AI Max is Google's newest automation for Search campaigns, and it arrives switched on. Create a new Search campaign and it is already there, ready to widen the searches your ads can match, write new ad text and choose which page people land on.
For many businesses that is a reasonable trade. For a plastic surgery practice, the middle part deserves the most attention. AI Max writes ad copy. It reads the practice's website and existing ads and produces headlines and descriptions the practice never wrote. In most industries, a clumsy generated headline wastes a little money. In plastic surgery, a generated headline can promise a result, quote a price that leaves out half the cost, or describe a surgeon's credentials in words the state medical board doesn't allow.
This chapter covers where AI Max fits in a plastic surgery account, what it might say that a surgeon can't, and the two fences to build before it ever runs.
Three Decisions AI Max Takes Off Your Desk
AI Max isn't a separate campaign. It's a setting inside a Search campaign, and it takes over three decisions this guide has taught the practice to make on purpose:
- Which searches the ads match. AI Max reaches beyond the keywords into searches Google judges relevant. In plastic surgery that can mean med spa searches, "gone wrong" searches and the other categories Chapter 5 worked to exclude.
- What the ads say. AI Max generates new headlines and descriptions from the site and the existing ads.
- Which page people land on. A feature called final URL expansion lets Google override the procedure page the practice picked and land the click on any page of the site it thinks will convert.
Each of those is useful in the right account. Each also has a specific way to go wrong for a surgical practice.
It Comes Last, and Never Near Isolation
The Isolation campaign from Chapter 6 exists for control: exact match, a manual bid for each ad group, ads written for each procedure and a page built for each one. AI Max loosens every piece of that, which is why Chapter 9 switched it off when Isolation was built. It stays off. Google also says AI Max's search matching works best with automated bidding, which Isolation doesn't use.
The natural home for AI Max is the Exploration campaign, which already runs on broad match with a target cost per conversion. Even there, it comes at the very end of the rollout. AI Max learns from the account's conversions, writes from its pages and matches around its negative list. It only helps when the consult tracking from Chapter 1 counts real consult requests, the negative list has months of work behind it, and every advertised procedure has its own page to send people to.
What a Machine Might Write That a Surgeon Can't Say
Imagine AI Max reading a typical plastic surgery website. It sees "exquisite, natural results" on the home page, a "starting at" price on the tummy tuck page, glowing testimonials, and the surgeon's biography. From that, it might generate lines like these:
- "Flawless Results Guaranteed." A promised outcome. Google's misrepresentation policy doesn't allow ads that present "an improbable result" as the likely one, and it requires a clear refund policy when an ad guarantees results.
- "Painless, Scarless Tummy Tuck." Surgery has recovery and scars. No surgeon can honestly promise otherwise.
- "Tummy Tuck From $5,900." Possibly true for the surgeon's fee, and misleading if the total includes anesthesia and facility fees the ad leaves out. Google's policy lists failing to "clearly and conspicuously disclose the payment model or full expense" as a dishonest pricing practice.
- "Board-Certified Cosmetic Surgeon." Credentials are regulated wording. Texas, the example market in this guide, lets a physician advertise "board certified" only when the certifying board meets the Texas Medical Board's standards, such as a member board of the American Board of Medical Specialties. A machine stitching together phrases from a biography doesn't know which board counts.
State rules go further than Google's. Texas also treats advertising as misleading when it creates "an unjustified expectation about the results of a health care service or procedure." Other states have their own rules, and in Texas the rules say plainly that physicians are responsible for the form and content of their practice's advertising.
That is the heart of this chapter. A practice answers for every line in its ads, whoever or whatever wrote it.
Fence One: The Words
Google gives AI Max campaigns text guidelines, and for a plastic surgery practice they aren't optional. There are two kinds.
Term exclusions are words and phrases that must never appear in generated text. Google allows up to 25 per campaign. A plastic surgery list might start with:
- "guaranteed," "guarantee"
- "painless," "pain-free"
- "scarless," "no scars"
- "risk-free," "safe" as a promise
- "perfect," "flawless"
- "cheapest," "cheap," "free" (unless a free consult is genuinely offered and approved)
- "permanent" and "forever"
Messaging restrictions are rules in plain English about what the generated text should and shouldn't say. Google allows up to 40. For example:
- "Never promise or imply a specific result."
- "Never describe surgery as painless, scar-free or without recovery time."
- "Describe the surgeon's credentials only as: Board-certified by the American Board of Plastic Surgery," written exactly as it is true for your surgeon, or leave credentials out entirely.
- "Always write the practice name and the surgeons' names exactly as follows."
There is one trap worth knowing. Excluding "{{BODY}}quot; doesn't stop AI Max from generating prices. Google's own guidance is to add the messaging restriction "Don't generate assets with prices." For a practice whose quotes depend on the patient, that restriction belongs on every AI Max campaign.
Write both lists before AI Max is switched on, and have a surgeon read them. The surgeon knows which words make them wince, which credentials they hold and how they want the practice described. Ten minutes of their time at the start is cheaper than a disapproved ad, a complaint or a headline they have to explain to a patient.
Fence Two: The Pages
Final URL expansion is the part of AI Max most likely to embarrass a plastic surgery practice, because a surgery website has pages that should never be an ad's landing page.
Set URL exclusions that keep AI Max away from:
- The before-and-after gallery. Many breast and body photos count as nudity under Google's rules, even when blurred or censored, and a gallery is not built to answer a search. Chapter 14 covers photos in full.
- Med spa, Botox and filler pages. A tummy tuck searcher sent to a Botox booking page may book, and the campaign will count it as a win. Chapter 15 covers keeping the two businesses apart.
- The blog, financing, careers and patient forms. None of them is a place to start a consult.
If the procedure pages from Chapter 4 are strong, the simplest approach is the reverse: URL inclusions, which limit AI Max to the procedure pages only.
Test It on Exploration, Against a Control
Don't switch AI Max on and hope. Google has an experiment built for exactly this. It divides the traffic of one Search campaign in two, leaving half untouched as the control and running AI Max on the other half. Both halves see the same market in the same weeks, which is the only fair way to compare them.
Run it on Exploration, with the fences above already in place. Let both halves produce enough consult requests to compare, then judge them the way Chapters 3 and 7 judge everything else: cost per real consult first, and a month or two later, surgeries. More clicks and more calls mean nothing if they are price checks and Botox questions.
Read What It Wrote, Every Week
AI Max doesn't stop writing once it starts, so someone has to keep reading. Three places to look:
- The search terms report, where searches found by AI Max carry their own label. Anything that isn't a prospective surgery patient becomes a negative.
- The generated headlines and descriptions in the asset report. Read them as the patient would. Any line the practice wouldn't have written becomes a new term exclusion or messaging restriction.
- The landing pages report, which shows the pages AI Max chose. Any page that shouldn't receive ad traffic becomes a URL exclusion.
If, after a fair run, AI Max is producing real consults at a cost the practice can afford, and the words it writes are words the surgeon would sign, keep it. If not, turn it off, keep the lessons and put the budget back into the campaigns the practice controls.
Next: Before-and-After Photo Rules
AI Max is the last piece of the rollout. Chapter 14 covers something every plastic surgery practice deals with and most advertisers never face: the rules around before-and-after photos in ads and on landing pages, from Google's image policies to patient consent.
Every chapter is on the Google Ads for Plastic Surgeons home page.
Fencing AI Max in before it writes a word is part of how our Google Ads management tests it for plastic surgery practices. If you are considering it for your own, start by writing down the ten words your surgeons would never want in an ad.
