How we measure who AI recommends

These rankings aren't opinions, votes, or paid placements. They are a record of what AI actually answered when we asked — the same way a patient would — who to see.

The five steps, in plain language

1. 1

   We ask the questions real patients ask.

   In each metro we asked leading AI assistants for a med spa 4 different ways — everyday phrasings like "What is the best med spa near me?", "Where should I go for Botox?", and "Which med spa should I go to?". No trick prompts, no leading questions. 26 metros × 4 questions = 104 checks for this edition.

2. 2

   We record every med spa it names.

   Each answer gets logged exactly as given. We then match every recommendation against the 1,671 U.S. med spas in our dataset. When AI names a business with multiple locations, we credit it once — one winner per named business, so no med spa is double-counted.

3. 3

   We publish the count, not a number one.

   We tested this. Running the identical questions on the identical list a second time, the same day, changed which med spa came out on top in more than a third of markets — and in most markets the top spot was already shared by two to five of them. What did NOT move was the count: a med spa named in most checks was named in most checks again. So the page shows how many of the 4 checks named each one. Med spas with the same count are shown together, alphabetically, because the measurement does not separate them.

4. 4

   Named once doesn't make the list.

   Med spas named in exactly one check reappeared less than half the time when we re-ran the same questions. That is a coin flip, not a recommendation, so we keep the data and don't publish the name. Two mentions came back 86% of the time; four came back every time. Each metro page shows only the med spas AI named more than once. We never publish a bottom list and never name who didn't make it.

5. 5

   We re-run it quarterly.

   The same benchmark, the same way, every quarter. Med spas that improve their AI visibility can appear in the next edition — and the run date is printed on every page. This edition: July 2026.

This edition

Measured July 4, 2026 on leading AI assistants: 26 metros × 4 question phrasings = 104 checks.

What this is — and what it isn't

Being on this list means AI recommended that med spa when we asked, in this edition, in that metro. It is a measurement of AI visibility — not a judgment of the quality of anyone's work, and not a claim that unlisted med spas are worse at what they do. AI answers also change over time, which is exactly why we re-measure quarterly and date every edition.