North America's medical aesthetics industry has grown rapidly over the past several years, with recent advances in minimally invasive technology and biohacking cosmetics growing the market from $18.4 billion in 2024 to $55.9 billion by 2033, registering a CAGR of 13.2%.
While the net positive for industry has resulted in the scaling of practices and the emergence of private equity investments, the expansion has also brought new questions around training, patient safety, clinical consistency and consolidation. As a result, many providers are asking whether growth can coexist with high standards of care.
Related: MedSpa Partners Launches Vos Collection: Medical Aesthetics Excellence Redefined
The Vos Collection, a physician-led network of premium medical aesthetics practices, is looking to close these gaps. After merging MedSpa Partners (MSP) on May 27, 2026, the collective positioned themselves the standard of medspa excellence by providing patients consistent, remarkable outcomes that help make them feel more like themselves.
Following the public launch of the organization, MedEsthetics spoke with VOS Founder & CEO Dominic Mazzone about why the company spent six years building its network before going public, how it approaches physician autonomy, and why he believes the industry's biggest challenge isn't competition—it's maintaining quality as demand accelerates.
ME: The aesthetics industry has seen rapid growth and increasing competition. What market challenges or gaps convinced you there was a need for a network like Vos?
The industry in North America has grown dramatically from approximately 6,600 clinics in 2019 to over 13,000 clinics in 2026. The industry has traditionally been structured as:
- Fragmented, individual-provider-run clinics
- Entrepreneur-run locations and multi-location chains
Though there have been many new clinics opening, the realities of the industry haven’t changed in that experienced, skilled injectors are difficult to find. This has resulted in a significant reduction of standards, compliance, safety and overall patient results. This has also created confusion for the consumer about where to go, what to expect and what’s possible.
Vos Collection is solving several patient pain points: (1) a source of truth on the treatments, devices, skincare, etc.; (2) an idea of what good actually looks like; (3) where to get great results; (4) the combination of individual high-end boutique results with institutional safety and compliance.
ME: Vos spent six years building before its public launch. What lessons emerged during that period, and why was it important to establish the network before introducing it publicly?
We always knew that the individual brands were important and in the beginning, we felt that the corporate entity should be in the background and not getting in the way of the patient experience. This is Especially so when you have the premium level of clinics we do. The way in which we approach our patients, our clinical approach, our cultural approach and our overall leadership philosophy has been honed over these years building up to who we are today, which is the premium platform in North America. The timing was right because we were finally at a place where we evolved into the sum being greater than the parts while still preserving the individuality of the clinics, and this coincided with the market being inundated with inexperienced clinics providing sub-par treatments which created an opening to show the world that we are in deed the leader in the industry and that there is a distinct differentiation between this new lower standard and the excellence Vos Collection clinics are providing.
ME: Many organizations say they’re raising standards in aesthetics. What specific standards or benchmarks do Vos member practices commit to meeting?
This is an easy question to answer because the answer lies in “no”. Many times, in aesthetics it’s about the things you don’t do that provide incredible outcomes and experiences. We consistently get patients asking for things that in the end, will look terrible and unnatural and it’s our job to be their aesthetic advisor. Sure we enhance lips and cheeks, but there is a limit to what looks good and when patients want to go beyond that limit, we say no. It’s not about the dollars, it’s about the results and it’s about the ethics. , If you didn’t believe that, a happier patient is more likely to stick around and create greater lifetime value so in the end, what’s best for the patient is also best for the business.
The providers in the Vos Collection are constantly being pushed for better experiences and outcomes by each other. They don’t just sit as shareholders together, but they act as advisors for each other. They are constantly sharing best practices. Dr. Day was just visiting Dr. Shamban in Los Angeles looking at how she has been rolling out peptides and how she has her skincare displayed. We hold virtual sessions for all of our providers on a consistent basis on many different topics — for example, Dr. Shamban did a session on her “signature feature” approach, and everyone from Ellen Marmur to Doris Day to Shannon Humphrey felt they learned something from it. Shannon Humphrey is an expert on 360 treatment planning and has trained so many of Vos’s HCPs how to do it. The Sharing is endless when you have the combination of experts and open minds the Vos Collection has.
In the end, this raises standards everywhere because you can’t change standards, without changing behaviours and you can’t change that without changing expectations. The Vos HCP’s are holding each other to a higher standard and you are not seeing that anywhere else in the industry. We know this is working because the industry retention rate as per Allergan is about 40%. Vos has an average retention rate that is almost 50% higher. Retention is the greatest proof of satisfaction.
ME: How does Vos measure success across the network beyond practice growth or revenue? Are you tracking patient outcomes, retention, satisfaction or other quality metrics?
As mentioned, we have a high retention rate that we watch consistently, we review our prebooking rates on a weekly basis which gives us a gauge on how likely patients are happy to return. We track treatment pathways telling us overall usage from patients in our clinics, satisfaction, VIP satisfaction and several other metrics that consistently watch both the quantitative factors as well as the qualitative ones. We also provide a competitive advantage for our provider through a considerable amount of proprietary data which allows them to see their patients and the overall business in ways they never have. We literally have our finger on the pulse of what’s happening in the aesthetics world in a unique way, because we have multiple clinics in two countries and in multiple regions and demographics that allows us to see trends sooner.
ME: What are the biggest quality-control or oversight challenges facing the aesthetics industry today, and how is Vos attempting to address them?
Experienced, skilled injectors are difficult to find, which has driven a significant reduction in standards, compliance, safety and overall patient results, and created confusion for consumers about where to go and what to expect. Patients are unaware that certification, mandatory training programs and testing for injectors doesn’t exist in the industry. Though there are rules about who can medical direct and who can inject, there truly is a frontier mentality and regulatory environment.
We are also seeing some shocking trends — such as people buying black-market toxin and injecting themselves — alongside encouraging ones, such as the potential for results getting better and better. Patients are starting to better understand not all injectors and clinics are not created equal, and that art is difficult to commoditize. Everybody has access to the science, but the art is exclusive to the few. The lack of certification and government oversight is a red flag for the industry as it creates the potential for more illegal activities such as using non-FDA approved products as well as overall reduction in quality results. The way Vos is addressing this is based on what we can control.
The vast majority of our injectors are highly experienced and new injectors are being brought up slowly, carefully and methodically through proper training and mentoring. In fact, not only are injectors trained in their own clinics but our mentorship program takes injectors out of their clinics to train with other injectors to give them more well-rounded training.
ME: Can you share examples of clinical innovations, treatment protocols or best practices that have emerged through collaboration among member physicians?
Due to the strength of our bench, we are constantly pioneering not only better ways to do treatments, but also better ways to combine and integrate treatments to get greater results. On the innovation side, biostimulators have been gaining a lot of attention and there is nobody more on the cutting edge of biostimulator pioneering than Vos’s Dr. Shino Bay. His combining of biostimulators, micronutrients and other modalities to create extraordinary results has been sought after across the world. Shino has been teaching many of the Vos providers his specialized techniques and these are producing results for patients across the platform.
Dr. Ellen Marmur and Dr. Shannon Humphrey are both incredible pioneers in combining treatments for better results and they also are consistently helping to educate many members of the platform. Dr. Poleman out of Calgary is researching consumable collagen and how that is affecting actual collagen production in the face. All of these are helping to create more natural-looking outcomes that seem to help pause the look of aging and, in many cases, reverse it. In addition, Vos has the largest cosmetic research consortium in North America which allows us to see what’s coming and what works. This unique access is invaluable which results in better outcomes for our patients.
ME: How do you balance creating consistency across the network while preserving each physician’s individual approach, expertise and brand identity?
This has been our secret sauce for consolidation. The one thing I made sure to preserve when I started the platform was to not create carbon copies. Every clinic has something that made it special, and it’s important not to disrupt that.
Yes, we have to manage all the back-office business and require a level of standardization — but those aren’t changes that actually affect the patient experience, and they don’t affect the provider experience either. We don’t force our providers to use certain products or sell certain skincare. That level of clinical freedom is a major differentiator and removes obstacles from creating great results. In addition, we don’t change the brands on the door which has been an especially successful strategy for preserving their identity while still feeling part of the broader culture that is Vos Collection.
ME: Private equity and consolidation continue to reshape medical aesthetics. How does the Vos model differ from traditional PE-backed or MSO-led approaches?
One simple philosophy I’ve held true to since the beginning is that I am trying to run a tight standardized operation while culturally creating the most un-corporate corporation for our providers. That philosophy has created a culture that is our greatest differentiator and is indicative of how we treat our HCPs. Many PE consolidations over-corporatize consolidations. They forget that there are people involved and this is an especially important consideration when working with physicians and nurses.
Physicians and nurses didn't get into medicine for quotes and sales targets. Medical aesthetics, especially, has an art component so corporatization feels all the more foreign to them. You have to treat them with the respect they deserve with an approach that speaks to them while also doing the things necessary to have a well run operation. Yes, there are times when those things have been at odds with each other but for six years, we have proven that if you take the time to-sit down and have reasonable discussions that are more collaborative than dictatorial, you end up with a platform like ours that creates a fantastic culture and work environment.
While Vos improves and simplifies clinic operations, we also provide a community that has democratized best practices to deliver real-world results. We don’t change the brands on the door, and we don’t dictate the products providers use giving them real freedom to produce great remarkable results without feeling like they have been assimilated into the corporate vacuum.
ME: Do you believe physician-led collaborative networks represent a viable alternative to consolidation for independent aesthetic practices? Why or why not?
I think these are apples and zucchinis, meaning these aren’t in the same family of options. There currently are plenty of study groups, and buying groups and other organizations that get their members together periodically. The real difference here is that true partnership is vastly different than collaboration. Destinies are tied together in partnership. Stakes are higher in partnership. The level of care for each other is different in partnership.
Accountability is higher in partnership. Healthy conversations are available in both, but real action only happens when everyone’s future is tied together. In today’s market, having an entire marketing department, procurement, tech team, data analysis, finance team, training teams, retail product managers, etc… working together and with the financial might to execute is vastly different from a buying group or study group. So, yes these can be helpful but as an alternative, no, not at all.
ME: What evidence can you provide that participation in the Vos network has improved patient care, clinical outcomes or practice performance during the six years it operated privately?
To be clear, we are very particular about what types of clinic we acquire, so to say that we have improved patient care, is to say that patient care wasn’t excellent to begin with. It was, and is in almost all of these clinics. Starting to improve their experience with loyalty programs and more focus on VIP patients is something that we have now implemented so, yes, we are seeing some improvement there.
As far as clinical outcomes, it is clear that the collaborative model has elevated all of the providers in the platform in a way they haven’t experienced before — even physicians regarded as among the best in the field, such as Dr. Sue Ellen Cox and Dr. Shino Bay, are continually learning from others on the platform. Concrete instances of this sharing include Dr. Parker leading the way on peptides and then collaborating with Dr. Shamban and then Dr. Day studying Dr. Shamban’s peptide rollout and skincare merchandising, and Dr. Shamban’s “signature feature” session that the wider provider group took lessons from as well as Doris Day teaching her consultation style to the rest of the platform. However, the most concrete example is Dr. Shannon Humphrey’s 360 training program that has now trained not only HCP’s on how to properly build a treatment plan for patients, but it is also training the mangers of the clinics.
This program has created greater patient satisfaction, higher revenues and overall better care by not treating patients in a transactional manner, but instead at looking at more of a sequenced plan to achieve an outcome. Lastly, the corporation assures that we are in regulatory compliance from everything to the products and devices we use to our proper consents and follow-ups for patients.
