Two firms control 80% of AI citations in U.S. aesthetics

What happened

A new AI Visibility Index measured how often aesthetic medicine brands are cited across five major AI answer engines (ChatGPT, Claude, Perplexity, Gemini, and Google AI Overviews) when patients research treatments. AbbVie/Allergan holds 47% of all drug and device AI citations in the category, Galderma holds 33%, leaving Merz Aesthetics and Revance to split the remaining 20%. The top 25 brands combined capture roughly 95% of all AI citations, while the remaining 11,500 med spa facilities split just 5%.

Why it matters

In aesthetic medicine, where patients rely on AI answer engines to research treatments and find providers, citation share has become a proxy for market reach—brands that don't appear in AI answers are excluded from patient consideration before a clinic is ever called. The index reveals that two pharmaceutical companies' molecules (Botox, Juvederm, Dysport, Restylane, and others) dominate the answer set, giving them outsized influence over patient routing in a $25 billion（約4兆円） U.S. market growing at approximately 15% per year.

What to watch

Daxxify, a botulinum toxin launched by Revance in 2023, already ranks #9 in the index—ahead of Merz's Xeomin, which has been on the market for over a decade—suggesting that recent launches can disrupt established citations quickly. The full Med Spa & Aesthetic Medicine AI Visibility Index 2026 is published at 5wpr.com, and 5W offers AI Citation Audits and custom indexes for aesthetic brands, med spa chains, and dermatology groups.