A med spa's first Google Ads campaign has one job: book real clients from searches you chose on purpose. Not every search that might someday lead to a booking. Just the ones where a person has already named the treatment she wants and made it clear she wants it close by.
That's a much shorter list than most owners expect, and it's the right place to start. This chapter builds that first campaign, then shows how the account grows beyond it once the bookings are coming in.
The First Campaign Holds Only Searches That Name a Treatment and a Place
We call the first campaign Isolation. You won't find that label anywhere in Google Ads; it's shorthand we use for a Search campaign built from exact match keywords, bid by hand, and walled off from everything but the searches most likely to book.
For a med spa, those searches pair a treatment with a place. In our example market, Miami:
- "laser hair removal near me," 2,400 a month, and "laser hair removal miami," 1,000
- "lip filler near me," 880, and "lip filler miami," 880
- "microneedling near me," 880
- "hydrafacial near me," 880
- "iv infusion near me" and its close variants, 2,900
- "med spa near me," 2,400
Your market's numbers will be different. The pattern holds anywhere: a treatment the client has chosen, plus a signal she wants someone nearby.
Notice what isn't on the list. Following the rule in Chapter 5, "botox near me" can't be a keyword for most med spas, and neither can the GLP-1 drug names. So the neurotoxin line starts with the searches that are allowed, like "lip flip" at 880 a month, while the weight-loss line starts with "weight loss injections" and "medical weight loss near me." Your name and your injectors' names run in their own brand campaign alongside Isolation from day one, as Chapter 2 laid out.
Each treatment gets its own tight ad group pointing to its own page, as Chapter 4 described. Isolation isn't one big bucket of "med spa" keywords. It's a set of small, clean lanes.
New Keywords Start as Broad Match Unless You Change Them
Here's a detail that catches a lot of new accounts. Google's help page on keyword matching says it plainly: "Broad match is the default match type that all your keywords are assigned."
So if you paste "lip filler near me" into a new ad group and move on, it goes in as broad match, and it can show your ad on a much wider set of searches than you meant. Isolation only works if you set exact match deliberately, which in the keyword field means wrapping the keyword in square brackets: [lip filler near me].
"Exact" also doesn't mean what it used to. Google's current definition lets an exact match keyword cover any search that means the same thing or carries the same intent. So [lip filler near me] may also pick up "lip fillers near me" or "near me lip filler." That's usually fine for a med spa. What exact match still keeps out is the looser stuff: "lip filler at home kit," "lip filler training," "lip filler gone wrong."
Starting Narrow Is How Google Learns What a Booking Looks Like
It can feel backward to start with the smallest possible campaign when broad match could reach far more people. There are two reasons we do it anyway.
The first is money. Early in an account, every dollar spent on a search you'd never have picked is a dollar that didn't go to a client who was ready. Isolation puts the budget where the booking intent is already obvious.
The second is data. The bookings Isolation produces are clean: each one came from a search you chose, so you know exactly what a booking costs on your best searches. That number becomes the foundation for the next campaign. Chapter 7 uses Isolation's real cost per booking to set a target for the broader campaign, so Google's automated bidding starts from your actual results instead of a guess.
Manual bids fit this stage for the same reason. With only a handful of bookings a week, automated bidding doesn't have much to learn from yet. You set the bids per ad group, watch what each treatment really costs, and adjust.
Bid High at the Start, Then Let Quality Score Bring It Down
A brand-new ad group starts with no history. Google hasn't seen your ads get clicked, and your treatment pages haven't proven anything yet. Until it has one, your bid is doing most of the work of getting the ad seen.
So set Isolation's starting bids toward the upper part of the example market's top-of-page range for each treatment, not the bottom. For "lip filler near me," with an estimated range of $3.48 to $14.01, that means starting somewhere in the upper half rather than at the $3.48 floor. For laser hair removal, where the range runs to $47.72, you may choose to start lower and accept a smaller share of the searches, a decision Chapter 7 takes up.
Then watch and ease off. Google itself says better ads frequently mean cheaper clicks, so as your lip filler and laser ads earn a track record, test whether a lower bid still holds the spot. Lower each ad group's bid in small steps, a week or two apart, and watch whether bookings hold. If they do, keep going. If position and bookings drop, step back up.
The same logic applies to your city name versus "near me." Some clients type the city, some type "near me," and in the example market the two are often close in volume, as with lip filler at 880 each. Put both in the same ad group so they share one bid and one set of ads.
The Long Tail Is Where the Account Grows
Isolation is safe, but it's small. The larger opportunity is in the long tail: hundreds of specific, lower-volume searches that also come from ready clients but are hard to predict one by one. In the example market's keyword data:
- "under eye filler," 480 a month
- "rf microneedling," 480
- "co2 laser resurfacing," 590
- "vi peel," 590
- "emsculpt," 880
- plus the cost searches from Chapter 2, like "laser hair removal cost" at 590
No one could write out every variation of these by hand. That's the job of the second campaign, which we call Exploration, also our name rather than a Google setting.
Exploration begins life as a clone of Isolation, trimmed to the handful of keywords (three to five) with the most bookings behind them. Flip those few to broad, then hand the bids to Google under Maximize Conversions, capped by the cost per booking you're willing to pay. Broad match lets Google find the related searches; the target keeps it from overpaying for them. It launches when the account is recording about 30 bookings a month, because below that, automated bidding has too little to learn from.
Expect Exploration to take a month or two to settle. It's learning which of the related searches actually book.
For the First 30 Days, Read the Search Terms Every Morning
Broad match brings back things you'd never have typed. That's its value and its risk. Every morning of Exploration's first month, pull up the search terms report and scan the real searches your ads appeared on overnight.
Expect the same themes Chapter 5 found in the keyword research:
- Competitor names. Broad match pulls these in constantly. They go on the negative list.
- Massage, day spa and hotel spa searches. The word "spa" invites them.
- Jobs and training. "Med spa jobs," "botox certification cost," "aesthetic injector course."
- At-home devices. "At home laser hair removal," "microneedling pen at home."
- Online and coupon drug buying. Anything pairing a GLP-1 drug with "online," "coupon" or "compounded."
Block each one the same morning. Put a narrow one on the campaign where it appeared, and anything no med spa client would ever mean on the account-wide list. After the first month, most accounts can move to checking a few times a week. The negative list never stops growing, but it grows more slowly.
Once Broad Match Carries the Bookings, the Exact Campaign Becomes a Lever
Over time, Exploration usually overtakes Isolation. It reaches more searches, and once its bidding has learned, it can book clients at a cost close to Isolation's.
At that point Isolation can be paused, and its budget moved to Exploration. But it doesn't get deleted. It becomes a lever. If a specific treatment starts slipping, say laser hair removal in the weeks before summer when the competition heats up, Isolation can be switched back on for just that treatment's searches to win back position with a manual bid. When things settle, it goes quiet again.
Balancing the two is ongoing work, not a one-time switch. The right mix depends on your market, your budget and which treatments you're pushing that season.
Next: Laser Clicks Cost the Most. Pick Which Auctions You Want.
With the right searches in place, the next question is what to pay for them, and in a med spa account the answer varies wildly by treatment. Chapter 7 covers manual bidding, impression share and auction insights, including when to let a national laser chain overpay and when to compete for the click.
Each stage of the rollout has its own chapter, all listed on the Google Ads for Med Spas guide home. Chapter 5 has the keyword research this campaign draws from.
In the med spa accounts we run under our Google Ads management, Isolation goes live first, on treatment-plus-place searches only, and Exploration waits for the bookings to justify it.
