TUSK Practice Sales' guide to plastic surgery practice sales outlines today's exit options for surgeons and how a competitive, marketed process maximizes valuation. Learn the key deal-structure levers that drive premium exits for plastic surgery practices.

CHARLOTTE, N.C., Sept. 5, 2025 /PRNewswire/ -- The market for plastic surgery practice sales remains active, with well-positioned practices commanding premium valuations from Management Services Organizations (MSOs) and Private Equity (PE) groups. Leveraging both industry data and TUSK's experience representing plastic surgeons nationwide, TUSK Practice Sales, the premier healthcare sell-side M&A advisor, is releasing insights into the current state of the market, the exit options available to surgeons, and how plastic surgery valuations and deal structures are expected to evolve heading into 2026 in the plastic surgery practice sales space.

Three Plastic Surgery Practice Buyer Paths — But Not Every Practice Qualifies
MSO Partnership Sale – MSOs are well-suited for established plastic surgery practices generating $2 million+ of revenue that want to maintain clinical autonomy while offloading administrative burden. They bring centralized services, marketing support, and operational infrastructure. The caveat is that not everyone qualifies for a plastic surgery practice MSO sale. Buyers view a solo-doctor practice as inherently risky because the surgeon is the practice. Without additional providers in place, it becomes nearly impossible to ensure continuity post-sale.

Private Equity Platform Deal – PE groups are targeting larger, multi-location plastic surgery groups with strong brand equity and scalability. Platform practices often command the highest EBITDA multiples and equity opportunities because they serve as the foundation for future acquisitions. Oftentimes, this can be a great fit for an owner who is highly entrepreneurial with a desire to expand. Yet here, too, buyers are highly sensitive to "key man risk". PE feedback has been consistent: without an associate or partner surgeon to step in if the founder leaves, the risk outweighs EBITDA.

Doctor-to-Doctor Sale – Still a common path for smaller or single-provider practices, especially those under $2M in revenue. In these cases, a younger plastic surgeon may purchase the business to step into an established brand, patient base, and location. While valuations in doctor-to-doctor sales do not reach MSO or PE levels, they remain a viable option for owners who want a straightforward transition and do not meet the criteria for institutional buyers.

Oftentimes, MSO & PE buyers will make unsolicited offers to practices. While these offers may seem appealing, they rarely represent the true market value. A marketed process ensures multiple competitive bids, creating leverage on both price and structure that unsolicited outreach cannot match. At TUSK, we will increase initial offers by 40 – 100% after a true marketed sales process. If you'd like to dive deeper into navigating unsolicited offers and evaluating buyer options, explore our guide here.

Beyond Valuation: What Surgeons Should Consider When Exiting

While valuation often takes center stage in plastic surgery practice sales, the structure of the deal and the terms surrounding it can be just as important, sometimes even more so. Plastic surgeons weighing an exit should consider these critical factors:

• Deal Structure & Timing of Proceeds:
  Most transactions are not 100% cash at close. Instead, they often involve a combination of upfront cash, rollover equity in the buyer's entity, and sometimes performance-based earn-outs. A deal advertised as a "10x EBITDA" offer could mean very different outcomes depending on how much is paid on day one versus how much is tied to future growth. Understanding the timing and certainty of proceeds is crucial for long-term financial planning.

• Employment Agreements:
  Most buyers require the selling surgeon to remain post-close. These agreements are typically in the 3–5 year range, with defined compensation and clinical responsibilities. For surgeons, this means evaluating not only the financial upside but also the lifestyle implications: how long you want to stay in the practice, what your role will look like, and how restrictive non-compete terms may be after you exit.

• Cultural Alignment & Clinical Philosophy:
  A strong multiple loses its appeal if the buyer's philosophy doesn't align with your own. Some groups focus on efficiency and aggressive growth, while others prioritize brand prestige and patient experience. For plastic surgeons who have spent years building a reputation, ensuring the buyer's approach to patient care, staff management, and practice identity matches your values can make the difference between a smooth transition and post-sale frustration.

• Equity Upside:
  In MSO and PE deals, part of the value is often tied to rollover equity, ownership you retain in the larger entity. If the platform grows and later sells again, that second payout can exceed the initial cash proceeds. However, equity only creates value if the platform is well-managed and continues to scale. Surgeons should carefully evaluate the buyer's track record, growth plan, and financial backing before committing to an equity position.

2025 as the Preparation Year for 2026's Buyer Surge

While current demand is strong, many analysts anticipate greater buyer activity in 2026 as more capital enters the medical aesthetics and plastic surgery space. That gives 2025 sellers a strategic choice:

1. Sell now to capture today's elevated plastic surgery valuations
2. Prepare now to position for next year's wave of competition among buyers

For owners, this is a critical moment to:

• Bring on associates or partners to address "key man risk"

• Benchmark your valuation to identify opportunities for improvement

• Refine operations and systems so the business is "buyer-ready"

• Plan deal structure preferences — cash now vs. equity upside

"The practices that achieve premium outcomes are the ones that maximize cash flow (EBITDA) and minimize risk for the buyer," said Kevin Cumbus, President of TUSK Practice Sales. "It's not just about EBITDA. It's about whether the practice can thrive after the close and the founder steps back. Owners who recognize this and prepare now will be in the best position to capitalize, whether in late 2025 or in the wave of 2026 activity. Building redundancy in your providers is critical in this deal environment."

About TUSK Practice Sales
TUSK Practice Sales ("TUSK") provides M&A Advisory services in the healthcare industry. TUSK has completed over $1B of transactions across all specialties. With an in-depth understanding of the marketplace and access to 100's of buyers nationwide, we help our clients confidently pursue M&A transactions that maximize their long-term value. With our significant collective experience of over 50+ years of practice transactions, we offer our clients solutions that help them achieve their strategic and financial objectives. For more information, visit www.TuskPracticeSales.com.

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SOURCE TUSK Practice Sales