The market for plastic surgery is expanding rapidly, and Richmond, VA, is no exception. With patient demand for cosmetic procedures higher than pre-pandemic levels, many practice owners are considering what a sale or partnership could mean for their future. Selling your practice is one of the most significant financial decisions you will ever make. This guide provides a clear overview of the market, key considerations, and the steps involved in navigating a successful sale in today’s environment.
Market Overview: A Seller27s Climate in Richmond
The timing for selling a plastic surgery practice has rarely been better, both nationally and here in Richmond. Several powerful trends are converging to create a uniquely favorable market for owners considering an exit or a strategic partnership.
Unprecedented Patient Demand
The post-pandemic era has seen a surge in cosmetic procedures. Nationally, 75% of cosmetic-focused practices report having more business now than before 2020. This is not a temporary blip. The global cosmetic surgery market is projected to grow at a compound annual rate of nearly 15%. This sustained demand makes established practices in desirable locations like Richmond highly attractive to buyers.
Local Market Growth
Richmond’s healthcare landscape reflects this national trend. We are seeing established local plastic surgery practices expand their facilities and services, which is a clear indicator of a healthy, growing regional market. Buyers, including private equity groups and larger health systems, are actively looking for opportunities to enter or expand their footprint in strong demographic areas like Richmond.
Key Considerations for the Practice Owner
A strong market is a great starting point. But a successful sale depends on your own preparation. Many owners think about selling only when they are ready to retire, but the most profitable exits are planned years in advance. Here are three questions to consider right now.
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What are my personal and financial goals? Are you seeking a full exit for retirement, or do you want to sell to a larger partner to shed administrative burdens while continuing to practice? Do you want to maximize cash at close, or is a long-term partnership with potential for future growth more appealing? Defining your ideal outcome is the first step.
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Is my practice ready for a buyer’s review? Buyers pay for proven, well-documented performance, not just potential. This means having clean financial records, clear compliance documentation, and organized operational data. The process of preparing these materials can take months, which is why starting early is so important.
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Who is on my advisory team? A successful transaction requires a team of experts. This includes your accountant, a lawyer familiar with healthcare M&A, and an M&A advisor who understands the plastic surgery market. Attempting to navigate this complex process alone often leaves value on the table.
Understanding Current Market Activity
The demand for high-quality plastic surgery practices has attracted a diverse range of buyers to the Richmond area. Understanding who these buyers are and what they look for is key to positioning your practice effectively.
The Buyers
Today’s buyers go beyond individual surgeons looking to take over a practice. The most active acquirers are often physician-led platforms, sometimes backed by private equity, and regional health systems. These groups are looking for established practices with a strong reputation, stable revenue, and potential for growth. They bring capital and operational support, offering a path for owners who want to grow but lack the resources.
The Deals
Transactions are typically structured as either an asset sale or an equity sale. Each has different tax and liability implications for you and the buyer. Sophisticated buyers often prefer asset sales. We find that more creative structures, like a partial sale where you “roll over” a portion of your ownership into the new, larger company, are becoming more common. This allows you to take chips off the table now while participating in the future growth of the platform.
Navigating the Sale Process
Selling your practice is a structured process that unfolds over several months. While every deal is unique, most follow a predictable path. Being prepared for each stage is the key to a smooth transaction and a successful outcome.
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Preparation and Valuation. This initial phase involves compiling your financial and operational documents and getting a comprehensive, market-based valuation. This is the foundation of your entire sales strategy.
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Confidential Marketing. Your advisor will create a professional overview of your practice (without revealing its identity) and share it with a curated list of qualified, vetted buyers. This creates a competitive environment to drive up value.
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Negotiation and Offer. After initial conversations, interested buyers will submit non-binding offers. Your advisor helps you compare these offers not just on price, but also on structure, cultural fit, and post-sale terms.
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Due Diligence and Closing. Once you select an offer, the buyer will conduct deep due diligence, verifying every aspect of your practice. This is the most intensive phase. Problems discovered here can derail a deal. With good preparation, it should be a straightforward confirmation of the information you have already provided. After a successful diligence period, final legal documents are signed, and the transaction closes.
How is a Plastic Surgery Practice Valued?
Many physicians believe their practice is worth a simple percentage of revenue. In reality, sophisticated buyers value your practice based on its profitability and future earnings potential. The key metric they use is Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization).
An advisor helps calculate this by starting with your net income and adding back expenses that a new owner would not incur, such as your personal auto lease, excess owner salary, or other discretionary spending. This normalized profit figure gives a true picture of the practice’s cash flow. That Adjusted EBITDA is then multiplied by a “multiple” to determine the practice’s Enterprise Value. The multiple is not a fixed number. It varies based on your practice’s size, growth rate, provider mix, and reliance on the owner.
Here is a simplified example:
| Metric | Calculation Step | Example Value |
|---|---|---|
| Reported Net Income | Your practice’s bottom line | $500,000 |
| Owner Adjustments | Add back excess salary, perks, etc. | +$150,000 |
| Adjusted EBITDA | True Cash Flow of the Practice | $650,000 |
| Valuation Multiple | Based on market, growth, and risk | x 6.5 |
| Estimated Enterprise Value | Potential Sale Price | $4,225,000 |
Planning for Life After the Sale
The day the transaction closes is not the end of the journey. A successful exit involves a well-designed plan for what comes next, for you, your staff, and your patients. Thinking about these elements early in the process ensures your personal and professional goals are met.
Your Transition Role
Most buyers will want you to stay on for a period of time, typically one to three years, to ensure a smooth transition of goodwill and patient relationships. The terms of this employment are a key part of the negotiation. This is your opportunity to define your future role. You can choose to shed management duties and focus solely on clinical work, or you can take on a leadership role within the larger organization.
Financial and Estate Planning
The structure of your sale has major tax implications. Working with financial planners and tax experts well before the close is critical to maximizing your net proceeds. If you own your building, you must also decide whether to sell it with the practice or retain it as a real estate investment and lease it to the new owner. These decisions shape your long-term financial security.
Frequently Asked Questions
Why is now a favorable time to sell a plastic surgery practice in Richmond, VA?
The post-pandemic era has driven unprecedented patient demand for cosmetic procedures, with the global market growing at nearly 15% annually. Richmond reflects this trend with expanding local practices and active buyers, including private equity and health systems, making this a seller’s market.
What should I consider before selling my plastic surgery practice?
Key considerations include defining your personal and financial goals (full exit vs. partial sale, cash now vs. long-term growth), ensuring your practice is ready with clean financials and documentation, and assembling an expert advisory team including accountants, healthcare lawyers, and M&A advisors.
Who are the typical buyers of plastic surgery practices in Richmond?
Buyers range from individual surgeons to physician-led platforms backed by private equity and regional health systems. They seek established practices with strong reputations, stable revenue, and growth potential, and often offer capital and operational support to expand the practice.
How is the value of a plastic surgery practice determined?
Value is based on Adjusted EBITDA — net income plus owner benefits and discretionary expenses — multiplied by a market-driven multiple that considers size, growth, provider mix, and owner reliance. For example, an Adjusted EBITDA of $650,000 multiplied by 6.5 could yield an estimated enterprise value of $4.23 million.
What should I plan for after selling my practice?
Post-sale planning includes negotiating your transition role (often 1-3 years to ensure smooth patient and goodwill transfer), and addressing financial and estate planning to maximize proceeds and tax benefits. Decisions about owning vs. selling your building also impact your long-term financial security.