-off in most physician deals.
- Discretionary expenses. Personal vehicles, travel, family on payroll and similar costs are added back.
- One-time items. Legal settlements, a website rebuild or a one-off equipment repair can be added back if they won’t recur.
- Rent. If you own your building or surgical suite, rent is reset to market. If you’ve been paying yourself below market, EBITDA goes down.
- Pro forma items. A new associate or a newly opened location might justify adjustments, but buyers discount projected earnings heavily.
Be realistic about add-backs. FOCUS lists “weak EBITDA add-backs” among the factors that compress valuations. Every adjustment you claim needs documentation, and a buyer’s quality of earnings review will test each one.
A worked example of a plastic surgery practice valuation
Here’s a hypothetical practice, with illustrative figures only, to show how the recast changes the number.
| Reported | Adjusted | |
| Revenue | $4,500,000 | $4,500,000 |
| Owner-surgeon compensation | $1,400,000 | $900,000 (post-sale formula) |
| Personal and one-time expenses | $120,000 | $0 |
| Rent on owned building | $60,000 | $180,000 (market) |
| Other operating costs | $2,300,000 | $2,300,000 |
| EBITDA | $620,000 | $1,120,000 |
At an illustrative 6x multiple, the adjusted figure suggests a value of about $6.7 million. On the reported figure, the same multiple would suggest about $3.7 million. The difference comes almost entirely from the compensation adjustment, which is why surgeons should model it carefully. Agreeing to lower pay after the sale raises the price, but it also changes your income for the next several years.
Notice the rent line too. This owner charged the practice $60,000 a year for a building worth $180,000 in market rent. A buyer will correct that, which lowers EBITDA, but the owner keeps the building and can lease it to the buyer. For help planning the full sale, see our guide on how to sell a plastic surgery practice.
7 factors that drive a plastic surgery practice valuation
These are the things that move your multiple up or down within its range. FOCUS Investment Banking lists similar drivers in its 2026 benchmarks.
1. Surgeon concentration
The most important factor. If one surgeon produces most of the revenue, buyers see risk. FOCUS lists single-surgeon concentration at 70% or more of revenue as a valuation detractor. Additional surgeons, with their own patient bases, raise value.
2. Revenue mix
Practices that combine surgery with injectables, skin care and other non-surgical services have steadier, recurring revenue. FOCUS cites both a mix of aesthetic and reconstructive work and ancillary revenue streams as value drivers.
3. Growth and case volume
Buyers pay for momentum. Growing consultations, conversion rates and case volumes over three years support a higher multiple. Flat case volumes do the opposite.
4. Payer mix
Aesthetic surgery is mostly cash pay. Reconstructive work adds insurance revenue, which can diversify the practice but brings billing complexity. FOCUS notes commercial payer mix as a positive and heavy Medicaid exposure as a negative.
5. Facility ownership
An accredited, owned surgical facility can add real value, because it captures facility fees and gives the practice control over scheduling and patient experience. It also brings accreditation and compliance obligations buyers will review.
6. Brand and marketing infrastructure
A recognized practice brand, a strong online reputation and a marketing system that generates consultations without the owner’s personal involvement all increase value. A brand tied only to your name is worth less to a buyer.
7. Operations and compliance
Clean financials, a capable practice manager, documented processes and a clean compliance record reduce risk. FOCUS lists compliance issues and a lack of operational infrastructure among the factors that compress valuations.
How does a surgery center affect your valuation?
An owned, accredited surgery center or office-based OR usually increases value, because the facility generates its own revenue and gives a buyer operating control. Buyers typically value the facility’s earnings together with the practice, while any real estate you own is valued and often sold or leased separately.
Surgery center valuation raises its own questions. Buyers look at case volume in the facility, accreditation history, staffing, equipment age and whether other surgeons use it. If the center has outside physician investors, their rights and the operating agreement will shape the deal. Real estate adds another choice: sell the building with the practice, keep it and lease it back to the buyer, or sell it separately to a real estate investor.
If you own the building, remember that keeping it means the practice must pay you market rent. That lowers EBITDA and the practice price, but gives you ongoing income and any future appreciation. Model both options before negotiating. For how the wider market is pricing practices right now, see our guide to putting a plastic surgery practice for sale.
Personal goodwill vs enterprise goodwill: why it matters
Personal goodwill is value tied to you as an individual: your reputation, skill and patient relationships. Enterprise goodwill belongs to the practice: its brand, systems, location and team. The split affects how buyers price your practice, and in some structures it can change how the sale is taxed.
In a plastic surgery practice, personal goodwill is often large, because patients choose a surgeon, not a building. Buyers pay less for goodwill that could leave with you, which is why employment agreements and non-competes are standard in these deals.
Taxes are the other reason it matters. Valuation firm Stout explains that personal goodwill, sold separately by an owner, can receive long-term capital gains treatment and avoid a second layer of tax in a C corporation asset sale. The approach traces to the 1998 Tax Court case Martin Ice Cream Co. v. Commissioner. It generally requires that you haven’t already signed an employment or non-compete agreement transferring those relationships to your practice, and it needs an independent appraisal. Talk to your tax adviser early, because the structure has to be set up before the deal is signed.
What documents do you need for a valuation?
Three years of history, in enough detail that someone who’s never met you can follow it. The better your records, the fewer assumptions a valuation has to make, and assumptions almost always cut against the seller.
Gather these before you ask for a number:
- Profit and loss statements and balance sheets, monthly, for three years plus year to date
- Revenue by surgeon, by procedure category and by service line
- Consultation, conversion and case volume data
- Owner compensation and benefits, with a list of proposed add-backs
- Leases, including any you hold as landlord through a real estate entity
- Surgical facility accreditation reports and equipment lists
- Staff roster with roles, tenure and pay
Who pays the highest multiple?
Usually a private equity-backed platform buying a larger practice, or a platform expanding into a new market where your practice becomes its anchor. Add-on buyers near an existing platform often pay less per dollar of earnings, and surgeon-to-surgeon buyers usually pay the least, though often with simpler terms.
Buyer type changes structure as well as price. Private equity offers usually include rollover equity, so part of the headline value arrives later and depends on the platform’s future. For a full breakdown, see our guide to who buys plastic surgery practices. And if rollover is part of an offer, read our guide to plastic surgery rollover equity before you compare headline numbers.
How can you raise your plastic surgery practice valuation?
Add surgeon capacity so the practice doesn’t depend on you, grow non-surgical revenue, keep clean monthly financials, document your add-backs, strengthen your practice brand and fix compliance gaps. Start 12 to 24 months before a sale, because buyers want to see a trend, not a single strong quarter.
A practical order of work:
- Get an independent recast of your earnings so you know your real starting point.
- Hire or develop an associate surgeon and help them build a caseload.
- Expand injectables, skin care and other recurring services.
- Move to accrual-based monthly financials with clear reporting by surgeon and service.
- Build marketing and patient intake that run without your daily involvement.
- Clean up contracts, accreditation files and compliance records.
- Decide what to do with any real estate you own.
Frequently asked questions
What multiple do plastic surgery practices sell for?
It depends on size and structure. FOCUS Investment Banking reported 2026 platform deals at 5x to 6x EBITDA for practices under $1 million, rising to 9x to 12x or more above $7 million, with add-on acquisitions at 5x to 9x. Surgeon concentration, growth and facility ownership decide where a practice lands.
Is a plastic surgery practice valued on revenue or EBITDA?
Mostly on adjusted EBITDA. Revenue multiples are sometimes quoted as a rough check, but they ignore margins and owner compensation, which vary widely between practices. Buyers recast your earnings, apply a multiple to adjusted EBITDA, then adjust for risk, growth, facility ownership and deal structure.
How much is goodwill worth in a plastic surgery practice?
Goodwill is often the largest part of the value, because patients choose surgeons and brands rather than equipment. Buyers pay more for enterprise goodwill that stays with the practice than for personal goodwill tied to you. Employment agreements, associate surgeons and a strong practice brand turn personal goodwill into enterprise value.
Does owning my surgery center increase my practice’s value?
Usually, yes. An owned, accredited surgical facility adds facility revenue and operating control, which buyers value. But the facility brings accreditation, staffing and equipment obligations that buyers review closely. If you also own the real estate, it’s typically valued separately and either sold or leased to the buyer.
How can I get a plastic surgery practice valuation?
Start with an independent recast of your financials by an advisor or valuation firm familiar with plastic surgery. A market-based estimate uses recent deal multiples and your adjusted EBITDA. A formal appraisal is needed for tax, legal or partner buy-in purposes. Either way, have clean monthly financials and three years of history ready.
Why do buyers adjust my compensation in a valuation?
Because a buyer will pay you under a new compensation formula after the sale. The difference between your current pay and that formula changes the earnings they’re buying. Lower post-sale pay raises adjusted EBITDA and the price, but reduces your future income, so model both sides before agreeing.
Plastic surgery practice valuation: the bottom line
A plastic surgery practice valuation starts with adjusted EBITDA and a multiple, but the real drivers are how much of the practice depends on you, how your earnings are recast and who’s bidding. Understand those, and you’ll know what your practice is worth well before a buyer tells you.
| Want a confidential view of your practice’s value? Get the Plastic Surgery Exit Report newsletter for quarterly valuation 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. |
