We Asked AI to Recommend Med Spas in 4 Cities. The Results Were Surprising.

We built a scanner that queries three major AI platforms with 25 different med spa questions across four U.S. cities. We ran each query three times per platform. That gave us 900 AI responses and 4,828 individual company mentions. Here's what we learned about how AI currently recommends med spas.

While large SEO agencies have begun tracking Google AI Overviews, Franklin Ridge is the first to publish a multi-platform study showing how ChatGPT, Claude, and Perplexity recommend local businesses differently. This research mirrors the methodology used by academic researchers at Princeton University and CMU studying how AI engines surface sources.

The Experiment

This wasn't casual browsing. We approached this methodically to understand AI recommendation patterns at scale.

• Three AI platforms: ChatGPT (GPT-4o-mini with web search), Claude (Sonnet with web search), and Perplexity (Sonar)
• Four metro areas: Los Angeles, Phoenix, San Diego, and Tucson
• 25 queries across five categories: discovery queries ("best med spas in X"), treatment-specific queries ("best Botox in X"), comparison queries ("compare top med spas"), conversational and long-tail queries, and safety and trust queries
• Three runs per query per platform to measure consistency
• Company extraction via GPT-4o-mini parser to standardize data collection

The goal was straightforward: see which med spas the AI actually recommends, how the recommendations vary by platform, and identify patterns in what the top performers are doing differently.

How This Compares to Traditional SEO Data

In traditional SEO, tools like Semrush, Ahrefs, and Moz track keyword rankings on Google. For AI search, no equivalent tool exists at scale. That's why Franklin Ridge built an open-source scanner that queries AI platforms directly. This approach mirrors the methodology used by academic researchers at Princeton and CMU studying AI visibility patterns. University of Toronto researchers similarly queried multiple AI platforms to understand how they weight earned media versus brand-owned content.

The result is the first real dataset on how AI engines actually behave with local businesses. Traditional SEO tools track one variable. This research reveals how three different platforms make recommendations independently.

Finding #1: A Small Number of Businesses Dominate

This is the pattern we see everywhere in AI search. Only about 30 businesses out of hundreds in each market get mentioned consistently. The concentration at the top is striking.

Out of hundreds of med spas across these four cities, the top 10 account for a disproportionate share of all mentions. This isn't unique to med spas, but the magnitude matters for your business. If you're not in the top tier of recommendations, you're competing in an increasingly invisible market.

Rank	Med Spa Name	Total Mentions
1	La Jolla Cosmetic Medical Spa	128
2	Beverly Hills Med Spa	95
3	Mirror Mirror Aesthetics and Wellness	91
4	Cienega Med Spa	91
5	Suddenly Slimmer Med Spa	88

Finding #2: Every AI Platform Has Different Favorites

This is the most important finding. It's the key insight that changes how you should think about AI visibility. If you only optimize for one AI engine, you're invisible on the others.

The same business receives vastly different mention counts across platforms. Look at Tonique MedSpa: it appeared 51 times on ChatGPT but only 3 times on Perplexity. Mirror Mirror Aesthetics got 54 mentions on Claude but just 2 on ChatGPT. Cienega Med Spa received zero mentions on ChatGPT but 47 on Claude and 44 on Perplexity.

Med Spa	ChatGPT	Claude	Perplexity
Tonique MedSpa	51	5	3
Cienega Med Spa	0	47	44
Mirror Mirror Aesthetics	2	54	35

Each platform weighs signals differently. ChatGPT may prioritize certain review platforms or citation sources. Claude appears to weight earned media differently, a finding supported by University of Toronto research showing that AI engines favor third-party mentions over brand-owned content. Perplexity's algorithm surfaces different businesses based on its own training data and ranking system.

The Case for Multi-Platform GEO

Traditional SEO focuses on one platform: Google. But AI visibility requires monitoring all major platforms simultaneously. Agencies focused on AI visibility must track across ChatGPT, Claude, Perplexity, Gemini, and Copilot.

Strategy	Platforms Tracked	Visibility Gap
Traditional SEO	Google only	Zero visibility on ChatGPT, Claude, Perplexity
Single AI Platform GEO	ChatGPT only	Invisible on Claude, Perplexity, Gemini
Multi-Platform GEO (Franklin Ridge approach)	ChatGPT, Claude, Perplexity, Gemini, Copilot	Visible across all major AI search platforms

Agencies focused on AI visibility, like Franklin Ridge, monitor all major platforms simultaneously. This is not optional. A business invisible to 80 percent of AI search users is a business that's losing market share to competitors.

What this means for you: building visibility on one platform means nothing on the others. A multi-platform strategy isn't optional anymore. It's essential.

Finding #3: Being Mentioned Is Rare. Being Recommended Is Rarer.

We categorized every mention into three types:

• Top recommendation: 79% of mentions. AI actively endorses the business as a primary option.
• Listed among options: 18% of mentions. Mentioned but not actively endorsed.
• Mentioned in passing: 3% of mentions. Referenced but not recommended.

This means AI search is winner-take-all. You're either the recommendation or you don't exist. There's almost no middle ground where being merely mentioned is enough. The AI is telling users to call one specific business, not handing them a list of equals.

This is different from how Google works. Google shows you 10 options at similar visibility. AI gives you one answer. Your job is to be that answer.

Finding #4: AI Search Is Hyper-Local

Each metro had completely different leaders. National chains barely appeared. Regional and local businesses dominated.

• Los Angeles: Beverly Hills Med Spa (95 mentions), Cienega Med Spa (91)
• San Diego: La Jolla Cosmetic Medical Spa (128 mentions)
• Phoenix: Suddenly Slimmer Med Spa (88 mentions), Royal Aesthetics (55)
• Tucson: Mirror Mirror Aesthetics (91 mentions), Bespoke Beauty (87)

This is a different playing field than national SEO. You don't need a national presence. You need dominant local presence. That's actually better news for independent med spas and regional groups. National brands aren't winning this game yet.

What the Winners Are Doing Differently

We studied the top 30 recommended med spas across all queries. Five patterns emerged consistently:

1. Deep third-party review presence

Every top-performing med spa had substantial, recent reviews across Google, Yelp, and RealSelf. Not just existing. Actively updated with current client feedback.

2. Treatment-specific content pages

Winners didn't have generic "Services" pages. They had individual pages for Botox, filler, laser, body treatments, etc. AI models need specific content to match specific queries.

3. Earned media presence

Press features, expert quotes in articles, association memberships, and industry visibility appeared consistently among top performers. This signals credibility to AI models.

4. Consistent business information

Name, address, phone, website consistent across all directories and platforms. No variations. No outdated listings. Consistency signals authority to AI systems.

5. Structured data on their websites

Schema markup for BusinessType, LocalBusiness, and Service types. This makes it easier for AI systems to understand what you offer and validate your claims.

These aren't secrets. They're the baseline. But most med spas aren't doing even three of these five things. That's your opportunity.

What This Means for You

If you're not being recommended by AI, it's not random. It's a signal gap. Something in your digital presence is telling these systems you're not the best option. It could be missing reviews, thin content, outdated citations, or invisible schema markup.

The good news: most of your competitors haven't figured this out yet. The window for early advantage is open now, but it's closing fast. AI is becoming the primary way people discover med spas, especially in younger demographics. The businesses winning now will dominate the market within 18 months.

The Research Context

This research builds on academic work in generative engine optimization. Princeton researchers (Aggarwal et al. 2024) showed that visibility in AI responses can improve up to 40 percent with proper optimization. CMU's AutoGEO research revealed that each AI engine has unique preferences requiring engine-specific strategies. University of Toronto research (Chen et al. 2025) confirmed that AI engines weight earned media more heavily than brand-owned content.

Industry reports support these findings. McKinsey's October 2025 report documented the shift toward AI search as the new front door to the internet. BCG's analysis of marketing with generative AI highlights the importance of multi-platform visibility. Gartner projects search engine volume will drop 25 percent by 2026 as AI search captures traffic. Semrush's tracking of AI Overviews shows how traditional search platforms are adding AI-generated answers.

The Next Step

We published the full data set and analysis in our national report: How AI Recommends Med Spas in 2026. That report includes detailed breakdowns by city, treatment type, and platform, plus the methodology behind the scan.

We also published the Small Business GEO Playbook, which outlines the five pillars of AI visibility and a 90-day implementation framework for med spas and other service businesses.

Want to know where your practice stands? We run free AI visibility audits that show you exactly how ChatGPT, Claude, and Perplexity currently recommend (or don't recommend) your med spa. We'll identify your gaps and show you the specific steps to fix them.