Case study — Local SEO, AI Search & Google Ads

Cutting cost per lead in half while organic search took over the job paid ads used to do alone.

Local SEO Google Business Profile Google Ads AI Search Optimization
Client
Meridian Aesthetics & Wellness
Location
Austin metro, TX
Business type
Two-location medical spa
Engagement
9 months, ongoing

The situation

Meridian Aesthetics had two well-reviewed locations and a loyal client base, but almost every new patient was coming from Google Ads. The campaigns worked, but cost per lead had crept up as competitors bid more aggressively on the same treatment keywords, and organic search wasn't picking up any of the slack — both locations sat on page two for their core treatments, and neither showed up consistently in the map pack.

The clinic was also completely absent from AI-generated answers. Patients researching treatments were increasingly asking ChatGPT and Google's AI Overviews to compare providers, and Meridian was never part of that conversation, while a newer competitor with a fraction of the reviews was.

The owner didn't want to spend less on ads — she wanted every dollar to go further, and to stop being entirely dependent on paid traffic to fill the schedule.

"We were paying more every quarter for the same leads. I needed the other channels to start carrying weight."

The approach

Four channels, working as one system.

Local SEO

Fixing the foundation

  • Technical audit across both location sites
  • Rebuilt treatment + location pages around real search demand
  • Structured data for treatments, pricing ranges, and providers
  • Local link building within the Austin med spa and wellness community
Google Business Profile

Owning both map packs

  • Separate, fully optimized profiles for each location
  • Treatment-specific service menus and photo libraries
  • Post-visit review generation system for front desk staff
Google Ads

Making paid traffic efficient

  • Rebuilt campaign structure around individual treatments
  • Dedicated landing pages to lift quality score and conversion rate
  • Negative keyword cleanup to cut wasted spend
  • Budget reallocated toward the highest-margin treatments
AI Search (GEO)

Getting recommended by name

  • Treatment-comparison content structured for how AI models cite sources
  • Consistent citations across directories and review platforms
  • Ongoing tracking of AI Overview and chatbot mentions by treatment

The timeline

What nine months looked like.

Months 1–2

Audit & ads rebuild

Technical SEO fixes alongside a full Google Ads campaign restructure and landing page rebuild.

Months 3–4

Profile & content

Both Google Business Profiles overhauled, new treatment pages published, review system live in both locations.

Months 5–7

Review velocity & AI structuring

Review volume compounding, GEO-focused comparison content and citations published across key sources.

Months 8–9

Organic takes the lead

Organic and map pack traffic overtake ads as the largest source of new patients; ad spend refocused on the gaps organic hasn't filled yet.

The results

Every channel pulling its weight.

2 / 129 / 12
target keywords ranking in the map pack top 3, across both locations
+210%
organic search traffic, month 1 vs. month 9
$86$41
cost per lead from Google Ads, down 52%
2.1x4.6x
return on ad spend
34118
monthly bookings across both locations
07
high-intent treatment queries where AI Overviews and ChatGPT now recommend Meridian by name

Why the channel mix mattered more than any single number

By month nine, organic and map pack traffic had grown enough that Google Ads no longer had to carry the whole clinic on its own — freeing that budget to chase harder, higher-value treatments instead of competing for the keywords organic search was already winning.

Reporting & tracking

What the dashboards showed.

SEO tracking
Organic Research — Traffic Trend
meridianaesthetics.com · both locations · last 9 months
4,000 3,000 2,000 1,000 0 M1M2M3 M4M5M6 M7M8M9
Position Tracking — Keyword Distribution
80 tracked keywords · before vs. after
Month 1 Month 9
45 34 23 11 0 Top 34–10 11–2021+
Google Ads performance
Campaigns — Cost Per Lead
all campaigns · last 9 months
$100 $75 $50 $25 $0 M1M2M3 M4M5M6 M7M8M9
Campaigns — Return on Ad Spend
all campaigns · last 9 months
5.0x 3.75x 2.5x 1.25x 0x M1M2M3 M4M5M6 M7M8M9

"Our ad costs used to climb every quarter no matter what we did. Now our phones ring from search and Google Maps before an ad ever gets clicked, and the leads that do come from ads cost half what they used to."

Alina Cho — Founder & Medical Director, Meridian Aesthetics & Wellness

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