What I Wish I Knew Before Opening a Med Spa

Opening a med spa can look incredibly exciting from the outside.

You picture the treatment rooms.

The equipment.

The branding.

The opening-day photos.

A beautiful lobby.

A full schedule.

A team of talented providers.

And eventually, a business that gives you more freedom and financial independence.

What you don't necessarily picture is sitting at your computer trying to understand why a business can generate a lot of revenue and still feel cash-poor.

You don't picture an expensive piece of equipment needing service.

An employee who isn't producing enough revenue to support her position.

A construction project costing more than expected.

A marketing campaign that doesn't work.

A provider leaving.

A slow month.

A contract you wish you had understood better.

Or the realization that every new level of growth seems to introduce an entirely new category of problems.

I'm Erica Roybal, founder of Denver Dream Medspa and Colorado Aesthetics Academy.

I've experienced the aesthetics industry as a provider, permanent makeup artist, educator, employer, and business owner.

And if I could sit down with the version of myself who was preparing to build a med spa, there are a lot of things I would tell her.

Not because I regret becoming an entrepreneur.

I don't.

Building my businesses has changed my life.

But I would enter entrepreneurship with a much better understanding of what I was actually signing up for.

This is what I wish I knew before opening a med spa.

1. Being Good at Aesthetics Does Not Mean You'll Be Good at Business

This might be the most important lesson.

You can be an incredible provider and struggle as an owner.

The skills required to perform excellent treatments are not the same skills required to:

• Understand financial statements

• Negotiate a commercial lease

• Hire employees

• Manage performance

• Build a website

• Generate leads

• Understand SEO

• Manage inventory

• Evaluate equipment

• Create policies

• Handle complaints

• Manage payroll

• Lead a team

• Understand contracts

• Make investment decisions

I entered this industry because I loved the work.

Then entrepreneurship required me to learn an entirely different profession:

Business.

The sooner you accept that, the better.

2. Revenue Is Not the Number That Matters Most

Business owners love talking about revenue.

"We did $50,000 this month."

"We crossed $500,000."

"We built a seven-figure med spa."

Those numbers can be exciting.

But they tell you surprisingly little about the health of a business on their own.

Imagine two med spas.

Med Spa A

Annual revenue: $1,000,000

Annual expenses: $950,000

Med Spa B

Annual revenue: $700,000

Annual expenses: $500,000

Which owner would you rather be?

Revenue can become a vanity metric when you stop asking what it costs to generate it.

I pay much more attention now to questions like:

What is our gross margin?

What is payroll as a percentage of revenue?

What are our fixed expenses?

What does each service actually cost us?

What is our average ticket?

What is our provider utilization?

What do we spend to acquire a new client?

How many clients return?

What is actually left after expenses?

Those numbers tell you far more than revenue alone.

3. Cash Flow Can Matter More Than Profit on Paper

A business can look profitable and still experience cash pressure.

Why?

Because timing matters.

Payroll doesn't care that next week is supposed to be busy.

Rent doesn't care that a large membership promotion is planned next month.

Equipment financing doesn't care that three clients canceled today.

Bills have due dates.

Your revenue does not always arrive on the same schedule.

One of the biggest shifts in how I think about business has been understanding that:

Cash gives you options.

Cash allows you to survive a slow month.

Replace something that breaks.

Take advantage of an opportunity.

Handle an unexpected expense.

Avoid making desperate decisions.

I would rather have a slightly less impressive business with healthy cash reserves than a business that looks enormous online and is constantly one bad month away from panic.

4. Don't Spend Every Good Month

When you have a great month, it is tempting to think:

We've made it.

Then you upgrade something.

Buy another device.

Hire another employee.

Increase spending.

Take on another payment.

And then the next month isn't as strong.

Businesses are seasonal.

Markets change.

People travel.

Economic conditions change.

Staff changes.

Equipment breaks.

Marketing performance changes.

A strong month should sometimes simply be:

A strong month.

You do not have to immediately turn every increase in revenue into another expense.

Build reserves.

Future-you may be extremely grateful.

5. A Med Spa Can Look Successful and Still Be Financially Unhealthy

A beautiful business can hide terrible economics.

You can have:

A gorgeous lobby.

Expensive devices.

A large team.

A beautiful Instagram account.

Thousands of followers.

A luxury buildout.

And still have a weak business.

This industry is especially vulnerable to appearances because aesthetics businesses are expected to look beautiful.

But beautiful does not mean profitable.

I would rather own an aesthetically simple business with strong margins, repeat clients, healthy cash flow, and a great reputation than a spectacular-looking business drowning in payments.

Ideally, of course, you eventually build both.

But financial health comes first.

6. Equipment Sales Projections Are Not Your Business Plan

Aesthetic devices can be incredible.

They can create excellent results.

They can differentiate your practice.

They can generate significant revenue.

They can also become extremely expensive furniture.

When you're evaluating a device, you may hear projections like:

"If you perform only two treatments per day..."

or:

"This device can generate $50,000 per month."

The word I pay attention to is:

Can.

A device can generate almost anything in a spreadsheet.

The real questions are:

Do clients in my market want this treatment?

How much will they actually pay?

How many competing providers offer it?

How many treatments can we realistically sell?

Who will perform them?

Do we already have the clientele?

How much will marketing cost?

What is the monthly payment?

What are the consumables?

What is the warranty?

What happens when the warranty expires?

How much does service cost?

How much downtime could we experience if it breaks?

How long before this technology becomes outdated?

A salesperson's revenue projection is not the same thing as demonstrated demand.

7. I Would Calculate the Break-Even Point Before Buying Any Major Device

If I were evaluating a $100,000 device today, one of the first things I would calculate is how many treatments it must realistically produce.

Suppose the payment, service allocation, consumables, marketing, provider compensation, processing fees, and other associated costs create a meaningful monthly obligation.

I want to know:

How many treatments must we sell just to cover this investment?

Then:

How many treatments must we sell for this investment to actually be worth the risk?

Those are different questions.

Breaking even is not the goal of owning a business.

Profit is.

8. Used Equipment Can Be Smart—and It Can Also Be Expensive

A lower purchase price does not automatically mean a better deal.

With used equipment, I would investigate:

• Age

• Service history

• Shot count or usage where applicable

• Calibration

• Software

• Handpiece condition

• Warranty

• Transferability

• Manufacturer support

• Replacement-part availability

• Previous repairs

• Consumable availability

• Training

• Installation requirements

Sometimes used equipment creates tremendous value.

Sometimes the money you save on the purchase price disappears in repairs.

Do your due diligence.

9. Don't Buy Technology Because You're Excited About Technology

I love technology.

That can be dangerous for a med spa owner.

New devices are exciting.

New modalities are exciting.

New launches make you imagine all the treatments you could add.

But I have learned to ask:

What business problem does this solve?

Does it allow us to treat something we cannot currently treat?

Does it produce better results?

Does it replace something inefficient?

Are clients requesting it?

Does it have strong margins?

Does it fit our brand?

Will providers actually use it?

If the answer is simply:

"It's really cool,"

that is not enough.

10. Your Buildout Will Probably Cost More Than You Think

Walls look simple until you start moving them.

Then you discover:

Electrical.

Plumbing.

HVAC.

Permits.

Engineering.

Architecture.

ADA requirements.

Fire requirements.

Lighting.

Flooring.

Cabinetry.

Doors.

Signage.

Technology.

Furniture.

And dozens of details you did not know you needed to budget for.

Commercial construction has taught me that the number you start with is not necessarily the number you finish with.

Build contingency into your budget.

And don't spend every available dollar making the space beautiful.

You still need money to operate the business after construction ends.

11. The Lease Matters More Than the Wallpaper

It is easy to fall in love with a space.

The natural light.

The neighborhood.

The parking.

The lobby you can imagine.

But the lease may determine whether that beautiful location becomes an asset or a burden.

Understand:

• Base rent

• Additional rent

• NNN charges where applicable

• Annual increases

• Term

• Personal guarantees

• Buildout responsibilities

• Tenant improvement allowances

• Maintenance

• HVAC responsibility

• Signage

• Permitted use

• Assignment

• Subleasing

• Renewal options

• Default provisions

I would spend far more energy negotiating the economics of a space than choosing its finishes.

You can replace a chair.

Getting out of a bad commercial lease is much harder.

12. Location Still Matters

Digital marketing is incredibly important.

But your physical location matters too.

Think about:

• Parking

• Visibility

• Accessibility

• Neighborhood demographics

• Travel patterns

• Safety

• Convenience

• Nearby businesses

• Competition

• Future growth

A beautiful location that clients hate driving to can create friction you have to overcome every day.

13. Zoning and Permitted Use Should Be Investigated Early

Do not assume that because a building previously housed a salon, office, or wellness business, you can automatically operate every service you want there.

Before becoming financially committed, understand:

• Zoning

• Permitted use

• Occupancy

• Building requirements

• Accessibility

• Parking requirements

• Signage

• Health or professional requirements that may apply

And if your business includes services subject to medical or other professional regulation, the analysis becomes even more important.

Get qualified local guidance.

14. A Certificate Does Not Expand Your Legal Scope of Practice

This is something I think the aesthetics industry needs to talk about more.

You can take an excellent training.

You can receive a beautiful certificate.

You can understand how to perform a procedure.

That does not automatically mean your professional license legally permits you to perform it independently.

Training and legal scope are separate questions.

Before adding a service, determine:

Who can legally perform it?

Under what license?

Under what supervision or delegation, if any?

In what type of facility?

What documentation is required?

What insurance is required?

A weekend certificate is not a substitute for understanding the law.

15. Compliance Is Not the Place to "Figure It Out Later"

When you're starting, compliance can feel like an expense standing between you and opening.

It isn't.

It is part of the business.

Depending on the services and jurisdiction, this can involve:

• Professional licensing

• Medical oversight

• Delegation

• Documentation

• OSHA

• HIPAA where applicable

• Infection control

• Device regulations

• Facility requirements

• Business licensing

• Insurance

• Employment law

The exact requirements vary by state and service.

This is where qualified legal, accounting, insurance, and regulatory professionals are worth paying.

16. Hiring Is One of the Hardest Parts of Growth

When you're overwhelmed, hiring another person sounds like relief.

Sometimes it is.

Sometimes it creates another full-time responsibility.

Employees need:

• Training

• Communication

• Expectations

• Feedback

• Scheduling

• Leadership

• Accountability

• Support

Hiring someone does not automatically remove work from your plate.

Initially, it often adds work.

The benefit comes when you hire the right person, train well, create clear systems, and give that person the opportunity to become productive.

17. Technical Skill Alone Does Not Make Someone a Great Hire

When I evaluate providers now, I care about technical ability.

Of course I do.

But I also care about:

• Sanitation

• Judgment

• Communication

• Coachability

• Reliability

• Consultation skills

• Professionalism

• Honesty

• Follow-through

• Confidence

• Ability to sell appropriately

• Ability to retain clients

• Ability to work with a team

You can teach someone a treatment protocol more easily than you can teach integrity.

Hire for the whole person.

18. Coachability Is More Valuable Than False Confidence

I would rather have someone say:

"I'm not sure. Can you show me?"

than pretend to know something she doesn't.

Aesthetics involves real people.

Overconfidence can create real consequences.

I value providers who:

Ask questions.

Receive feedback.

Correct mistakes.

Keep learning.

Know when they need help.

Confidence is valuable.

But confidence without judgment is dangerous.

19. Avoiding Performance Conversations Makes Everything Worse

This is one leadership lesson I had to learn.

When someone is struggling, it can feel kinder to wait.

Give them more time.

Hope things improve.

Avoid making them uncomfortable.

But unclear expectations are not kind.

People need to know:

What is expected of me?

How am I performing?

Where am I falling short?

What needs to change?

By when?

Good leadership requires uncomfortable conversations.

Have them respectfully.

Have them clearly.

Have them early.

20. Payroll Changes How You Experience a Slow Week

When you're solo, an empty appointment primarily affects your income.

When you have employees, slow schedules affect the entire business.

Payroll continues.

So do rent, software, insurance, equipment payments, and other expenses.

That's why I pay attention to provider productivity.

Being physically present in the clinic is not the same as producing value.

When providers have open time, there should be productive work available:

• Client outreach

• Rebooking

• Follow-up

• Before-and-after organization

• Content creation

• Training

• Referral development

• Room preparation

• Inventory

• Membership education

A growing company cannot afford a culture where everyone waits passively for clients to appear.

21. Your Team Needs to Understand the Business

I don't think employees need access to every financial detail.

But I do think teams perform better when they understand that businesses have economics.

An appointment that cancels affects something.

A client who never rebooks affects something.

Unused supplies affect something.

Poor retention affects something.

A bad review affects something.

Payroll comes from revenue.

Equipment has to be paid for.

Marketing costs money.

The stronger the team understands cause and effect, the more ownership they can take in the outcome.

22. You Cannot Want Someone's Career More Than They Do

This was difficult for me to learn as an educator and employer.

You can:

Train someone.

Coach her.

Give opportunities.

Give feedback.

Provide clients.

Teach marketing.

Encourage content creation.

Show her how to improve.

But eventually, the individual has to want it.

You cannot manufacture someone else's ambition.

Your job as a leader is to create opportunity and clarity.

Their job is to decide what they do with it.

23. Marketing Is Not Optional

You can have:

The best device.

The most beautiful space.

The most talented injector.

The most knowledgeable esthetician.

The best customer service.

None of that matters if nobody knows you exist.

Marketing is not something you do when the schedule gets slow.

Marketing is part of operating the company.

Consistently.

24. Social Media Is Not a Complete Marketing Strategy

Social media matters.

We use it.

But I would never want an entire business dependent on one platform.

Algorithms change.

Reach changes.

Accounts can disappear.

People become less engaged.

A healthier marketing ecosystem can include:

• Search engines

• Website content

• Google Business Profile

• Reviews

• Referrals

• Social media

• Email

• Partnerships

• Local reputation

• PR

• Community involvement

• Returning clients

The stronger the business becomes, the less vulnerable it should be to one platform.

25. Learning SEO Changed How I Think About Marketing

One of the most valuable marketing concepts I learned was search intent.

Someone watching a skincare video may someday become a client.

Someone searching:

"Morpheus8 Denver"

may be actively deciding where to book.

Those are very different audiences.

That is why I became so interested in SEO.

I wanted Denver Dream Medspa to appear when people were actively researching the services we actually provided.

That led me into:

Service pages.

Educational articles.

Local content.

Treatment comparisons.

FAQs.

Before-and-after portfolios.

Internal linking.

Reviews.

Authority building.

And trying to answer the questions people ask before they ever contact the business.

The lesson was bigger than SEO:

Good marketing starts by understanding what the customer is trying to accomplish.

26. Your Website Should Answer Questions Before Your Front Desk Has To

If clients repeatedly ask:

How much does this cost?

Does it hurt?

How many sessions do I need?

What's the downtime?

Can this treat my concern?

What's the difference between these treatments?

those answers should probably exist somewhere on your website.

A good website doesn't simply look beautiful.

It reduces uncertainty.

It educates.

It establishes trust.

And it makes booking easier.

27. Reviews Are One of Your Most Valuable Assets

A business saying:

"We're amazing."

is advertising.

A client saying:

"They took incredible care of me."

is reputation.

Build a consistent, ethical process for asking happy clients to leave honest feedback.

Don't fake it.

Don't script it.

Don't manipulate it.

Earn it.

Over time, reviews become an enormous trust asset.

28. Retention Is More Important Than Constantly Finding Strangers

Imagine spending thousands of dollars every month generating new clients.

They come once.

Then disappear.

So you buy another group.

Then another.

That's an exhausting business.

I would rather acquire a client once and give her enough value that she stays for years.

That is why I care so much about:

• Consultation

• Treatment planning

• Rebooking

• Follow-up

• Results

• Client experience

• Memberships where appropriate

• Home care

• Relationships

Marketing gets someone through the door.

Retention builds the company.

29. Memberships Can Be Powerful—If the Economics Work

Recurring revenue can create predictability.

Memberships can encourage:

• Retention

• Routine treatments

• Client loyalty

• Predictable monthly revenue

But do not create a membership simply because recurring revenue sounds attractive.

Understand:

• Redemption behavior

• Treatment costs

• Provider capacity

• Pricing

• Cancellation rules

• Minimum commitments where lawful and appropriate

• Unused benefits

• Administrative requirements

• Client experience

A badly priced membership can make you extremely busy without making you sufficiently profitable.

30. Discounts Can Become an Addiction

Discounts work.

That's why businesses use them.

But if you constantly teach clients:

Never pay full price because another sale is coming,

you create a problem.

Use promotions strategically.

Ask:

What behavior am I trying to create?

First visit?

Membership conversion?

Package purchase?

Slow-season demand?

New service trial?

Have a reason.

A promotion is a tool.

It should not become your entire brand.

31. Don't Confuse Being Busy With Being Profitable

This lesson applies to providers and owners.

A completely full schedule looks successful.

But if your:

Prices are too low.

Labor costs are too high.

Consumables are expensive.

Discounts are excessive.

Equipment payment is enormous.

Then a packed schedule may simply mean:

You're losing money efficiently.

Know the contribution of each service.

32. Some Services Deserve More Attention Than Others

Not every treatment deserves equal marketing.

Look at:

• Demand

• Margin

• Repeatability

• Treatment time

• Equipment utilization

• Client satisfaction

• Cross-selling opportunities

• Retention

A service that generates excellent margin, strong results, repeat visits, and high client satisfaction may deserve significantly more attention than a service that is complicated, low-margin, and rarely requested.

Your service menu should evolve.

33. You Don't Need to Offer Everything

A huge menu can feel impressive.

It can also create:

• Inventory complexity

• Training burden

• Confusing marketing

• Underused equipment

• Inconsistent provider skills

Sometimes narrowing your focus makes the business stronger.

Become excellent at what your market actually wants from you.

34. Know Why You Are Adding a New Service

Before adding something, ask:

Are clients requesting it?

Does it complement what we already do?

Can we perform it exceptionally well?

Does it fit our positioning?

Is the margin attractive?

Does it require significant new inventory?

Will it cannibalize another service?

How will we market it?

New is not automatically better.

35. You Will Eventually Outgrow Systems That Once Worked

A system that works with:

Two employees

may completely fail with:

Ten.

The same is true for:

Scheduling.

Inventory.

Communication.

Training.

Meetings.

Payroll.

Marketing.

Management.

Growth requires rebuilding systems.

Do not become emotionally attached to the way you've always done something.

36. Document Processes Earlier Than You Think You Need To

When you're the only person doing something, the process lives in your head.

Then you hire someone.

And you realize:

Nobody else knows what "the normal way" is.

Write things down.

Create:

• SOPs

• Checklists

• Training materials

• Policies

• Scripts where appropriate

• Treatment standards

• Cleaning protocols

• Opening and closing procedures

Documentation makes consistency possible.

37. Your Culture Is Whatever You Tolerate

You can write beautiful company values.

But culture is what actually happens.

If lateness is repeatedly ignored, lateness is acceptable.

If poor sanitation is ignored, standards are negotiable.

If gossip is tolerated, gossip becomes culture.

If high performance is never acknowledged, people notice.

Leaders teach teams what matters through what they reinforce.

And through what they allow.

38. Leadership Can Be Lonely

Employees may see the schedule.

You see the payroll.

They see a new device.

You see the loan.

They see the expansion.

You see the risk.

They see the busy lobby.

You know whether the month is actually profitable.

There are parts of ownership you cannot appropriately share with everyone around you.

Build relationships with:

• Other owners

• Mentors

• Attorneys

• Accountants

• Financial professionals

• Advisors

You need people who understand the decisions you're making.

39. Ask for Professional Help Earlier

There is a difference between being resourceful and trying to become your own:

Attorney.

Accountant.

Architect.

Engineer.

Insurance broker.

HR specialist.

Tax professional.

At some point, DIY becomes more expensive than professional help.

I still believe business owners should understand what they're signing and paying for.

But understanding something does not mean you have to personally do everything.

40. Read the Contract

Every time.

Equipment.

Lease.

Construction.

Employment.

Software.

Financing.

Vendor.

Marketing.

Partnership.

Read it.

Ask questions.

Understand:

• Term

• Cancellation

• Renewal

• Payment

• Liability

• Warranty

• Default

• Dispute provisions

• Personal guarantees

Do not assume the salesperson's explanation replaces the written agreement.

The document matters.

41. Construction Will Teach You Patience Whether You Want It To or Not

If you expand into a larger location, you enter another world.

Architects.

Engineers.

Contractors.

Permits.

Inspections.

Drawings.

Budgets.

Change orders.

Lead times.

Financing.

And delays.

My advice:

Ask questions.

Document decisions.

Understand the budget.

Understand who is responsible for what.

Do not assume verbal conversations will be remembered the same way by everyone.

And keep contingency.

42. Expansion Is Not Automatically Progress

A bigger building is not automatically better.

More employees are not automatically better.

Another location is not automatically better.

Before expanding, ask:

What problem does expansion solve?

Capacity?

Demand?

Education?

Client experience?

Operational efficiency?

Long-term asset building?

Then ask:

What new problems does expansion create?

More rent.

More payroll.

More management.

More construction.

More complexity.

More risk.

Growth should be intentional.

43. Bigger Businesses Require Different Owners

This surprised me.

The skills that help you build the first version of a business can become the skills you need to let go of later.

In the beginning:

Doing everything yourself can save the company.

Later:

Doing everything yourself can hold the company back.

Your role has to evolve.

Provider.

Owner.

Manager.

Leader.

Strategist.

Those identities do not always coexist comfortably.

44. Stepping Back From Treating Clients Can Feel Like Losing Part of Your Identity

I built part of my reputation through hands-on work.

Permanent makeup.

Advanced aesthetic treatments.

Clients.

Results.

There is something rewarding about being the person physically creating the transformation.

But as my responsibilities changed, I had to recognize that my highest-value contribution to the business might not always be another appointment.

Sometimes it is:

Hiring.

Strategy.

Marketing.

Education.

Systems.

Leadership.

Expansion.

That transition can feel uncomfortable.

But a business cannot become independent of its founder if the founder refuses to let her role evolve.

45. Motherhood Changes How You Measure Opportunity

Before I became a mother, an opportunity might have been evaluated primarily by:

How much can this grow my career?

Now there is another question:

What will this require from my life?

An opportunity can be financially attractive and still not be right.

A bigger business can create more income and less freedom.

A new project can create growth and take time away from your family.

There is no formula that solves that tension.

But I think asking the question matters.

46. You Cannot Be Everywhere at Once

This has been one of the hardest realities for me.

The business may need you.

Your employees may need you.

A client may need you.

Your family may need you.

Your child may need you.

All at the same time.

You will disappoint someone occasionally.

Sometimes that person will be you.

I've had to become much more intentional about deciding:

What actually needs me?

Not:

What could I possibly do?

There will always be more you could do.

47. Building a Business as a Mother Requires a Different Definition of Balance

I don't think balance means every part of your life receives equal attention every day.

That has never been realistic for me.

There are seasons.

Sometimes business needs more.

Sometimes motherhood needs more.

Sometimes you have to deliberately step back.

The goal is not a perfect 50/50 split.

The goal is building enough awareness and flexibility that one part of your life does not permanently consume all the others.

48. Success Eventually Has to Mean More Than Growth

For a long time, business gives you easy scoreboards.

Revenue.

Appointments.

Employees.

Locations.

Followers.

Reviews.

Square footage.

Eventually, I started asking different questions.

Can the business function without me?

Are we financially healthy?

Do clients trust us?

Are students succeeding?

Are employees growing?

Am I proud of what we're building?

Do I have room to be a mother?

Does this business support the life I want—or is my life supporting the business?

Those questions have become more important to me.

49. You Will Make Mistakes

Some will be small.

Some will cost money.

Some will embarrass you.

Some will change how you operate forever.

You will probably:

Hire someone you shouldn't have.

Buy something you wouldn't buy again.

Trust the wrong person.

Misjudge demand.

Spend too much somewhere.

Spend too little somewhere else.

Wait too long to make a decision.

Move too quickly on another one.

That does not automatically make you a bad entrepreneur.

It makes you an entrepreneur.

The goal is to become increasingly difficult to fool—including by your own assumptions.

50. Don't Hide the Mistakes From Yourself

When something doesn't work, there is a temptation to explain it away.

The economy.

The employee.

The vendor.

The algorithm.

The client.

Sometimes those things really are responsible.

But I also ask:

What was my part?

Did I hire poorly?

Did I fail to train?

Did I ignore a warning sign?

Did I buy based on excitement?

Did I misunderstand the numbers?

Did I wait too long?

Did I communicate badly?

Ownership means taking responsibility for the things you actually control.

That is uncomfortable.

It is also where improvement happens.

51. Entrepreneurship Will Make You More Humble If You Let It

Every time you think:

I've finally figured this out,

the business introduces another problem you have never seen.

That's not necessarily bad.

It keeps you learning.

I know far more about business today than when I opened my first company.

And I am probably more aware today of how much I still don't know.

I consider that progress.

52. You Don't Have to Know Everything Before You Begin

After everything I just told you, I don't want the conclusion to be:

Don't open a med spa until you're an expert in 52 different subjects.

You won't be.

I wasn't.

The point is to understand that opening the doors is the beginning of your education—not the end.

You need enough knowledge to make responsible decisions.

Then you keep learning.

Find good advisors.

Ask better questions.

Read.

Study.

Pay attention.

Measure.

Adjust.

Would I Open a Med Spa Again?

Yes.

But I would do some things differently.

I would protect cash earlier.

I would analyze purchases more aggressively.

I would understand the numbers sooner.

I would build systems earlier.

I would ask more questions before signing contracts.

I would recognize sooner that hiring is not the same thing as creating productivity.

I would think more carefully about how each new expense affects the entire business.

I would build my personal professional brand alongside the company brand earlier.

I would invest even more intentionally in search visibility, educational content, reviews, and owned marketing channels.

I would remind myself that a slow month is not automatically a crisis.

And I would understand much earlier that eventually my job as the founder would have to change.

But I would still build.

Because entrepreneurship has given me something beyond businesses.

It has taught me how capable a person can become when there is a problem she has no choice but to learn how to solve.

Should You Open a Med Spa?

Maybe.

But don't open one because it looks exciting.

Don't open one because you want the title CEO in your Instagram bio.

Don't open one because you calculated how much your employer charges for treatments and assumed that revenue would become your paycheck.

And don't open one because entrepreneurship is being sold to you as the only definition of professional success.

Open one because:

You understand the opportunity.

You understand the risk.

You have relevant experience.

You have appropriate professional and legal guidance.

You understand your market.

You understand the economics.

You have a plan for generating clients.

You have enough financial runway.

You actually want to operate a business.

And the business fits the life you are trying to create.

What I Would Do Before Opening a Med Spa Today

If I were starting again, I would work through this list before signing a lease.

1. Define the Business Model

What exactly are we selling?

To whom?

Why us?

2. Research the Market

Who are the competitors?

What is saturated?

What is missing?

What are clients actually searching for?

3. Verify the Legal Structure

Business ownership, professional practice, medical services, delegation, and scope can be state-specific.

Get qualified legal guidance.

4. Build the Financial Model

Estimate:

• Startup costs

• Buildout

• Equipment

• Payroll

• Rent

• Marketing

• Supplies

• Insurance

• Professional fees

• Working capital

Then create multiple scenarios.

Not only the optimistic one.

5. Protect Cash

Separate:

startup money

from

operating reserves

from

personal financial runway.

6. Validate Demand

Do not assume the market wants what you want to sell.

7. Evaluate the Location

Zoning.

Parking.

Access.

Cost.

Visibility.

Buildout.

Future capacity.

8. Review the Lease Professionally

Before signing.

9. Evaluate Equipment With Real Math

Not sales projections.

10. Build the Brand

Know what you want to be known for.

11. Build the Website

Before opening if possible.

12. Start Marketing

Before the first appointment.

13. Build Systems

Before the team grows.

14. Hire Slowly

And intentionally.

15. Track Everything

Revenue.

Profit.

Cash.

Average ticket.

Retention.

Utilization.

Lead sources.

Marketing return.

Then make decisions from data.

Frequently Asked Questions About Opening a Med Spa

Is owning a med spa profitable?

A med spa can be profitable, but profitability depends on much more than treatment pricing. Labor, rent, equipment, consumables, marketing, financing, insurance, administrative expenses, utilization, pricing, and client retention all affect the economics. High revenue does not automatically mean high profit.

How much does it cost to open a med spa?

There is no meaningful universal number. A small existing treatment space and a large multi-room medical aesthetics facility have completely different economics. Location, construction, equipment, staffing, professional requirements, insurance, working capital, and service mix can materially change startup costs.

Build your budget from your actual business model rather than relying on a generic number online.

Do you have to be a doctor to own a med spa?

Ownership and operation of businesses providing medical aesthetic services depend on the jurisdiction and the services being offered. State laws may regulate professional ownership, the practice of medicine, delegation, supervision, and who may perform particular procedures. Do not assume a general business entity can provide medical services in the same way in every state. Obtain state-specific healthcare legal advice.

Can an esthetician own a med spa?

The answer depends on what "own" means, how the business is structured, where it operates, and what services it provides. An esthetician license does not independently authorize the practice of medicine or expand an esthetician's scope. Business ownership and professional practice are separate legal questions.

What is the biggest mistake new med spa owners make?

There isn't only one, but misunderstanding the economics is a major one. Owners can overestimate demand, underestimate expenses, overfinance equipment, underprice services, hire too quickly, or focus on revenue while ignoring profitability and cash flow.

Should I buy aesthetic devices before opening?

Only after evaluating demand, scope, treatment economics, warranty, service, financing, marketing requirements, provider capacity, and alternatives. A device should fit an established business strategy.

How do med spas get clients?

There is no single channel. Strong med spas can combine local search visibility, an educational website, reviews, referrals, social media, email, partnerships, reputation, paid advertising, and client retention.

How important is SEO for a med spa?

For a local aesthetics business, search visibility can be especially valuable because many potential clients use search engines while actively researching a treatment or provider. SEO should be part of a broader marketing strategy rather than the only acquisition channel.

When should a med spa hire another provider?

Hiring generally makes more sense when there is sufficient demand, capacity constraints, a clear role, financial support for the position, and systems to train and manage the person. Hiring simply because the owner feels busy can create unnecessary overhead.

What numbers should a med spa owner track?

The exact dashboard varies, but I care about metrics such as revenue, expenses, profitability, cash flow, average ticket, provider production, utilization, rebooking, retention, membership performance, lead sources, acquisition costs, and marketing return.

What Opening Denver Dream Medspa Taught Me

Denver Dream Medspa has been one of the greatest business educations of my life.

It taught me aesthetics.

But it also taught me:

Marketing.

SEO.

Hiring.

Leadership.

Equipment.

Finance.

Customer service.

Real estate.

Construction.

Contracts.

Sales.

Systems.

And risk.

Some lessons came from success.

Others came from mistakes.

Both mattered.

The business I operate today is not the business I would have built on day one.

That's because I'm not the same owner I was on day one.

And I think that's what entrepreneurship is supposed to do.

It changes the business.

But if you're paying attention, it changes you too.

[VISIT DENVER DREAM MEDSPA →]

If You're Thinking About Becoming an Owner

Start learning before you need the information.

Understand money before you're responsible for payroll.

Learn marketing before you're desperate for clients.

Learn leadership before you have a large team.

Learn how contracts work before signing an expensive one.

Learn to evaluate equipment before sitting across from a salesperson.

Build your reputation before your grand opening.

And learn what you actually want from entrepreneurship before creating a business that requires your entire life to sustain it.

You don't have to know everything.

But you should know enough to recognize what you don't know.

That may be one of the most valuable skills business ownership has taught me.

— Erica Roybal

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