Why the Google “Right Side Wipeout” Is a Big Opportunity for Savvy Cosmetic Surgeons

Andrey PolstonGeneral

If you’re a cosmetic surgeon advertising with Google AdWords then perhaps you’ve recently felt like somebody just pulled a pin and threw a “Google Grenade” into the middle of your campaigns.

And in the short term that is exactly how it’ll feel.

With Google removing the entire “right side display” feature for search ads, it means the available options to bid for have shrunk from eleven spots to just three or sometimes four above the organic results, and sometimes a few below.

It’s like a cosmic game of musical chairs. And a whole ‘lotta advertisers are about to land flat on their butts.

[NOTE: this is a topic for a different post, but the REAL losers with this “Right Side Wipeout” are practices with a heavy investment in SEO. Paid position #4 (new AdWords position) used to be the old organic (SEO) position #1. Now the top non-paid result will no longer be visible without scrolling (“above the fold”) on desktop computers. But I digress…]


  • Your ads are getting absolutely no impressions and drowning in the sea of competing advertisers clamoring to just get impressions (eyeballs) let alone precious clicks (traffic) …because with more than half the “chairs” gone it’s now much more competitive for each ad spot…
  • Your previous high bid isn’t enough for even the cheapest seats to the Google Show … because with more than half the seats gone, you won’t show. Lost lots of traffic recently? That’s probably the reason…
  • The ads that you do bid higher on DO get some impressions and clicks, but just barely tread water for a short time before sinking into the abyss (this happens because of a much shorter “trial period” for your ad performance to demonstrate to Google that it can get a decent CTR (Click Through Rate) and therefore make Google some moolah…)



Listen to me. And listen to me very carefully.

This is also an incredible opportunity for the few savvy cosmetic surgeons who understand what is happening, what’s about to happen, and most importantly how to leverage it

Let me ask you a question…

Ever heard the contrarian advice “buy when there’s blood in the streets”?

Well, it applies the current situation that’s unfolding. And it’s exactly what a few savvy surgeons are going to do to position their practice to win.

To say it in business expansion terms…

“When others are contracting from fear, chaos, and frustration … that is precisely the time to strike and expand as aggressively as you possibly can.”

If everyone is retreating from an arena where you’ve all been competing, what’s one of the results of this?

They leave empty space for you to fill.

So, said differently:

“When others are contracting, they’re leaving a behind a vacuum where they used to be. That is precisely the time to expand and gobble up that market share. When the dust settles and the smoke clears, you’ll be left standing with most of the chessboard under your control.”

Right now the proverbial iron is hot with chaos and frustration … time to strike.

Here’s what will begin to unfold…

  • Over the next few months much your competition is going to make a valiant effort to adjust things the right way, and fail – tanking their new patient acquisition effort until they fix things or work on new advertising channels. A good thing, right? Read on…
  • But of the remaining minority, the top 20% — the savvy practices – will first get a toehold, then establish a foothold, and ultimately end up with a stranglehold on their chosen corners of the market because they did it right…
  • The other 80% (of that remaining minority who don’t immediately tank) will have periodic success with some of their ads and campaigns. For them it’ll be a constant ebb and flow of grinding it out by brute bidding warfare for only temporary success before having to start all over again with new campaigns. Keep in mind that this will wreak havoc on your planning and budgeting and ROI.


How exactly are the top 20% of the initial top 20% going to achieve a stranglehold on their chosen markets?

In broad strokes, here’s how:

  • They’re going to “micro-niche” their marketing campaigns to focus on specific procedures and then promote these campaigns to only specific types of prospective patients.
    • They’re going to make sure that everything, from the ad copy, to the landing page copy, to the offers in these micro-niched campaigns relates to the Point-of-View of their specific prospective patients so that it stands out as the best choice for that type of patient.


    • Instead of diluting their available budget by bidding on all types of procedures, they’re going to focus their budget on only 1-3 micro-niched campaigns at a time. So that, in effect, they have 5-10X the buying power of their competition for that specific type of patient. And they’re going to outbid their competition for as long as they have to — until the competition tires out from treading water and sinks.


  • Because the niched copy in their ads, landing pages, and offers will be getting them much high conversion rates on traffic than their competition, they’ll be able to bid higher and still actually be more profitable at the end of the day.

Here’s a simple example of how a cosmetic surgeon would do this for their practice…

Let’s say the micro-niche this surgeon wants to corner in their city is “non-invasive fat removal procedures.”


  • They’ll pick a specific type of client who would be a good candidate for this specific procedure …and they further drill down and wind up picking brides-to-be (we have a whole formula around how to pick profitable micro-niches of people who are ready and eager patients)
    • In addition to targeting keywords just for fat removal procedures, they also add in targeting search phrases that couple weddings with weight loss and fat removal…


    • Next they deploy ads, landing pages, and offers that speak directly (and only) to brides-to-be…


  • Now, when a bride-to-be is searching online for fat removal procedures for her big day … this plastic surgeon’s ads will cut through the clutter and immediately stand out … which in turn will create a much higher CTR (Click Through Rate) and conversion rate…

The higher CTR means Google will show this ad more frequently and charge less per click than what Google is charging this surgeon’s competitors!

… and, the higher conversion rate (along with lower cost per click from Google) will give this surgeon much better ROI than the competition.

And they’ll simply rinse and repeat, picking new types of patients. And matching different types of procedures to these specific types of patients.

Remember also what they’ll be doing with their budget:

Let’s say they have $5,000.00 available to spend on Google PPC this month. Instead of spreading that $5,000.00 across every type of procedure they offer, they’re going to focus it on just 1-3 micro-niched campaigns.

So now, in effect, they might have 5-10X the buying power of a competitor who has their budget diluted by bidding on every type of procedure offered.

So if a competitor is bidding $8.00 a click for a search phrase the savvy surgeon is targeting as well, the savvy surgeon can simply bid $10.00 without sweating it. (Actually, they’d bid $10.02 if they were really savvy, but more on that some day.)

The $2.00 higher bid will trigger Google to give the ad more chances by serving it more often. When the high CTR kicks in because of the laser-targeted ad copy, a “buoyancy effect” will kick in.

What’s a buoyancy effect?

It’s basically when, because of the high CTR your ad is getting, you get a higher quality score, and Google serves it as often as it possibly can to people searching for the target search phrase. Oh, and Google rewards you by charging less per click than your maximum bid.

So while a competitor is bidding $8.00 a click and actually paying that price per click. The savvy surgeon can be bidding $10.02 per click but maybe only be paying $7.80 per click … because the micro-niched campaign is pulling a high click-through rate. (This gets really technical and is greatly simplified to keep this post below 10 pages…)

But the savvy surgeons realize the game is changing, and understand how critical it is to get narrowly-niched. They’ll start with that toehold, then a foothold, and again … they’ll end up with a stranglehold.

If you’d like to discover how you can do the same for your practice, download our free whitepaper “3 Secrets To Getting High Quality Patients”, and you’ll see exactly how you can do this. It’s an in-depth, no fluff document – check it out.