Online aesthetic medicine supplier for clinics (USA): $900,000 revenue from Google Ads, 832% ROMI

The task

A B2B store for licensed practitioners in the US — injectors, clinics and medspas. It sells dermal fillers and aesthetic medicine products from leading brands: 2,000+ products, tiered wholesale pricing, next-day shipping. Customers buy in volume, so the average order is about $1,200, not a $100 retail basket.

The task: grow online sales from paid traffic in a niche with a narrow audience (licensed practitioners only) and strict ad policies for medical products.

What we did

• Built Google Ads around Performance Max bidding for conversion value, not conversion count: with ~$1,200 orders, order value matters more to the algorithm than the number of purchases.
• Reworked the product feed — titles, attributes and categories matched to how practitioners search — and ran Shopping on Target ROAS.
• Protected branded search so resellers could not take the brand’s own demand.
• Kept a test Shop + PMax setup, with half the return, as a separate campaign so it would not dilute the main one.
• Sent orders and order values to Google server-side, so the algorithms learn from paid orders, not pixel fires.

Results

09.2024–05.2026 (20 months), account in Canadian dollars:

• Ad spend — CA$136,021 (≈ $96,500)
• Ad revenue — CA$1,268,254 (≈ $900,000)
• ROMI — 832%
• 2,561 purchases from ads

By campaign:

• Performance Max — CA$66,691 → CA$710,761 (ROAS 10.7)
• Branded search — CA$28,636 → CA$318,689 (ROAS 11.1)
• Shopping, Target ROAS — CA$27,637 → CA$168,794 (ROAS 6.1)
• Shop + PMax test — CA$13,057 → CA$70,010 (ROAS 5.4)

The store over the same period: $2.61M in revenue, 2,127 orders, 1,075 new customers, 2.3% conversion rate.

Insights

Performance Max drove the growth: half the budget and 56% of ad revenue at ROAS 10.7. For a wholesale store with large orders, bidding for conversion value beats bidding for volume — the algorithm goes after clinics that buy in bulk.

A quarter of ad revenue came from branded search. To be fair, some of those sales would have happened anyway — but without brand protection, resellers bidding on the name would have taken them.

The $900,000 from ads is about a third of the store’s $2.61M over the period. Paid traffic brings volume; it does not replace clinics’ repeat orders.