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How Do You Maximize Pay Per Click Ad Performance?

July 14, 2025

PPC Strategy Planning

We’re all about maxing out your bang for the buck when it comes to online marketing costs. For many of our clients, Google Ads are a sizable portion of their total online marketing spend each month. But without careful planning and monitoring, a $3000 monthly spend can deliver a wildly different amount of quality leads. So how do you maximize PPC performance? Let’s take a closer look!

Identify Your Highest Margin Services

Google Ads are getting more and more expensive, which means that to still get value out of them, they need to be bringing you a high amount of revenue. One of the easier ways to have that equation continue to make sense is to focus your ad creative on high margin services. This usually means the more popular surgery options, such as breast augmentation, mommy makeovers, and eyelid surgery.

But in practice, many if not all of your highest margin services will be the same as those of your competition. And since Google Ads are priced based on demand, you may end up paying dearly to be found for these top services. So we often recommend clients look a little further down the list for services that still have a healthy margin, but might not be a top priority for the competition. These may be procedures such as breast lifts, neck lifts and body lifts.

Find the Right Budget

We regularly get the question “how much do I need to spend on Google Ads?” Our response is always the same, though the dollar amount can differ significantly. Your spend on Google should be delivering a sufficient amount of quality leads that, when combined with your other lead streams, fills your consult schedule.

If you are spending too little, you may be twiddling your thumbs on consult days. That’s an easy one to suss out. And if you’re booked out months in advance, it’sprobably time to dial back the Google Ads budget a bit. But there can also be harder cases when it’s not as easy to determine if you are spending too much. For instance, after a certain point, there are diminishing returns to additional spend on Google Ads. You may be able to reduce your budget 25% but only see a 5-10% drop in leads. Finding the “sweet spot” involves communicating closely with us to arrive at the lead volume that keeps you busy while always working to reduce total ad spend.

We’ve found that most of our cosmetic and plastic surgery clients are well served with Google Ads budgets between $2,000-5,000/month, but in highly competitive markets the spend needed can be $10,000/month or more.

Look for Missed Keyword Opportunities

Google advertisers bid on sets of keywords. For example, you might pay more for your ad to run when someone searches “best eyelid surgeon” vs. “what is eyelid surgery” since the first one suggests the searcher is more likely to schedule a consultation, instead of just learning more about the procedure. By doing in-depth keyword research, it’s possible to uncover keyword searches that your competition may be overlooking.

We regularly review keyword reports to look for keywords that are getting clicks and conversions at a lower cost than average for each campaign. By targeting these keywords, over time our campaigns are able to achieve better performance.

Respond to the Competition…to a Point

Competition for individual keywords will go up and down depending on time of year, local economic health, and other factors. When competition increases (for instance, due to a seasonal increase in demand) and you’re paying a boatload more to be found for searches that used to give you a great return on investment, it may be time to do more keyword research and find some other options to test out some new campaigns.

And what if a competitor starts to run ads on your own name or practice name? If you have a familiar relationship with them, the best first step is to reach out and ask them to stop. If that’s not in the cards, you may need to put some budget toward your own brand terms. And you could also start running ads on their brand terms in response, but in our experience, the only winner there is Google, as you both drive up the cost for clicks you would have received through organic search anyway. People searching for one practice or another almost exclusively want to reach that practice, not get sidetracked in ad trickery. It’s not a good use of spend for anyone, and hopefully you can convince your competitor of this rather than getting into a PPC war.

Stay Actively Engaged

Google would just love it if you entrusted their automated systems to set and adjust budgets and manage your ads on their behalf. It’s a bit like trusting a fox to watch the hen house though. No matter how helpful their recommendations seem, the bottom line is that they’re always working toward extracting more money from your wallet, not looking out for your best interests.

That’s why having a real person taking a real hard look at ad performance and making regular adjustments is so important. The Google Ads marketplace is everchanging, but if you keep reviewing ad performance based on a target cost per acquisition, it’s easier to know when to start experimenting with new campaigns and keywords.

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