On June 23, 2026, AI Communications Firm, 5W AI Communications, released The Med Spa & Aesthetic Medicine AI Visibility Index 2026, the first defensible measurement of how patients are routed to brands and providers by ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews when researching aesthetic medicine treatments,
Its central finding: two pharmaceutical companies — AbbVie/Allergan and Galderma — control 80% of all drug and device AI citation share in the category. AbbVie/Allergan (Botox, Juvederm, CoolSculpting, Kybella) holds 47%. Galderma (Dysport, Restylane, Sculptra) holds 33%. Merz Aesthetics and Revance split the remaining 20%.
The Index covers a roughly $25 billion U.S. market growing at approximately 15% per year, with an estimated 12,000 facilities operating nationwide.
"Citation share is the new market share. In aesthetic medicine, it is also the new patient pipeline," said Ronn Torossian, founder and chairman of 5W AI Communications. "The brands that don't appear in AI answers are excluded from consideration before the patient ever calls a clinic."
Key Findings
- Botox scored 95 out of 100 — the highest single-brand score in the Index. The drug, the brand, and the category are the same word in nearly every AI answer about wrinkles.
- RealSelf, a patient-review marketplace, scored 86 — higher than every individual med spa, dermatology group, and device brand in the country. The marketplace owns the answer to "is this safe," "what's it like," "how much does it cost," and "how do I find a provider."
- Daxxify, launched by Revance in 2023, already ranks #9 — ahead of Merz's Xeomin, which has been on the market for over a decade.
- LaserAway, the largest national med spa chain at 190+ locations and $200M+ in revenue, ranks #7. Cited less than the smaller marketing budgets of RealSelf and AEDIT combined.
- Board-certified dermatology groups — Schweiger, U.S. Dermatology Partners, and Forefront Dermatology — outrank 19 of the 25 ranked brands. Authority signal beats scale in medical and aesthetic categories.
- Device manufacturers including InMode, Cutera, Lutronic, BTL Industries, Solta Medical, and Hydrafacial (NASDAQ: SKIN) failed to crack the top 25. Patients ask AI for outcomes, not machines.
The Visibility Gap
The Index also documents what 5W calls the "Visibility Gap": the top 25 ranked brands capture roughly 95% of all AI citation share in the category, leaving the remaining 11,500 facilities — 96% of every med spa in America — to split just 5%.
"AI did not create the compression we're measuring," Torossian said. "It exposed it. Two pharmaceutical companies effectively control the answer set. Every med spa in America books patients using one of four companies' molecules. The brand wars play out one tier above the clinic."
