Guide to Selling a Plastic Surgery Practice in Nevada

If you own a plastic surgery practice in Nevada, you are likely aware of the state’s thriving aesthetic market. The demand creates a significant opportunity for practice owners considering a sale. However, navigating a transaction here involves more than just finding a buyer. The state’s unique regulatory landscape presents specific challenges that require careful planning. This guide will walk you through the key market dynamics, structural requirements, and valuation principles to help you prepare for a successful transition.

Market Overview

Nevada’s market for plastic surgery is one of the most dynamic in the country. The combination of a rapidly growing population and a global reputation as a tourist destination creates powerful tailwinds for aesthetic and reconstructive practices.

A Destination for Aesthetics

Cities like Las Vegas and Reno are not just vacation spots. They are hubs for high-end services, including elective medical procedures. This creates a deep pool of cash-pay patients and sustains high demand for everything from injectables to complex surgical procedures, making practices here particularly attractive.

Sophisticated Buyer Interest

This consistent demand has not gone unnoticed. The Nevada market is drawing significant interest from private equity groups and large strategic operators looking to build a presence. These groups are seeking established, profitable practices to anchor their expansion in the region. For practice owners, this means the potential for a competitive sale process and premium valuation.

Key Considerations

Beyond market trends, the single most important factor for a practice sale in Nevada is its status as a Corporate Practice of Medicine (CPOM) state. This legal doctrine is critical to understand. It means that only a licensed physician can own the clinical components of a medical practice. This directly impacts who can buy your practice and how the deal must be structured, especially when the buyer is a private equity group or corporation. The common solution is a Management Services Organization (MSO) model. In this structure, the buyer acquires all the non-clinical assets (like equipment, real estate, and branding) and provides management services to the clinical practice, which remains physician-owned. Structuring this correctly is not just a suggestion. It is a legal requirement.

Market Activity

Private equity firms and strategic buyers are actively using the MSO structure to invest in Nevada. This has created a competitive environment, but these buyers are selective. They are not just buying a practice. They are investing in a platform for growth.

Here are three things buyers in Nevada are looking for right now:

1. Scalable Operations. A practice that relies entirely on the owner is difficult to transition. Buyers pay a premium for practices with associate surgeons, a well-trained team, and systems that can support growth without the founding physician working more.

2. A Strong Aesthetic Revenue Stream. While reconstructive surgery is a core service, a robust and growing cosmetic business is highly attractive. Buyers value the high margins and direct-to-consumer nature of non-insured aesthetic services and medspa offerings.

3. Clean and Organized Financials. Sophisticated buyers conduct intense due diligence. Practices with clear, professionally prepared financial statements signal a well-run business and make the entire process smoother. Messy books are a major red flag.

Sale Process

The path from deciding to sell to closing the deal follows a structured process. It is not about simply listing your practice for sale. A well-managed process protects your confidentiality and creates the competitive tension needed to maximize value. It generally begins with a comprehensive valuation to understand what your practice is worth. Next is the preparation phase, where we work with you to organize financials and frame your practice’s story. Only then do we confidentially approach a curated list of qualified buyers. The most critical stage is often due diligence, where the buyer inspects every aspect of your business. Many unguided deals encounter unexpected problems here. Proper preparation is the key to navigating this phase and moving smoothly toward negotiation and closing.

Valuation

Determining your practice’s value is not based on revenue or a simple rule of thumb. Sophisticated buyers value your practice based on a multiple of its Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure represents your true cash flow after normalizing for owner-specific expenses and one-time costs. While a baseline multiple is set by the market, several factors unique to your practice can push that multiple higher or lower. For well-positioned plastic surgery practices, these multiples can range from 5x to over 8x Adjusted EBITDA.

Post-Sale Considerations

Your transition strategy should be driven by your personal and financial goals. A sale does not always mean walking away on day one. In fact, most deals with private equity partners are designed to keep the founding physician involved. Two common structures help align everyone for future success. An earnout allows you to earn additional payments post-sale for hitting specific growth targets. An equity rollover, where you reinvest a portion of your proceeds (typically 10-30%) into the new, larger company, gives you a “second bite of the apple.” This allows you to benefit from the growth you help create, often leading to another significant payday when the larger platform is sold years later. These structures let you de-risk by taking cash off the table now while maintaining upside and a role in your practice’s legacy.