Plastic Surgery Office Real Estate: Buy or Lease
Plastic surgery office real estate is rarely ordinary office space. Aesthetic patients expect privacy, comfort and a refined setting, and many practices invest heavily in custom finishes, consultation suites and sometimes an accredited surgical suite. Because so much money goes into the space, the decision to buy or lease can have a lasting effect on the practice’s finances, flexibility and long-term wealth.
This article compares owning and leasing, explains when ownership may make sense and outlines how a purchase may be financed. Zoning, facility, tax and legal considerations vary by location, and nothing here is legal, tax or real estate advice.
Why Real Estate Decisions Matter More in Plastic Surgery
Several features make this choice especially important for plastic surgeons:
- Costly build-outs: high-end finishes and specialized rooms are expensive and hard to move
- Surgical suites: an office-based OR requires mechanical, electrical and medical gas systems tied to the building
- Location and image: visibility, parking and neighborhood can shape the patient experience
- Long time horizon: many surgeons practice in one location for much of their career
When the improvements are significant, who owns the building can matter as much as who owns the practice.
The Case for Leasing
Leasing can make sense in many situations:
- It usually requires less upfront cash than buying
- It offers flexibility if the practice may relocate or grow
- A landlord may contribute a tenant improvement allowance
- The landlord may handle certain building maintenance and repairs
The trade-off is less control. Rent can increase at renewal, the landlord may not renew, and leasehold improvements often stay with the building when the lease ends. Surgeons who lease should review the term, renewal options, assignment rights, restrictions on medical use and who owns the improvements. Counsel should review the lease before signing.
The Case for Buying Plastic Surgery Office Real Estate
Ownership can offer advantages that are especially relevant to aesthetic practices:
- Control: freedom to design, renovate and add a surgical suite without landlord approval
- Protection of the build-out: the investment in improvements stays with an asset you own
- Payment stability: fixed-rate financing may make occupancy costs steadier than rent subject to increases
- Equity: loan payments may build equity in the property over time
- Exit flexibility: at retirement, a surgeon may sell the building with the practice or keep it and lease it to the buyer
Ownership also brings responsibilities, including maintenance, property taxes, insurance and the risk that the property’s value changes. It also ties up capital that might otherwise support the practice.
When Ownership May Make Sense
Buying is often worth considering when the surgeon:
- Plans to stay in the same market for many years
- Is building or already has an office-based OR
- Wants a highly customized space
- Has a stable practice with consistent cash flow
- Has enough liquidity to buy without straining operations
Our article on financing a surgical suite for plastic surgeons explains why a build-out of that kind often favors ownership.
How Plastic Surgery Office Real Estate May Be Financed
There are several common paths for owner-occupied medical property:
- SBA 504 loans: designed primarily for owner-occupied real estate and certain long-term fixed assets, often combining a bank loan with a second loan through a certified development company
- SBA 7(a) loans: SBA 7(a) loans may finance real estate, sometimes together with a practice acquisition or improvements
- Conventional loans: conventional real estate loans follow the lender’s own standards and may suit established borrowers with strong financials
SBA programs generally require the business to occupy a required portion of the building. Eligibility and terms depend on the borrower, the property, the use of proceeds, program rules and lender review. Every loan is subject to approval, and nothing here is a commitment to lend. Our SBA loan calculator can help you estimate payments for planning purposes only.
Buying the Building With a Practice
Some acquisitions include the seller’s building. Combining the practice and real estate in one transaction can give the buyer control of the location at closing, but it also increases the total amount financed and the equity a lender may expect. In other deals, the seller keeps the building and leases it to the buyer, sometimes with an option to purchase later. Each approach has trade-offs that should be weighed with counsel and your financing advisor.
Ownership Structure
Many surgeons hold real estate in a separate entity from the practice, with the practice leasing the space from that entity. This structure can separate business and property risks and may simplify a future sale of the practice. The right structure depends on legal, tax and lender considerations, so it should be set up with counsel and an accountant.
Real Estate and Future Growth
If you expect to add a satellite location, the decision for one site may differ from the other. Many practices own their main surgical location and lease smaller consultation offices. Our article on opening a second plastic surgery office covers that planning.
Questions to Ask Before Deciding
- How long do you expect to practice in this market?
- How much will you invest in improvements?
- Can you buy without draining working capital?
- What will happen to the building when you retire or sell?
- Does the property suit medical use and any planned surgical suite?
Final Thoughts
The choice between buying and leasing plastic surgery office real estate depends on your timeline, build-out plans, cash position and long-term goals. For surgeons investing heavily in a custom space or surgical suite, ownership can offer control and long-term value, while leasing can preserve flexibility and capital.
US Medical Funding helps plastic surgeons finance owner-occupied medical real estate and build-outs. Learn more about SBA 504 business real estate loans and our full range of plastic surgery practice financing options.
