Google Ads vs. Facebook Ads for Plastic Surgery: Where Local Services Ads Fit and How We Choose

Start with Google Local Services Ads (LSA) if your practice qualifies and someone reliably answers the phone. On a smaller budget with a surgeon who's comfortable on camera, Meta is usually the better first step. Google Search earns a bigger budget once you can fund one procedure properly and send the clicks to a page that persuades.

Which ad channel should a plastic surgery practice start with?

It comes down to six things: budget, procedure, content, phone coverage, market, and eligibility. LSA suits practices that pass Google's screening and can answer calls live. Search suits practices that can fund one procedure well and have a strong page for it. Meta suits smaller budgets when the surgeon has good video and the team follows up by text.

Pick the channel with no red flags in the rows that matter most for your practice.

In our experience, phone coverage usually decides LSA, budget decides Search, and content decides Meta.

What do we check before picking a channel?

We start with the practice's inquiry records, then check LSA eligibility and phone coverage, and only then open the ad accounts. Without a reliable record of inquiries and outcomes, no channel comparison holds up. If nobody can cover the phone, LSA is off the list.

Inquiry records. We ask for the last 60 to 90 days of inquiries with the source and status of each. If that list doesn't exist, building it is the first job. We've seen CRMs still showing completed surgeries as open months later, and closed deals with no dollar value. A spreadsheet the front desk updates daily beats a CRM nobody touches.

Eligibility and phones. We check LSA screening for the practice's exact location, then ask who answers between noon and 2 and after 5. We compare the Google Business Profile hours with the hours someone is at the desk. They often don't match, and with LSA the gap costs money.

Google Ads. We open the Search terms report first, then the location setting, since "Presence or interest" can show ads to people who live outside your city. Then the network settings, and the ad schedule against front desk hours.

Meta. We check the campaign objective and performance goal, then the form type, then whether Advantage+ audience is on. In one audit, a surgeon expected inquiries from a campaign set to chase profile clicks, and Meta delivered exactly what it was asked for.

Can plastic surgeons run Google Local Services Ads?

Yes, in the US, if the practice passes Google's screening. "Plastic surgeon" is a Local Services category, and screening covers provider and practice background checks, state licenses, liability insurance, and National Provider Identifier checks for some users (Google's screening requirements). It averages three to four weeks.

Health care can't use pre-badge ads, so nothing runs while you wait (Google's getting started page). Check eligibility for your location before you build a budget around LSA.

Google is also moving LSA into Google Ads as Performance Max campaigns with pay-per-lead goals. Home and storefront services started moving in August 2026, and categories that don't move in 2026 follow in 2027 (Google Ads Help). Health care isn't named in a 2026 phase. Ads keep their spots on Search and Maps, but LSA performance reports won't transfer, so export your LSA history before your migration date.

No client of ours has been moved from the LSA portal yet. The new version is reportedly more controlled than standard Performance Max, which has brought poor-quality leads in our Search accounts, even ones with long histories. We don't use standard Performance Max for surgical search right now.

How do LSA inquiries behave after they come in?

For plastic surgery, an LSA lead is a live phone call, because Google doesn't offer message or booking leads for health care (Google's lead management page). When the practice answers, the conversation starts right then. The trade-offs show up in the call log: missed calls can be billed, existing patients call too, and there are no recordings or credits.

Around 2024, one practice spending about $10,000 a month on Search ran Search and LSA side by side for four to five months. Valid Search inquiries booked consultations at just under 20%, and LSA inquiries booked at over 60%, both measured before anyone had surgery. The practice later moved its Search budget into LSA. It was one practice with no controlled test, and it convinced us that the price of the first inquiry was the least useful number in the account.

"What stood out was how quickly people booked. A form lead from Google or Meta starts a chase that can take days before you're in a real two-way conversation. With LSA, the patient is calling you, so once someone picks up you're already answering their questions, and if it goes well they book right there."
— Vahe Tirakyan, founder of MD Logica

• Missed calls. Google charges for a missed call during business hours if the caller stays on the line more than 20 seconds, including voicemail (Google's how leads work page). Those hours come from your Google Business Profile, so if it says 9 to 6 and the desk empties at 5, missed calls in that last hour can be billed.
• Ranking. Google says regularly failing to answer calls may hurt your ad ranking (Google's getting started page).
• Existing patients. Google filters some invalid calls, but that same practice still got existing patients calling through LSA to confirm or reschedule, since the ad is the easiest number to tap. Those calls can be charged, so the inquiry definition below removes them.
• No recordings or credits. US health care accounts get no call recordings or lead credits (Google's how leads work page), so your own call log is the only record.

We ask practices to log every LSA call with the date, new or existing patient, answered or missed, the procedure, and whether a consult was booked. Repeat calls from the same number within 15 days aren't charged again (Google's how leads work page).

How do Google Search inquiries behave?

Search inquiries arrive as forms and calls, usually after the person has seen your procedure page and gallery. A strong page turns those visits into inquiries, and a weak one loses them. Search forms need chasing and carry more noise, and a thin budget spread across several procedures teaches you very little.

When click-through rates look healthy and page conversion is weak, we look at the page before touching bids: too few relevant cases, changes a first-time visitor can't easily see, or photos with mismatched lighting and angles. The Search terms report shows where most of the form noise comes from.

In Beverly Hills, $5,000 a month on Search doesn't stretch far in our experience. That's about $164 a day, or about four clicks at a hypothetical $40 each. Split across four procedures, each gets roughly one click a day, which is too little to learn from, so we'd rather run one procedure properly. Our Google Ads page covers how we set that up.

How do Facebook and Instagram ad inquiries behave?

Meta reaches people who weren't searching, so its inquiries tend to come earlier in the decision. In our accounts they've had higher nonresponse than Search or LSA, and some people don't remember inquiring. The form type, the first contact, and the creative usually fix more than switching channels does.

Meta's default instant form, "More volume," is built for quick mobile submissions. "Higher intent" adds a note that your business may follow up plus a review screen, and Meta says it may make more sense when each lead needs follow-up (Meta Business Help Center), which describes nearly every surgical lead. Higher intent forms only run in mobile feeds.

In late 2026 we've seen surgical Meta leads cost around $40 to $60, a range that moves a lot with the practice's creative.

We like a consent-based text soon after the form comes in that names the procedure and asks something easy, like whether they'd rather keep texting or get a call. Practices we work with have seen more replies and booked consults after adding texting, though we haven't measured it as a controlled change.

We're more willing to recommend Meta when the surgeon is natural on camera and someone owns filming and editing. The videos we look for show the surgeon explaining a decision, walk through a specific case, or let patients describe their own experience. You can see how we approach Meta ads for practices.

How do you compare Google and Meta leads fairly?

Use one definition of an inquiry for every channel, give every channel the same follow-up, and group inquiries by the month they arrived. Then compare booked-consult rates, followed by attended consults, surgeries, and collected revenue. Cost per inquiry alone can rank channels in the wrong order.

One definition. A valid inquiry is a unique new prospective patient asking about a service you offer, with contact details that work. Remove duplicates, existing patients, spam, job seekers, vendors, and wrong-service requests the same way for every channel.

Same follow-up. If LSA callers get a live answer while Meta leads get one email two days later, you're mostly measuring your follow-up. One unanswered call doesn't make a lead bad, so before we call an inquiry low quality, we check how many attempts were made, when and how, and whether the message answered what the person asked.

Group by inquiry month. Surgical decisions can take around 90 days in the practices we've followed, so a March consult may come from a February inquiry. Follow each month's inquiries forward, and review channel mix over a longer stretch, such as a year.

Booked-consult rate first. Divide booked consults by valid inquiries, then track attended consults, surgeries, and collected revenue separately. Specific feedback, like "Meta inquiries replied at half the rate of Search," gives the practice and the agency something to act on.

In this hypothetical month with invented numbers, each channel gets $5,000.

On cost per inquiry, Meta looks nearly three times cheaper, yet each booked consult costs twice as much.

What mistakes do practices make when choosing a channel?

The three we see most often are judging channels by cost per form, starting LSA without anyone to cover the phone, and writing off a channel after a quiet week or two. The easiest number to see on a dashboard is rarely the one that tells you whether the practice is growing.

• Judging by cost per form. It's the first number every ad dashboard shows, and often the only one the agency can see. Shared inquiry records fix that.
• LSA without phone coverage. In health care, missed calls during listed hours can be billed, and there are no credits to get the money back.
• Calling it too early. A quiet week or two says little about a channel. Let the monthly numbers build before you decide.

What don't we know yet?

Nobody knows yet how health care LSA will behave inside Performance Max, because Google hasn't named a date and we haven't seen it in an account. We also can't tell how many LSA callers would have found the practice anyway, or why some Meta leads don't remember inquiring.

Once your account moves, compare booked-consult rates before and after.

A practice with strong reviews and organic visibility will get some LSA calls from people who already knew its name, so don't credit LSA with every booking. If organic is carrying your practice, our SEO page covers that side.

Meta's instant forms prefill contact details, which makes submitting easy. We can't prove that explains the "I don't remember" replies.

For a second set of eyes on your channel mix, request a second opinion.

This post is for general education. It isn't legal, marketing, or operational advice for your practice, and any examples aren't typical outcomes, predictions, or guarantees.