A cosmetic surgery business with clinics in Manchester and Liverpool were disappointed with the lead numbers that their existing PPC agency were getting. They felt like they should be able to get more leads from their Google Ads PPC account and approached Pepper PPC Agency to see if we could help.

The client offers various forms of cosmetic surgery including breast enlargement, rhinoplasty, tummy tucks, and otoplasty to name a few.


In the first month after taking over the client's PPC account and running on our Pepper account structure, leads increased by 370%, the clickthrough rate increased by 79%, the conversion rate increased by 256%, and the cost per lead came down by 77%.

After a few months of optimising the account, the client turned their focus towards lead growth by increasing their advertising spend. After 12 months, we increased leads by nearly 200% compared to the first month. By month 21, we had increased leads by 307% compared to month one.


  • Dynamic text replacement on website to improve relevancy
  • Complete account restructure removing irrelevant traffic
  • Landing page content and design recommendations to improve Quality Score and conversion rate
  • Segmentation optimisations increasing spend on the best performing keywords, age groups, gender and device
  • Ad copy customisation based on user's location


  • Leads increased by 370% in the first month
  • Cost per lead dropped from £200 to £45 in the first month
  • Further 307% lead growth from month one to month twenty-one
  • 76% increase in clickthrough rate from month one to month twenty one

Expertise and implementations

We initially carried out a PPC audit, where we identified general areas for improvement and outlined some of the features

  • Very poor-quality traffic being picked up by broad match keywords
  • No ad customisation based on the closest clinic to the user
  • No thought of customising bids on some of the forms of audience segmentation that Google Ads allows for (e.g. time of day, age group, gender, audience, device, location)

Once we had identified the issues on the account, we had a strategy PPC audit on the solutions we had proposed. Merging our PPC knowledge with the client’s knowledge of the industry, we:

  • Restructured the Google Ads account, making the Paid Search campaigns more granular without relying on broad match keywords
  • Used historical data to identify irrelevant and poor performing traffic
  • Used historical data and insights from the client to decide how much to bid on each segment (keywords, location radius, device, and time of day to name a few)
  • Customised ad copy to include the closest branch to the user in the ad

After seeing a 370% increase in leads in month one, we would continue to optimise the Google Ads account. In addition, as more search data started coming in, we started making website content recommendations to allow the website to answer the user’s query and secure a successful lead.

We later implement a display campaign, where the client paid for leads instead of clicks, as well as moving to advertising on the Microsoft Advertising platform (Bing).

We’re now looking at implementing offline conversion tracking so that PPC traffic can be tracked through to a sale and not just through to a lead.

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