CS-06Engagement file
An anonymised practice: 4.2× consultation bookings
An anonymised Dubai plastic surgery practice rebuilt inside DHA and Google healthcare rules — consultation requests grew from 18 to 76 a month, with international patients rising from 22% to 41% of the mix. Data runs through 31 July 2026, sourced from GA4 and Google Search Console, reported exactly as our internal QBR deck reads it.
- Industry
- Plastic surgery practice
- Locations
- Jumeirah 2, Dubai
- Engagement window
- Aug 2024 — ongoing
- Duration
- 24 months
At a glance — day one vs. today
Organic sessions / month
from 2,890 at day one
Consultation requests / mo
from 18 at day one
International share of consultation requests
from 22% at day one
AI Overview & LLM citation share
from 0% at day one
01 · The starting point
A referral-built practice that search couldn’t see
The surgeon trained in London and Geneva and built the Jumeirah 2 practice on word-of-mouth — referring GPs, patient introductions, a de facto waitlist. Online, that reputation didn’t travel: 2,890 organic sessions a month in August 2024 produced just 18 consultation requests, four of them from non-brand search. The website was gallery-first — before-and-afters up top, credentials three clicks deep, nothing written for someone researching from Riyadh at midnight before a decision they cannot undo.
The brief came with hard edges. DHA advertising rules and Google’s healthcare content policies restrict what a surgical practice may claim: no price promises, no outcome guarantees, no imagery that implies certainty. The competitors on every commercial keyword are medical-tourism platforms that aggregate clinics and outrank all of them. And the NDA governs everything — no clinic name, no city pages that could identify the practice, initials-only quotes. We agreed the engagement file would show less rather than more.
The thesis underneath all of that: international patients — KSA first, then Western Europe — research heavily before they travel, and the research they need is exactly what healthcare policy permits. Process, credentials, candidacy, recovery. The practice didn’t need louder claims; it needed the claims it is allowed to make, structured so that a patient and an AI answer can both find them.
Day-one audit findings
- 214 indexed URLs, 61% thin or duplicated procedure templates (Screaming Frog crawl, Aug 2024)
- 18 consultation requests/month; 4 arrived from non-brand organic — the rest by referral, direct or brand search
- Zero structured data sitewide; before/after galleries carried no alt text and no licensing metadata
- 37 claims on the site that breached Google healthcare content policy or DHA advertising rules (claims inventory, Aug 2024)
- Arabic pages machine-translated in 2022, no hreflang; “دكتور تجميل أنف دبي” (1,300/mo) sat at #49 behind directories and medical-tourism platforms
02 · What we actually did
Four phases, in the order they happened
Months 1–3 · Aug–Oct 2024
YMYL triage before anything rankable
- Screaming Frog crawl confirmed 214 indexed URLs, 61% thin or duplicated procedure templates; consolidated to 68 canonical pages, 301-mapped with no orphaned referral traffic
- Entity layer built: Physician, MedicalClinic and MedicalProcedure schema marking up DHA licensing, fellowship credentials and hospital affiliations — everything the NDA allows us to show, and nothing more
- Claims inventory: 37 outcome statements and price hints removed or rewritten as process descriptions to satisfy Google healthcare content policy and DHA advertising rules
- GA4 + Search Console rebuilt around consultation-request events; a Looker Studio board the surgeon actually opens (five numbers, no jargon)
Months 4–8 · Nov 2024–Mar 2025
Procedure architecture and the Arabic mirror
- 14 procedure pages rewritten consultation-first: candidacy, process, recovery, revision policy — before-and-after galleries moved below the fold, the surgeon’s voice above it
- Noor S. wrote the Arabic rhinoplasty cluster natively (Gulf dialect, consultation-first CTAs); hreflang en-ae/ar-ae grid shipped
- Internal linking rebuilt: every answer article routes to one procedure page and one consultation CTA; booking module pinned above the fold on mobile
- March 2025 core update landed mid-phase — two procedure pages dropped before the Phase 1 E-E-A-T work was fully re-crawled (see trajectory)
Months 9–15 · Apr–Oct 2025
International patients and a deliberate pause
- International patient hub shipped: virtual-consultation flow, travel and stay logistics for KSA and European patients, English and Arabic
- Review governance rebuilt: written-consent workflow, initials-only testimonials, zero clinical details — the NDA extends to patients, not just the clinic
- Oct 2025: six-week content freeze while engineering cleared WCAG 2.2 accessibility remediation (contrast, focus states, form errors) — rankings held flat through it
- Sara A. stood up the AI-citation panel: a fixed 120-query medical-YMYL set tracked monthly across Google AI Overviews and Perplexity
Months 16+ · Nov 2025 — ongoing
AI answers and the KSA research journey
- Citation share climbed from a 0% baseline to 19% of the panel; Rami T.’s expert-commentary program (4 UAE health outlets, 9 medical referring domains) feeds the sources AI answers cite
- KSA journey briefs: how Riyadh and Jeddah patients shortlist a Dubai surgeon — licensing, travel logistics, virtual-first assessments
- Arabic rhinoplasty cluster wave 2 scoped (septorhinoplasty and revision intents); quarterly E-E-A-T re-audit cadence locked in
03 · The trajectory
Quarterly checkpoints — including the dips
Organic sessions / month — 13 data points
Source: GA4 · Google Search Console
- Mar 25 — March 2025 core update — medical YMYL reshuffle, two procedure pages dropped before E-E-A-T signals caught up
- Oct 25 — Deliberate content freeze during website accessibility remediation
04 · Keyword movement
Where the rankings actually went
| Keyword | Lang | Volume | Day 1 | Best | Now | Δ |
|---|---|---|---|---|---|---|
| rhinoplasty dubai | EN | 1,600/mo | #24 | #3 | #4 | +20 |
| septorhinoplasty surgeon dubai | EN | 140/mo | #71 | #2 | #3 | +68 |
| revision rhinoplasty cost | EN | 90/mo | #85 | #4 | #5 | +80 |
| دكتور تجميل أنف دبي | AR | 1,300/mo | #49 | #5 | #6 | +43 |
| nose job price dubai | EN | 320/mo | #37 | #11 | #13 | +24 |
Average google.ae positions · Search Console · through 31 July 2026
05 · Results
What the client banked
Organic sessions grew from 2,890 to 9,740 a month (Aug 2024 → Jul 2026) and consultation requests from 18 to 76 — the 4.2× headline. The mix matters more than the volume: international patients went from 22% to 41% of requests, KSA first, then the UK and Germany, and the virtual-consultation flow converts 6.8% of its sessions into requests. The practice now books consultations from patients who have not yet booked a flight.
On the SERPs: “rhinoplasty dubai” holds position 4 (best 3), “septorhinoplasty surgeon dubai” — the surgeon’s actual specialty — position 3 (best 2), and the Arabic term sits at 6 behind directories we cannot and would not try to out-spend. On the fixed 120-query AI panel Sara stood up in late 2025, the practice went from a 0% baseline to being cited in 19% of sampled Google AI Overview and Perplexity answers.
The numbers stop where the NDA says they stop. Consultation bookings are the last line we report; surgery conversion and procedure revenue stay inside the practice. Within that limit the file is consistent month to month: 76 requests, 47 booked consultations, 41% international.
Where the maths stops — on purpose
The retainer is AED 12,000/month. The chain we can defend: 76 monthly consultation requests → 41% international (KSA first, then Western Europe) → 47 booked consultations after screening, a 62% request-to-booking rate tracked in GA4. The baseline 18 requests screened at the same rate — 11 bookings — so the 4.2× headline holds on bookings as well as requests. There the arithmetic stops, deliberately: consultation-to-surgery conversion and procedure revenue are clinical-commercial data the NDA keeps inside the practice. The most we can honestly show is the booking line, and any ROI multiple past it would be invented — so there isn’t one.
06 · Where it got hard
What didn’t work — reported the same way
Honest file note 01
This file shows less than the others, by design
The NDA allows no clinic name, no city pages, no full testimonials and no photography we can link to. There are no gallery URLs to inspect, and the quote below is initials-only. We could have disguised the client further to publish more; disguising a practice that paid for discretion is how case studies become fiction. What you see here is the full extent of what we may show.
Honest file note 02
“nose job price dubai” is parked at #13 — by policy
The keyword (320/mo) moved 37 → 11, then settled at 13 and has stayed there. The SERP is price-promise pages — “AED 9,999 all-inclusive” listings that Google healthcare policy and DHA advertising rules prohibit a surgical practice from matching. The surgeon prices every procedure in consultation, so we will not build the page the SERP rewards. Tracked, stuck, and reported as stuck in every QBR.
Honest file note 03
There is no revenue line, and there never will be
Consultation-to-surgery conversion and procedure values are clinical-commercial data the NDA keeps inside the practice. The most we can honestly show is the booking line — 76 requests, 47 booked consultations a month — and we think an agency that quotes an ROI on a medical client without that data is inventing it. We report bookings; outcomes belong to the patient file, not the marketing deck.
07 · The client’s words
“My instruction to the team was that patients in Riyadh or London should be able to research properly before they fly, and that nothing on the site may promise what surgery cannot guarantee. They worked inside the rules I set for patient privacy without once asking for clinical numbers — the reporting stops at booked consultations, which is exactly where I needed it to stop. Forty-one percent of my consultation requests now come from outside the UAE.”
08 · The desk & what’s next
The team on this file
- Layla H.Account Director
- Omar K.Technical SEO
- Noor S.Arabic Editorial
- Rami T.Digital PR
- Sara A.Analytics & AI-citation panel
Current focus — Q3 2026
- Arabic rhinoplasty cluster wave 2 — septorhinoplasty and revision intents, written natively
- KSA patient-journey content built on Riyadh and Jeddah research patterns: shortlisting behaviour, virtual-first assessments
- AI citation share: pushing past 25% of the 120-query panel
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