A med spa's first campaign starts with some of the work already done. Before you open the settings page, Google has decided a few things about who can see a Botox or lip filler ad: no teenagers, no retargeting lists built from your client file, no lookalike audiences. You didn't pick any of that. Google's policies did.
That's the good news. The catch is everything Google didn't decide. Those settings ship pointed at Google's reach, not your booking calendar, and nobody at Google is going to call and suggest you change them. This chapter covers both halves: what's already limited, and the switches you set yourself before launch.
Google Already Hides Your Lip Filler Ads From Teenagers. On Search, Too.
Google runs a policy called Ad-serving Protections for Teens. It adds safeguards for users under 18 and lets Google hold back whole categories of ads from reaching them. Two of those categories cover most of a med spa menu.
The first is body modification, which Google describes as cosmetic procedures, weight loss, tanning, piercings and tattoos. Injectables, laser treatments, body contouring and a medical weight loss program all sit comfortably inside it. The second is pharmaceuticals and supplements, which reaches Botox, semaglutide and any vitamin drip or supplement line you sell.
The part many owners miss is where this applies. Google says the restrictions cover YouTube, Display and Search campaigns, so a search ad for lip filler is covered just like a video ad would be. Google also says the list may grow to more products over time.
You don't switch any of this on. There's no teen box to find and no age setting to add. For a med spa that's a relief, not a loss. A 16-year-old searching "lip filler" isn't a client you want, or one you'd want to explain to her parents.
Injections and Drug Names Cost You Remarketing. Your Keywords Survive.
The teen limits are one layer. The second is Google's personalized advertising policy, which sorts some topics into sensitive categories where advertisers lose certain audience tools.
A med spa usually lands in two of them. The Health category names invasive medical procedures, and Google lists injections among them, so neurotoxins and fillers are in. The Restricted drug terms category covers prescription medications, so ads and pages that name Botox, Dysport, semaglutide or tirzepatide are in too. That's separate from the keyword rule in Chapter 5, which decides whether you can bid on a drug name at all.
What the two categories take away is the same list. You can't use:
- Customer Match, the upload of your client emails and phone numbers.
- Your data segments, Google's name for remarketing lists of past site visitors.
- Audience expansion, which widens an audience beyond the people you chose.
- Lookalike segments, built to resemble your existing clients.
What still works matters more for a new account. Keywords on Search are unaffected, and that's where Isolation lives. Location targeting works. So do the audiences Google builds itself, such as people it sees actively shopping for a service, and you can watch how they perform next to a campaign's results.
For a Search campaign built from treatment keywords, that's a short list of losses. The person typing "lip filler near me" doesn't need to be on a list. She just told you what she wants. The limits bite harder later, when Performance Max and Demand Gen lean on audiences, and those chapters account for it.
Google's Default Location Setting Buys Clicks From People a Thousand Miles Away
Location targeting has a setting most owners never open, and its default is wider than it looks.
Out of the box, a campaign aimed at your city reaches two groups: people physically in or regularly in that area, and people who have shown interest in it, wherever they are. That second group includes someone in another state reading about your city. For a hotel it's a feature. For a med spa it's the difference between a neighbor walking past your door and someone in Ohio reading about South Beach on a lunch break. Only one of them is booking lip filler this week.
The other option is called Presence, and it limits ads to people in or regularly in the places you target. Google's own guidance recommends it for a few kinds of advertisers, including businesses in a sensitive vertical with strict targeting limitations. A med spa running injection and weight loss ads fits that description closely.
Then size the area to how far your clients actually travel, not how far you'd like them to. Your booking system can tell you: sort last year's clients by ZIP code and draw the radius, or pick the cities, that cover most of them. A spa in a dense city might find nearly everyone lives within a few miles. A spa in a smaller town might draw clients from the next county over.
Search Partners Put Your Lip Filler Ad on Sites You'd Never Pick
A new Search campaign is set up to run in more places than Google's search results page. Two boxes decide it.
Search partners. Google describes these as hundreds of non-Google websites, as well as YouTube, where your search ads can also appear. You pay only for clicks, but you don't get a say in which sites, and the traffic behaves differently from someone typing a treatment into Google. Turn search partners off at launch. Once Isolation has a few months of bookings, you can test it on the treatment lines that already work and keep it only if the cost per booking holds.
The Display Network. A Search campaign can also push its ads onto websites and apps across Google's display inventory. Those placements put a lip filler ad in front of someone reading a recipe blog. Turn it off in every Search campaign. Display has its own campaign types, built for images and audiences, and a med spa will reach them later in this guide with the right creative and the sensitive-category limits in mind.
With both off, every dollar in the first months goes to the people who typed a treatment into Google, which is the clean read Isolation needs.
AI Max Rewrites the Ads You Just Wrote. Switch It Off Until Chapter 13.
AI Max is Google's bundle of automation for Search campaigns, and new Search campaigns get it turned on by default. Two of its parts are on by default too: text customization, which writes new ad text from your site, and final URL expansion, which sends clicks to whichever page on your site Google picks.
For a med spa in the build stage, both are a problem. Chapter 8 wrote the ads from clients' own words, and Chapter 4 built a treatment page for each ad group. Text customization can swap those lines for copy you never approved, and final URL expansion can send a lip filler click to last year's holiday specials page. You did the careful work. Don't let a default undo it on day one.
What used to be called automatically created assets is the same thing under a new name. Google renamed the old feature text customization and moved it into AI Max, and says that starting in September 2026, campaigns using it are being upgraded to AI Max automatically. So an older account that had auto-created assets on may find AI Max switched on without anyone choosing it. Check every campaign, not just the new ones.
While you're in there, keep broad match out of Isolation. Chapter 6 built it on exact match with hand-set bids, and broad match belongs to Exploration later, once bookings are flowing.
AI Max has a place in a med spa account. It comes last, in Chapter 13, once there's booking history to judge it against and your old specials pages are fenced off from it.
If Your Front Desk Speaks Spanish, Your Ads Should Too
Language targeting tells Google which users can see your ads, based on the languages they use. Most campaigns get set to English on day one and never touched again, which is fine right up until half your waiting room is speaking something else.
Look at who your clients are first. In our example market, Miami, about 28 of the 504 Google reviews we collected from med spas there were written wholly or partly in Spanish. Two reviewers brought up language directly, one noting that "speaking Spanish was needed" during a treatment and another writing, "As someone who doesn't speak fluent English, I was a little nervous about the communication."
If your team can serve clients in Spanish, or Vietnamese, or Portuguese, add those languages to the campaign.
Then decide how far to go. Adding a language to the targeting still shows your English ads. If you want ads written in Spanish, give them their own campaign, with Spanish ad text and a Spanish treatment page to land on, so the searcher reads the same language from the ad to the booking button. Only promise the language if someone at the front desk and in the treatment room speaks it.
Six Boring Switches That Decide Whether You Can Trust Your Numbers
None of these will make a good story at the next staff meeting. Each one protects a number you'll be making decisions from for months, and getting one wrong means months of reports you can't trust.
- Auto-tagging on. Google turns it on by default for new accounts, but older accounts and accounts opened by a previous agency sometimes have it off. It's what lets your analytics tie a booking back to the ad click.
- Call reporting on. It puts a Google forwarding number on your ads so calls count as conversions, with duration and whether the call connected. Chapter 1 covered the 30-second minimum.
- Ad rotation set to "Optimize: Prefer best performing ads." Google then favors the combinations more likely to get results, rather than rotating everything evenly forever.
- Only real bookings as primary conversions. The campaign should bid on the confirmed bookings, paid holds and qualified calls from Chapter 1, not on page views or button clicks.
- Your brand in its own campaign. Searches for your spa's name and your injectors' names get their own budget, as Chapter 2 laid out, so they never compete with treatment searches for money.
- A starting budget you can read. Enough to learn what clicks really cost in your market, as Chapter 3 described, and no more until the bookings show which lines deserve it.
Before you publish, open the campaign once more and read the settings from top to bottom. A campaign copied from an older one brings the older one's settings with it, so check again after any copy.
Next: Give Performance Max One Treatment Line
With Isolation running on clean settings, the account can start reaching people who aren't searching yet. That's where Performance Max comes in, and for a med spa, where the sensitive-category limits start to bite. Chapter 10 covers how to give it one treatment line instead of the whole menu.
Every chapter is listed in launch order on the Google Ads for Med Spas guide home. Chapter 5 explains which drug names you can bid on and which you can only mention.
In the med spa accounts we build under our Google Ads management, this list gets checked setting by setting before a campaign is switched on, and again after anything is copied.
