Meet RealSelf: the profitable, under-the-radar plastic surgery site

By Erin Griffith , written on January 23, 2013

From The News Desk

It's like Yelp, but for plastic surgery, or what RealSelf likes to call, "medical beauty."

Started in 2006 by former Expedia exec Tom Seery, RealSelf has flown under the radar in tech circles. But the site boasts 3 million unique visitors a month and is doubling its audience year-over-year. Having raised just under $2 million in angel funding from early Microsofter and man-about-computing Mike Slade, Expedia and Zillow co-founder Rich Barton, and Orbitz CEO Barney Harford, RealSelf has been profitable for over a year.

The idea is fairly simple -- so simple that it's a bit of a surprise no one else has done it. It follows one of a handful of classic startup business models that Seery learned at Expedia: Find a market that thrives on its lack of transparency and make it transparent.

Expedia/Hotwire/Orbitz/Priceline did it for the airline industry. Zillow and Trulia are doing for real estate. Castlight Health, ClearHealthCosts, and probably a dozen others are doing for healthcare. Catercow is doing it for catering prices. Speakerfile is doing it for conference speakers. Thuzio is doing it for pro athlete appearances.

RealSelf does it for plastic surgery. The decision to get a nose job, breast implants, or a tummy tuck is a big one. It's optional surgery, and it's not cheap. The average consideration period is one to two years. Potential patients want to talk to people who've done it. And people who've done it want to share their experience.

But instead of focusing on the doctor (like, in the case of Yelp, which hosts reviews of specific restaurants), RealSelf focuses on the procedure. "We uncovered that there are a lot of people that want to have the conversation at that level," Seery says. That is more useful to a wider audience, than say, rating something as specific as a Nashville rhinoplasty doctor.

These communities existed before -- mostly in whispered conversations at social gatherings. There were also message boards like But many of these early online communities rewarded frequency of posting, which meant that extreme plastic surgery patients dominated the community. Likewise, directories that offered "pay to play" for doctors to be listed have been killed off by Google's improvements to its search rankings.

Plastic surgery, a $10 billion-plus industry in the US, is increasingly going mainstream, but it's still a controversial dinner table topic. I doubt there will ever be a time when the country universally withholds its judgement of boob jobs. Which drives people online. It's why anonymous sites like The Experience Project have 10 million members who come to emote with strangers. There will always be a demand for personal, emotional, anonymous sharing with strangers on the Web.

The problem for RealSelf came when users started answering each others' medical questions. "That made me really scared," Seery says. "We thought we might be doing more damage than good." So RealSelf invited a team of doctors to answer questions. The site has been meticulous about limiting doctors to verified specialists that can only answer questions on the topic of their expertise. It's become a popular section of the site and a lead generation tool for the site's 5,000 active doctors. "Until RealSelf, doctors just thought they had to put an ad up and annoy enough people in the American Airlines magazine to get new patients," Seery says. "We discovered if we can jst have the doctors be helpful and be agents of education, it does an amazing job of building integrity and trust."

Beyond personal stories and doctor Q&A, the site's third, and perhaps most surprising, element is photo sharing. RealSelf users feel enough trust there to post images of their surgery results. "The unexpected thing was the way a mom in the midwest would take off her clothes (with the face blacked out) and anonymously share what her concerns were," Seery says. "Photos is a great part of the storytelling and have emerged as its own experience."

RealSelf isn't trying to be booster for the plastic surgery industry. In fact, many in the industry view it as disruptive. Prices are listed, which means patients are armed with more information when shopping around. In fact, that's the whole goal of RealSelf: giving people as much information as possible about a procedure. In many cases, reviews convince users not to get a procedure done. For example, the Lifestyle Lift, a facelife alternative that advertises heavily on late night infomercials (um, red flag?), is so poorly reviewed that, after browsing the site's horror stories, it's unlikely anyone would want to sign up for it. "That's why we're a media company, not a pay-per-lead company," Seery says. "That would set us on the wrong side of this."

RealSelf makes money with a subscription ad product for the doctors, not unlike the Zillow model for realtors. If you hold a four or five-star rating and are in good standing with the community, you can buy a presence in search results.

The next step is to take its community global. China and Brazil have large markets for cosmetic surgery, Seery says. Surprisingly, the hottest US for researching breast implants is not LA, but pious Salt Lake City.