Second Annual Benchmark Report From Growth99 Reveals 67% Increase in High-Investment Practices as ROI-Focused Decision-Making Becomes Dominant

SALT LAKE CITY, UT, UNITED STATES, January 5, 2026 — Growth99, the leading marketing and technology platform for aesthetic and elective wellness practices, today released its second annual State of Aesthetic & Elective Wellness Marketing Report, revealing a rapidly evolving industry landscape where strategic sophistication increasingly determines success.

The comprehensive study of 81 practice owners, managers, and marketing leaders across the United States uncovered dramatic shifts in how practices approach growth, with artificial intelligence adoption emerging as a defining competitive advantage and marketing investment decisions maturing significantly.

The report reveals several significant findings. Practices investing $5,000 or more monthly in marketing jumped from 15% to 25%, representing a 67% increase in the high-investment category. More significantly, 35% now cite ROI and performance as their primary factor influencing marketing investment, representing a fundamental shift from cost-minimization to strategic optimization.

Despite increased investment and technology adoption, 77% of practices still find differentiation moderately to extremely challenging, unchanged from 2025, suggesting that increased spending alone doesn’t solve the positioning problem. The report reveals a clear demarcation between top performers making strategic investments and the rest of the market. While 65% of practices expect revenue growth in 2026, success increasingly correlates with concrete actions rather than market optimism alone.

The report arrives as the aesthetic and elective wellness industry experiences rapid expansion. This growth has intensified competition, with 18% of survey respondents identifying increased competition as one of the most significant changes impacting their practice. Despite these pressures, the industry maintains strong fundamentals, with average medical spa revenue of $1.39 million, 73% repeat patient rates, and healthy profit margins of 38%. The projected 15% compound annual growth rate through 2030 suggests significant opportunities for well-positioned practices.

Rob Pickell, CEO of Growth99, explained the findings. “We’re witnessing a clear demarcation between top performers and the rest of the market. The practices thriving in 2026 have increased their marketing efforts, embraced integrated technology platforms, and fundamentally reimagined how they engage patients. Crucially, their investment decisions have matured. 35% now cite ROI and performance as their primary decision-making criterion. These practices aren’t just spending more, they’re spending smarter, and that strategic sophistication is creating a widening gap between leaders and the rest.”

The report identifies four critical takeaways for practice success. First, strategic marketing investment is essential. Industry benchmarks suggest practices should allocate at least 5% of revenue to marketing, yet 52% still invest less than $2,500 monthly, significantly below recommended levels for average-sized practices. Second, multi-channel digital marketing is table stakes. While social media remains dominant, with 70% citing Instagram as most effective, success requires integration across platforms, including SEO, email marketing, and emerging channels like TikTok, currently used by only 7% surveyed.

Third, technology integration creates competitive advantages. With 52% citing integration as their top priority, practices must connect existing systems to enable seamless data flow, efficient operations, and comprehensive ROI tracking. Fourth, differentiation requires strategic positioning, not just operational excellence. Practices must move beyond competing on similar service menus and pricing to develop authentic differentiation through specialized expertise, target market focus, or experiential advantages.

The complete 2026 State of Aesthetic & Elective Wellness Marketing Report is available for download at https://growth99.com/resources/report/2026-state-of-aesthetic-elective-wellness-marketing-report.

About Growth99

Growth99’s impact extends to over 1,000 practices and 2,300 owners, providers, and staff across the aesthetic and elective wellness industry. The company’s data-driven approach and customized brand development strategies have consistently delivered remarkable results for clients. Learn more at growth99.com.

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