Executive Summary
Selling your Cincinnati plastic surgery practice is one of the most significant financial decisions of your career. The market is active, but realizing your practice’s full value requires more than just finding a buyer. It demands strategic preparation, a deep understanding of your financials, and a clear vision for your future. This guide provides a clear roadmap for navigating the process, from valuation to post-sale planning, helping you transition on your terms.
Market Overview
The market for established plastic surgery practices in Cincinnati is strong. A growing patient demand for aesthetic and reconstructive procedures makes your practice an attractive asset. This is not just about local competition anymore. The landscape has changed significantly with the entry of sophisticated buyers, including private equity firms and large multi-state operators. These groups are actively seeking to partner with successful, well-run practices.
For you, this means there are more options than ever before. However, these buyers look at your practice through a different lens. They analyze your revenue streams, your operational efficiency, and your growth potential with a high level of scrutiny. Understanding their perspective is the first step toward a successful sale.
Four Key Considerations Before You Sell
Thinking about a sale involves more than just the final handshake. Your preparation in these four areas will directly impact your valuation and the smoothness of the transition.
- Your Timeline Isn’t Just About Today. The ideal time to start planning your exit is actually 4 to 6 years before you want to leave. Buyers pay for proven performance, not just potential. We find that building a track record of stable or growing profitability in the years leading up to a sale gives you maximum leverage.
- Your Financials Need a Story. A standard profit and loss statement is not enough. Sophisticated buyers want to see your Adjusted EBITDA. This means rebuilding your financials to account for owner-specific perks, one-time expenses, and other “add-backs.” This single step can significantly change your practice’s perceived value.
- Your Clinic’s Appearance Matters. In a specialty focused on aesthetics, the look and feel of your facility is part of your brand. An updated, modern office with current technology sends a powerful message to buyers about the quality and health of your practice.
- Your Practice’s Value Should Outlast You. Is the practice’s success tied entirely to you? This is a “key man risk” for buyers. By diversifying your service mix and empowering other providers on your team, you create a business that has value independent of any single person.
Market Activity
We are seeing a consistent trend of consolidation in plastic surgery, and the Cincinnati area is no exception. Private equity-backed platforms are actively acquiring practices to build regional and national density. This has created a seller’s market for high-quality practices, but it’s a competitive one. The days of a simple sale to an associate are becoming less common.
This activity means that instead of receiving a single, unsolicited offer, the best strategy is to run a confidential, structured process. By discreetly approaching a curated list of qualified buyers, you can create competitive tension that often results in better terms and higher valuations. It puts you in control of the negotiations, rather than reacting to a single buyer’s demands.
The Three Stages of a Successful Sale
A practice sale is a project with a clear beginning, middle, and end. When managed correctly, the process unfolds in three distinct stages.
Stage 1: Preparation and Valuation
This is the foundational work. It involves a deep dive into your financials to calculate your true Adjusted EBITDA, preparing a compelling narrative about your practice’s strengths, and establishing a professional valuation. Getting this stage right sets the tone for everything that follows.
Stage 2: Confidential Marketing
Here, we identify and discreetly approach a list of the most likely strategic and financial buyers for a practice like yours. This is not about listing your practice for sale publicly. It’s a confidential process designed to protect your staff and patient relationships while generating serious interest.
Stage 3: Negotiation and Due Diligence
After receiving initial offers, the focus shifts to negotiating the best price and terms. The chosen buyer will then conduct due diligence, a thorough review of your financials, operations, and compliance. This is where many deals face challenges. Being prepared for their questions is critical to reaching the closing table smoothly.
What is Your Cincinnati Practice Really Worth?
Valuation isn’t guesswork. It’s a formula based on your practice’s true cash flow and its position in the market. Most buyers use a multiple of your Adjusted EBITDA. Adjusted EBITDA is your profit after adding back owner-specific and one-time expenses. The multiple reflects your practice’s risk and growth potential. A larger, multi-provider practice in a growing market like Cincinnati will command a higher multiple.
The basic formula looks like this:
| Component | Description | Example |
|---|---|---|
| Adjusted EBITDA | Your real annual cash flow | $700,000 |
| Valuation Multiple | Based on risk, growth, and market | 6.5x |
| Enterprise Value | The total value of your practice | $4,550,000 |
The key is getting the inputs right. An expert can help you calculate your maximum defensible EBITDA and argue for the highest possible multiple, ensuring you don’t leave money on the table.
Planning for Life After the Sale
The transaction is not the end of the story. A successful exit plan considers what happens on day one after the closing. Thinking through these points ahead of time is crucial for your long-term financial health and peace of mind.
- Your New Role. Most buyers, especially private equity, will want you to stay on for a transition period of 3-5 years. Your role, compensation, and clinical responsibilities are all key points to be negotiated as part of the deal.
- Your Net Proceeds. The structure of your sale has major tax implications. How the deal is structured can dramatically change how much you take home after taxes. Planning for a tax-efficient sale structure should begin long before you have an offer.
- Your Legacy and Staff. You’ve built more than a business. You’ve built a team and a reputation. The right partner will share your commitment to clinical excellence and will want to retain your key staff, protecting the culture you worked so hard to create.
Frequently Asked Questions
What is the ideal timeline to start preparing for selling a plastic surgery practice in Cincinnati, OH?
The ideal time to start planning your exit is 4 to 6 years before you want to leave. Buyers value a track record of stable or growing profitability, so early preparation maximizes leverage and practice value.
How is the value of a Cincinnati plastic surgery practice determined?
The value is primarily based on a multiple of your practice’s Adjusted EBITDA, which accounts for real annual cash flow after adding back owner-specific perks and one-time expenses. A larger, multi-provider practice in a growing market like Cincinnati will command a higher multiple, resulting in a higher enterprise value.
What makes a plastic surgery practice attractive to buyers in the Cincinnati market?
Growing patient demand for both aesthetic and reconstructive procedures makes practices attractive. Additionally, buyers such as private equity firms look for operational efficiency, diverse revenue streams, and growth potential. An updated, modern clinic appearance and a business model independent of any single provider also increase attractiveness.
What are the key steps in the sale process for a Cincinnati plastic surgery practice?
The sale process consists of three main stages:
1. Preparation and Valuation – deep diving into financials and establishing a professional valuation.
2. Confidential Marketing – discreetly marketing the practice to qualified buyers to generate competitive interest.
3. Negotiation and Due Diligence – negotiating terms and undergoing buyer due diligence to finalize the sale.
What should a seller consider for life after selling their Cincinnati plastic surgery practice?
Post-sale planning includes negotiating your new role (which may involve staying on for 3-5 years), structuring the sale to maximize after-tax proceeds, and ensuring the buyer shares your commitment to retaining key staff and maintaining the practice culture and clinical excellence.