We run clinic advertising in Florida from California, which works fine — the auction does not care where the agency sits. What it does care about is that Tampa, Orlando and Miami behave like three separate countries.
The short version
Miami is the most expensive and the most saturated. Aesthetics is a mature, competitive category with sophisticated operators, strong Spanish-language demand, and patients who shop aggressively on price and on Instagram presence.
Tampa is the most balanced. Real competition, but not Miami's. A growing, relatively affluent population with a mix of long-term residents and transplants. For most clinic categories this is the best risk-adjusted market in the state.
Orlando is the strangest. A large service economy, a substantial transient and tourist population that is largely irrelevant to a clinic, and a residential market that is easy to miss if your targeting is not careful.
In Orlando, more than anywhere else in Florida, half your impressions can go to people who do not live there. Exclude travelers or pay for them.
What changes in the creative
Language. Miami without a Spanish-language variant is leaving a lot on the table, and a translated version of the English ad is not the same as an ad written in Spanish. Tampa has meaningful Spanish-language demand too. Orlando has a substantial Puerto Rican population whose Spanish differs from Miami's Cuban-inflected Spanish in ways that matter to whether an ad sounds native.
Instagram weight. Miami aesthetics is an Instagram market to a degree the other two are not. Creative that performs on Facebook feed in Tampa can underperform badly in a Miami placement mix.
Price posture. Miami patients shop. Naming a price is more often necessary there and more often counterproductive in Tampa, where credential and continuity matter more.
Seasonality. Snowbirds are real, and they are a genuine patient population for aesthetics and hormone therapy between roughly November and April. They are also a population that will disappear in May, which is fine if you planned for it and alarming if you did not.
The retiree market, handled properly
Florida's demographics make retirees a larger share of the addressable market than almost anywhere else, particularly outside Miami. Ocala and the surrounding retirement corridor is a market we know directly.
Two things matter.
Do not write to age. Meta's Personal Attributes policy prohibits ads that assert or imply knowledge of a person's characteristics, and copy addressing the reader's age or an age-related condition gets rejected. It is also bad advertising. "Look younger" and "at your age" are both worse than simply describing the treatment well.
Mind the payment question. Much of what a med spa sells is cash-pay and not covered by Medicare, and a retiree audience will assume otherwise more often than a younger one. Saying so plainly in the ad saves a lot of front-desk time and raises show rate, because the people who book already understand the terms.
Where we would start
Tampa, for most clinic categories, for a practice that can only afford to win one market. It is competitive enough to be worth winning and not so competitive that a well-run account cannot get established.
Miami if you have a genuine Instagram presence, Spanish-language capability, and the margin to pay for attention.
Orlando if you have the discipline to exclude the tourist population properly, which most accounts do not.
If you are running one Florida campaign across all three metros, the split is worth doing before your next budget increase.