A step-by-step SEO framework you can audit this week

This checklist is built for plastic surgery practices—solo practitioners, multi-surgeon groups, and cosmetic surgery centers—launching new websites or auditing existing ones. You don't need technical expertise to work through it; each checkpoint is paired with context on why it matters and what to check for.

Use this if you:

• Are planning a website redesign or rebrand and want to avoid SEO mistakes before launch
• Have a live site but aren't sure if technical SEO is optimized
• Want a repeatable quarterly audit process to track improvements
• Need to brief a developer or agency on what "SEO-ready" actually means
• Manage multiple locations and need a consistent audit standard

Note: This checklist covers SEO mechanics. For regulatory compliance beyond these checkpoints—HIPAA data handling, FTC endorsement compliance, state medical board advertising rules—refer to your legal and compliance team. We've embedded key compliance signals throughout, but this is not legal or regulatory advice.

Priority: Complete before launch. Technical issues block crawlers and tank rankings. Work through these first.

Crawlability & Indexing

• robots.txt exists and allows Googlebot access to key pages (no accidental disallow rules blocking /procedures or /about)
• XML sitemap generated and submitted to Google Search Console
• No noindex tags on important pages (check homepage, service pages, blog)
• Internal linking structure is logical; all key pages reachable in under 3 clicks from homepage

Mobile & Performance

• Mobile-first indexing: website renders properly on mobile; test via Google Mobile-Friendly Test
• Responsive design confirmed across breakpoints (320px, 768px, 1024px)
• HTTPS implemented site-wide; no mixed content warnings
• Core Web Vitals in acceptable range: LCP <2.5s, CLS <0.1, FID <100ms (monitor in GSC and PageSpeed Insights)

Site Architecture

• URL structure is consistent and logical (/procedures/facelift, not /svc?id=12)
• 301 redirects in place for any migrated or renamed pages
• Duplicate content resolved (canonical tags or consolidation)
• Pagination handled correctly (rel=prev/next or consolidated facets)

Priority: Complete before or immediately after launch. Procedure pages are your revenue drivers; they need intentional optimization.

Page Structure & Keywords

• One primary keyword per procedure page (e.g., "facelift surgery" on /procedures/facelift, not /procedures/facelifts-and-fillers)
• H1 matches primary keyword or close variant; appears only once
• H2 and H3 structure is logical; breaks up long text (target 150–300 words per section)
• Meta title includes primary keyword and practice name; 50–60 characters
• Meta description includes keyword, value prop (e.g., "Board-certified, same-day recovery"), and CTA; 120–155 characters

Body Content

• Intro paragraph (first 100 words) answers: What is this procedure? Who is it for? Why choose us?
• Internal links to related procedures (e.g., Facelift → Mini Facelift, Brow Lift) using descriptive anchor text
• At least 3 internal links per page (back to homepage, to related procedures, to consultation CTA)
• Schema-appropriate content: recovery time, cost range, surgeon credentials mentioned naturally (not stuffed)

CTA & Trust Signals

• Clear, single primary CTA above the fold (e.g., "Schedule a Consultation")
• Secondary CTA mid-page (testimonial or "See Results")
• Board certifications, credentials, or practice accreditations visible near CTA

Priority: Complete before launch. Schema markup tells Google your site is a legitimate medical practice and improves rich snippets in search results.

Schema Implementation

• LocalBusiness or MedicalBusiness schema on homepage with: name, address, phone, hours, website URL, service areas
• FAQPage schema on procedure pages listing common patient questions and answers
• AggregateRating schema if you have reviews (minimum 5 verified reviews recommended); includes rating, count, and review date
• BreadcrumbList schema for navigation clarity (Home → Procedures → Facelift)
• VideoObject schema if you embed before-after videos (with proper consent)

HIPAA & Medical Compliance Signals

• Patient testimonials use first name + last initial only (no full patient names); stored with HIPAA-compliant consent documentation
• Before-after photos marked as property of practice (no identifying metadata in EXIF); alt text does not include patient names
• Privacy policy visible, mentions HIPAA compliance (link footer or header)
• Terms of use include disclaimer: "Results vary by individual. This information is educational, not medical advice. Consult with our surgeon for personalized guidance." (Regulatory requirement; see FTC Health Products Compliance Guidance.)
• No claims of designed to results; use language like "many patients experience" or "typical recovery is 7–10 days"

Priority: Complete before launch; ongoing. Before-after galleries are unique to cosmetic surgery and crucial for both SEO and Core Web Vitals: LCP under 2.5s, CLS under 0.1, FID under 100ms—critical for ranking and [user trust](/resources/plastic-surgeon/plastic-surgeon-online-reputation-management). Optimize them carefully.

Technical Image Setup

• All images in WebP format (with JPEG fallback for older browsers); 40–60% file size reduction vs. JPEG
• Images lazy-loaded (native loading=lazy or JavaScript library) to improve page speed
• Image dimensions optimized for mobile (max-width: 100% on mobile, 600px on desktop)
• Responsive images using srcset to serve appropriate sizes per device

SEO & Compliance Metadata

• Descriptive alt text for every image (e.g., "Facelift before-and-after: 58-year-old female, 6 weeks post-op"); alt text does not include patient names or identifying details
• Image filename is descriptive, not generic (facelift-before-after-58yf-6weeks.jpg, not img_001.jpg)
• EXIF metadata stripped or cleared (use image compression tools to remove location, date, camera data)
• Gallery page has clear H1 and H2 structure ("Facelift Results" as H1, "Browse Before-After Gallery" as H2); alt text doubles as SEO content

Priority: Monitor continuously; audit quarterly. Performance and rankings require ongoing attention, not just a one-time setup.

Performance Baseline

• Largest Contentful Paint (LCP) <2.5 seconds on all device types (desktop, mobile, tablet)
• Cumulative Layout Shift (CLS) <0.1; test with real user data (RUM) via Google Analytics or similar
• First Input Delay (FID) <100ms; if not available, monitor Interaction to Next Paint (INP)
• Page loads under 3 seconds on 4G mobile; optimize images, defer non-critical JS, use CDN
• 99% uptime SLA with hosting provider; monitor via uptime service (e.g., UptimeRobot, Pingdom)

Quarterly Audit Cadence

• Monthly: Core Web Vitals check via Google Search Console; monitor for ranking fluctuations
• Quarterly: Full technical crawl using Screaming Frog or Semrush; check for new crawl errors, mobile usability issues, index coverage
• Quarterly: On-page audit: verify H1/H2 structure, keyword usage, internal linking remain aligned
• Quarterly: Image gallery audit: verify alt text accuracy, EXIF data still clean, lazy loading active
• Annual: Comprehensive schema audit; test with Google Rich Results Test; verify compliance signals still in place

Track results in a shared spreadsheet (Google Sheets or similar) with dates, findings, and owner assigned for each checkpoint.