Deep Dive 11
By Rick Polito · October 29, 2026
The complaint from many practitioners in the longevity industry holds that anybody can put a sign over the door that says “longevity clinic” and instantly become a longevity clinic. Testosterone replacement therapy and Botox don’t really add up to what most people would regard as “longevity.”
Indeed, the question for a movement that grows by the headline might be whether the range of services at many clinics will ever reach the point where longevity is truly the goal, or whether there is a right and responsible way to convince patients who come in the door for hormone replacement or aesthetic procedures that longevity is bigger than that.
Customized care
Brooke McKeever says a big picture conversation is essential not just for the patients’ health, but for the business plan.
“Skin glow up and hormones can get people in the door, but keeping them there is going to be a challenge if all the longevity clinics offer a one-size-fits-all approach,” says McKeever, owner of Ultra Light in Newport Beach, CA.
McKeever’s clinic is solely light therapy, but she promises “a custom approach as each client’s needs are different.” She’s not sure she sees that anywhere else. “If every longevity company has customers go through the same stack: cold plunge, red light, sauna, peptides, microneedling, Botox, etc., it is the same for everyone.”
Beyond the quick fix
Frank Agullo is a plastic surgeon, but much of his aesthetic clinic practice happens outside the operating room. As he sees it, many patients come in with a goal measured in weeks, maybe a wedding or a high school reunion a month away. Gratification is instant, or nearly so in the case of Botox. Longevity is an entirely different conversation. “Patients interested in aesthetics are not necessarily interested in aging and longevity,” Agullo says.
While he doesn’t consider himself a longevity medicine provider, he does coax patients through longevity-adjacent regimens like strength training, nutrition and biomarker tracking, especially patients who come to him for body sculpting or GLP-1 therapy. Where he sees the overlap between focused longevity medicine and what he does is in the transparency. “It is important to set proper expectations for the patient, how much improvement, how long, what to expect during follow-up, and be transparent up front. That is what helps a clinic cultivate long-term patients.”
Telling the story
Michael Hall layers education on top of transparency when he thinks about patients who come in to look good and might need convincing that feeling good is an option. “In my experience, the most important thing is developing an educational relationship with the patient. Trust is part of the equation. Once that relationship is established, it becomes much easier to introduce someone who came in for aesthetics to a broader, integrative approach to their health,” says Hall, an MD and medical director at Hall Longevity Clinic.
Hormone therapy, in particular, has effects across the body that many patients might not know about, opening the door to education and a conversation that might go well beyond what men think of when they come in for testosterone replacement therapy. “The relationship between hormone therapy and cardiovascular health is a good start,” Hall says. “That understanding and the trust you build are what make the conversation about broader longevity care possible.”
The “internal environment”
At Eternum Longevity Center, education is also key to pulling people past the aesthetics and hormone services, says founder Dan Miller. He compares such services without serving the “internal environment”—sleep, nutrition, strength, cardio and community—to “painting your car every 10,000 miles instead of changing the oil.” When patients understand that and work the practices into their lives, they are open to more services, he says. “Adding on 'anti-aging' and other more superficial services is an easy upsell after establishing the right program,” Miller says.
The starting line
Meeting the patients where they are means knowing where they are physically, says Sean Hall, MD, author, podcast host and founder of the Medlab Group. “Hormone and aesthetic services bring people in, but a credible longevity offer has to be built on what actually predicts healthy years,” says Hall, explaining that such a workup would include cardiorespiratory fitness, muscle strength, sleep, blood pressure, glucose and lipids “measured at the start and tracked over time.” If a doctor can talk about what that means, Hall says, the doctor-patient conversation can move past the quick fixes the patient came in seeking.
“Clinics that keep clients are the ones that coach those basics and show progress in numbers, not the ones that add more tests or therapies with thin evidence,” Hall says. “Clear consent, honest limits and referral back to the person’s GP are what separate a longevity practice from a wellness shop.”
The flashing engine light
Many people come in to clinics complaining of fatigue, libido and menopause symptoms with the idea that hormone replacement will solve the problems, says Nadav Fields, DO, but he sees that as a starting point more than a goal. There is more going on than a hormone imbalance for most people, he explains. “The labs we run to start hormones already show us a lot about thyroid function, metabolic health, and nutrient status. When I walk a patient through those results, the conversation naturally widens from 'fix my hormones' to 'how do I stay healthy for the next thirty years?' The shift happens when patients see their own data, not when we sell them a package.”
Jonathan Fields, a doctor of acupuncture and Oriental medicine, is Nadav Fields’ brother and the two work together at CR8 Health. For Jonathan Fields, the shift comes when he can move the conversation past what a patient may see as purely medical. “The first step is nutrition, with gut health as a focus. Then we add the pieces that keep them engaged over time: acupuncture, breathwork, meditation, and Qigong for the nervous system and stress. Aesthetics and hormones bring people in. Testing, education, and a relationship with the provider keep them.”
Turning down the buzz
In all things medical, but perhaps especially in longevity therapy, people ask about what they hear about. That’s why pharmaceutical companies run endless TV commercials. It’s why people come into clinics for aesthetics or hormone replacement. More recently, it might be peptides and red-light therapy that has them Googling the nearest clinic.
Regen Therapy CEO Sanjiv Lal puts it simply, “Consumers have been trained to buy products and procedures.”
The key to moving patients to a path that could lead to a long-term relationship with longevity as a goal, Lal says, is turning down the sales pitch. “Instead of asking what someone wants to buy, we ask what that person actually wants to improve.”
That approach, he says, sets the stage for continuing services that could start with an assessment that’s broader than a hormone panel, and plugs into continuing consultations and follow-up assessments tuned to the patient’s goals. “A transactional clinic has to keep selling the next procedure,” says Lal. “A longevity clinic can build a relationship with a patient that lasts for years. Revenue can come from ongoing diagnostics, physician oversight, health optimization, nutrition, hormone management when appropriate, metabolic programs, recovery and regenerative services.”
A clinical continuum
David Holcomb says he doesn’t see aesthetics as separated from “longevity.” For him, it’s part of the same picture, a component in quality of life. “I believe maintaining a youthful appearance should be considered part of longevity care,” he says, explaining that improved appearance and balanced hormone levels “all contribute to overall well-being,” he explains.
But while improved well-being can set the stage for additional therapies, Holcomb isn’t sure that the clinics that patients found when they sought aesthetic or hormone therapy should always be the clinic that provides the next steps on a longevity journey. Holcomb sees the longevity clinic sector moving toward “a sort of unified vision that aesthetics, age management, and weight loss are interrelated.” He just doesn’t believe that every clinic should seek to deliver every longevity-related service, expanding their services beyond their expertise and capacity. “Providers need to play to their strengths,” Holcomb says. “They shouldn’t necessarily try to be a one-stop location for all-encompassing services.”
“Patients seem very open to these not-so-tangential topics because they relate to their overall well-being.”
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