Thinking about the next chapter for your plastic surgery practice? For owners in New Hampshire, the current market presents a unique window of opportunity. The landscape is active, driven by national growth and increasing investor interest. Navigating this environment correctly is the key to protecting your legacy and realizing the full value of the business you have built. This guide provides insight into the trends, valuation drivers, and strategic steps for a successful sale.
Market Overview
The New Hampshire market for plastic surgery is robust, reflecting a powerful national trend. The demand for both cosmetic and reconstructive procedures is strong. This creates a favorable environment for practice owners who are considering a sale. The current climate is defined by a few key characteristics.
- Surging National Demand: The cosmetic surgery market is forecasted to grow by over 9% annually through 2030. This national tailwind directly benefits New Hampshire practices, attracting a wider range of buyers looking to enter or expand in a growing sector.
- Strategic Location as a Premium: Practices located in the Seacoast region, Portsmouth, or near major transit corridors like I-95 are particularly attractive. Buyers pay a premium for access to desirable patient demographics and regional hospital networks.
- Investor Appetite is High: Private equity investment in the aesthetics space has grown exponentially. This influx of capital means more well-funded buyers are actively competing for high-quality practices, driving up valuations.
Key Considerations
While market trends are strong, sophisticated buyers look closely at the details of your specific practice. A successful sale depends on preparing and presenting a compelling, practice-specific story. Buyers will look beyond the top-line numbers to understand the quality and sustainability of your operations. This means having clear answers and organized documentation for everything from your facility’s accreditation and surgical equipment to patient retention rates and the strength of your clinical team. Preparing for this level of buyer scrutiny in advance is not just helpful. It is what separates a smooth, premium transaction from a difficult, discounted one.
Market Activity
The theoretical market strength is visible in real-world transactions across the state. This is not a hypothetical opportunity. It is happening now.
Local Transaction Buzz
We have seen notable activity in New Hampshire’s prime locations. A 5,000-square-foot surgical center in Portsmouth, home to a plastic surgery practice for over 20 years, was recently sold. Another cosmetic practice and surgical center on the Seacoast was also recently brought to market. These public examples are just the tip of the iceberg, signaling a healthy and active deal environment for well-positioned sellers.
The Rise of Private Equity
Perhaps the most significant trend is the accelerating pace of consolidation. From 2000 to 2023, private equity-backed acquisitions in plastic surgery grew by an incredible 4300% in practice volume. These groups are strategic, well-capitalized, and actively looking for platforms in markets like New Hampshire. For a practice owner, this can mean an opportunity for a higher valuation and a structured partnership, but it also means negotiating with a highly experienced counterparty.
The Sale Process
Many owners think of a sale as a single event, but it is a multi-stage process that begins long before a buyer is ever contacted. A well-managed process protects your confidentiality and creates competitive tension to maximize value. It typically starts with strategic preparation, including financial cleanup and operational review. This is followed by a comprehensive valuation to set a realistic and defensible price. Only then does confidential marketing to a curated list of potential buyers begin. The final stages involve navigating intensive due diligence, negotiating the fine points of the deal, and structuring a close that meets your personal and financial goals.
Valuation
Understanding your practice’s value is the foundation of a successful sale. The simple “rule of thumb” multiples you may hear are often misleading. Professional buyers use a more detailed method based on Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure normalizes your profits by adding back owner-specific personal expenses and any above-market owner salary. This true cash flow figure is then multiplied by a number that is heavily influenced by your practice’s specific risk and growth profile.
| Factor | Lower Multiple | Higher Multiple |
|---|---|---|
| Provider Model | 100% Owner Reliant | Associate-Driven, Scalable |
| Service Mix | Mostly Insurance-Based | Strong Cash-Pay & Medispa |
| Facility | Leased, Needs Upgrades | Owned Real Estate, Modern |
| Growth | Flat Year-over-Year | Consistent Patient & Revenue Growth |
| Size (EBITDA) | Under $500k | Over $1M+ |
Getting this calculation right can change your practice’s perceived value dramatically.
Post-Sale Considerations
Successfully closing the deal is a milestone, not the finish line. The structure of your sale has lasting implications that need to be planned for. Your role during the clinical transition, whether for six months or two years, must be clearly defined to ensure patient and staff stability. The structure of your proceeds, including potential earnouts or equity rollovers, directly impacts your final financial outcomes after taxes. Planning for these elements upfront is critical to protecting your hard-earned value and ensuring your personal legacy and your team are secure long after you have moved on to your next adventure.
Frequently Asked Questions
What makes the New Hampshire market attractive for selling a plastic surgery practice?
The New Hampshire market is attractive due to strong national demand for cosmetic and reconstructive procedures, strategic locations that command premiums, and high investor appetite, particularly from private equity. Practices in areas like the Seacoast, Portsmouth, and near major transit corridors are especially appealing to buyers.
What should I do to prepare my plastic surgery practice for sale?
Preparation includes organizing detailed documentation about your practice’s operations, such as facility accreditation, surgical equipment, patient retention, and clinical team strength. Financial cleanup and operational reviews are essential to present a compelling and buyer-ready story that highlights the quality and sustainability of your practice.
How is the valuation of a plastic surgery practice determined in New Hampshire?
Valuation is based on Adjusted EBITDA, which normalizes profits by adding back owner-specific expenses and above-market salaries. This figure is multiplied by a factor influenced by practice-specific elements such as provider model, service mix, facility condition, growth rate, and EBITDA size. Practices with scalable models, strong cash-pay services, owned modern facilities, consistent growth, and higher EBITDA receive higher multiples.
What trends are impacting sales of plastic surgery practices in New Hampshire?
Key trends include rapid growth in private equity-backed acquisitions, which have increased over 4300% since 2000, driving consolidation. There’s also significant local transaction activity and national market growth projected at over 9% annually, making this a competitive environment with well-capitalized buyers seeking quality practices.
What considerations should be made post-sale for my plastic surgery practice?
Post-sale planning involves defining your clinical transition role to maintain patient and staff stability, structuring proceeds to optimize financial outcomes including tax efficiency, and considering earnouts or equity rollovers. These steps ensure protection of your legacy, financial security, and smooth continuation of operations after your departure.