Of 81 real med spas we audited across 12 US metros in June 2026, AI answer engines named only 16 — just 20% — when asked for the best med spa in the area. The other 80% were not recommended, and the AI listed an average of 10.8 competitor spas instead.
Why we ran this study
Med spa owners keep telling us “clients can find us — we've been here for years.” But being findable on Google is not the same as being recommended by an AI. So instead of guessing, we measured it. Recommd runs live, grounded queries against AI answer engines for any business, which gave us the one thing most AEO commentary lacks: real, first-party data on which med spas AI names and which it skips.
Methodology
- 81 real med spas, each an operating practice with a real website, across 12 US metros (Dallas, Houston, Atlanta, Phoenix, San Diego, Columbus, Raleigh, Las Vegas, Chicago, Miami, Denver, and Nashville).
- 2 answer engines per audit: Grounded AI search and Perplexity — each asked the client's real question, “best med spa in [city].”
- Scored 0–100 on whether the spa was named in the AI's recommendation, with the number of competitor spas the AI named instead recorded for every audit.
- Dates: all audits run on June 21–22, 2026 via the live Recommd API. Every number below traces to an actual engine response — none are estimated.
The headline numbers
of med spas were not named by AI when a client asked for the best in their city (65 of 81). Four out of five spas are invisible at the exact moment of intent.
named by the AI per query, on average (range 5–18). Across all 81 audits, the engines handed out 874 competitor recommendations — the short list clients see instead of you.
spas scored a flat 0 — the AI didn't surface them at all. Most of the rest existed in the AI's world (avg score 57/100) but still weren't recommended. That gap — known-but-skipped — is the whole game.
Results by city
We're reporting at the metro level rather than naming any single spa as “invisible.” The spread is stark: in some metros half the audited spas got named, in others not a single one did. City size isn't the driver — local signal density is.
Toughest metros in our data: Las Vegas and Atlanta — 0% of audited spas were named. Most winnable: Chicago and Miami — 50% named. The difference is how many local spas keep complete, recent, treatment-specific signals on the sources AI trusts.
Three patterns the data supports
- 1. Being established ≠ being recommended
80% of these operating med spas were not in the AI's answer. A client who asks an AI for the best spa in town simply never hears them. Years in business and a busy Instagram don't register — only complete, current signal on the sources the engine quotes does.
- 2. The competition is a crowded short list
The AI named 10.8 spas per query on average. That's the entire universe a prospective client sees — there is no page two. If you're not one of those ~11 names, the booking goes to someone who is, regardless of who actually does better work.
- 3. The gap is “exists in AI” vs “recommended by AI”
Only 4 spas were fully invisible — the AI knew the rest existed. The split was binary: named, or known-but-skipped. Closing it isn't about getting discovered; it's about giving the engine enough recent, treatment-specific, consistent signal to feel safe putting your name in the answer.
What this means if you run a med spa
The reassuring read: you don't need to out-spend anyone — in winnable metros like Chicago and Miami, half the spas got named, and the fix is rarely mysterious. The uncomfortable read: assuming you're recommended because you're established is exactly the trap 80% of these spas fell into. The only way to know is to ask the AI your clients' question and see who it names.
If you're in the 80% that's known-but-skipped, the fix maps to the sources the engine reads: a complete Google Business Profile with tagged treatments and real photos, a steady flow of recent treatment-specific reviews, a claimed RealSelf profile, identical name/address/phone everywhere, and a local “best med spa in [city]” mention.
Recommd asks the same live engines your clients' real question, scores your AI visibility 0–100, shows whether you were named, how many competitors got picked instead, and a personalized fix plan. It's pre-set to the med spa category — this is the exact audit that produced the data above.
Run my free med spa AI-visibility audit →Keep reading
- Why ChatGPT recommends other med spas, not yours — the five source-level reasons behind the 80%.
- How med spas get named by AI in 2026 — the seven-move playbook, in priority order.
- The med spa AEO checklist (2026) — every signal AI reads, grouped by source.
- AI visibility for med spas (hub) — free audit, the fixes, and a done-with-you Coach.
Frequently asked questions
- What percentage of med spas does AI actually recommend?
In our June 2026 study of 81 real med spas across 12 US metros, AI answer engines named only 20% (16 of 81) when asked for the best med spa in the area. The other 80% — 65 spas — were not named, even though all are established, operating practices. When a client asks AI for the best med spa near them, four out of five spas are simply invisible. - How many competitors does AI name instead of your med spa?
On average, AI named 10.8 competitor med spas per query (range 5–18). Across all 81 audits the engines named 874 competitor spots in total. So a client asking "best med spa near me" sees a short list of roughly 11 names — and if you're in the 80% that wasn't named, you're not on it. - Which cities are hardest for med spas to get recommended by AI?
In our data, Las Vegas and Atlanta were the toughest — 0% of the med spas we audited there were named by AI. Chicago and Miami were the most winnable, with 50% of audited spas named. The pattern isn't about city size: it's how many local spas have complete, recent, treatment-specific signals on the sources AI trusts (Google Business Profile, RealSelf, Yelp, and local "best med spa" roundups). - Why would an established med spa not be recommended by AI?
Because AI doesn't read your website — it assembles its med-spa recommendation from a few trusted sources: Google Business Profile (treatment tags, reviews, photos), RealSelf, Yelp, and local "best med spa in {city}" roundups. 4 of the 81 spas we audited scored 0 (the AI didn't surface them at all), and most of the rest existed in the AI's world but weren't recommended. Being established doesn't matter if those sources lack complete, recent, treatment-specific information about you. - How do I check if AI recommends my med spa?
Run the same audit we did: Recommd asks the live AI engines your clients' real question ("best med spa in [city]"), scores your AI visibility 0–100, shows whether you were named, how many competitors got picked instead, the sources the AI cited, and a personalized fix plan. The first audit is free, and it's pre-set to the med spa category.
Methodology note: 81 real med spas audited via the live Recommd API on June 21–22, 2026. Each audit queries 2 AI answer engines (Grounded AI search and Perplexity) with the client's real question (“best med spa in [city]”) and records whether the spa was named, its 0–100 visibility score, and the number of competitors named. Per-spa non-named results are reported in aggregate by metro; no individual spa is identified as invisible.