Time for another mini SEO audit on a random plastic or cosmetic surgery website. But this time, I want to focus on hair transplants. If you don't know, hair restoration was the very first type of client I worked with back in 1992.
In trying to find a website as randomly as possible, I did the same thing as last time: I turned on my VPN, chose USA as my country of choice, and Googled “hair transplant surgeon.” I then clicked to page four of the SERPs (search engine results), I scrolled down a bit, and I selected a site at random.
Site Selected For This Quick SEO Audit
As strange as this might sound, I literally clicked on a result without paying attention. The URL I clicked on is HairTransplantation.com by Dr. John Kiely. (Talk about a keyword-driven domain name! Let's see if it helps him.)
Remember, this audit will be brief. My 360° SEO Audits go far beyond this. But it might give you some insights you can apply to your own website.
So without further ado, here we go.
SEO Crawl and Overview
A crawl with Screaming Frog's SEO spider, I found 108 pages. However, 16 are redirects and six are 404s (page not found errors). At first glance that might look odd or bad, but a closer look reveals that the redirects are from a few pages that have trailing slashes to versions of the pages that don't.
That's actually a good thing, and here's why.
A trailing slash is the slash at the end of a URL. The jury is still out on whether trailing slashes help rankings. But the important thing is to choose one protocol and to be consistent with the rest of the website.
Consistency is key in SEO. With different versions of the same URLs, if they're not canonicalised (i.e., a canonical tag is piece of code that tells search engines which URL is the definitive address for that page), you risk having Google index multiple versions of the same page and cannibalizing your rankings.
Specifically, the result is that this will either confuse Google or force it to split ranking signals across the various addresses, diluting the ranking power of what really is just one page. For example, look at the 12 URLs below:
http://www.domain.com http://www.domain.com/ http://domain.com/index.php http://www.domain.com http://www.domain.com/ http://www.domain.com/index.php https://domain.com https://domain.com/ https://domain.com/index.php https://www.domain.com https://www.domain.com/ https://www.domain.com/index.php
All these URLs are pointing to the same page.
That's why adding redirects and canonical tags is crucial. But in a perfect world, there shouldn’t be any redirects at all. Use redirects only for pages that no longer exist — pages you renamed, moved, or deleted. Don’t use redirects internally when a simple search and replace can do the job.
Of course, have redirects if other sites link to the wrong URL (which is one the reasons I recommend setting up a Google Search Console account), so you can find out if any backlinks are leading to 404 errors. But when doing an internal crawl like I just did, there shouldn't be any redirects.
Back to the audit.
Regardless of redirects to pages without trailing slashes, there doesn't seem to be a predominant protocol because I can see that the site has pages with trailing slashes and some without. It's not terrible but it is confusing and may also lead to issues down the road, such as when adding pages or links.
Location, Location, Location
The 404 errors seem a little odd, which prompted me to investigate further. The URLs of the missing pages seem to be similar to pages that already exist on the site. They have the same titles but with different city names appended to the URLs (e.g., “hair-loss-baltimore” and “hair-loss-washington-dc”).
Now, this tells me three things.
First, the site is trying to optimize for multiple locations. There's nothing wrong with that. But I think the clinic may have moved or switched from Washington-Baltimore to Rockville-Townson at some point. So the crawl found lingering links to older locations (or removed pages) that they have not yet updated.
Second, I manually visited pages similar to the 404s (e.g., “hair-loss-rockville-md” and “hair-loss-townson-md”). They seem to be the same page but with two different cities. This means there are duplicate content issues, which are not good for SEO. This may indirectly penalize your rankings.
To confirm my suspicions, I looked up other pages:
Every page has keyword-based links that lead to duplicated pages for different service areas around the Baltimore–Washington metropolitan area. Duplicate content is the bigger and more important issue, but keyword stuffing and repetitive internal location links are far from good practices.
Let me be clear. Building out multiple pages for each service area is actually a good practice, and I recommend it, too. But each page should be different. They can be similar but they should not be exact verbatim copies.
Think of Your User, Not Google
Also, there's no need to stuff entire site with location links, too. Just have one master location list or page with links to individual locations. If you link to the location list or the master location page on an indexed page (or in your sitemap), Google will find it and crawl all the subsequent location pages.
For example, a website could have a page called “locations” such as:
/locations/ (listing all locations)
/locations/location-one/ (first location)
/locations/location-two/ (second location)
/locations/location-two/sublocation-one/ (e.g., district)
Like the example above, you can create sublocation- or community-specific pages, as long as you serve those areas and put unique content on them.
(Remember, they only allow you one Google My Business listing per physical location, not service area. But you can create landing pages for each area.)
Just optimize each landing page with specific information about that area. If you can, add reviews or testimonials from people in that area. If you can add directions from that area to your clinic, add them, too.
There's no need for duplicate content. To quote Moz.com:
There's a real danger of putting up a bunch of weak, silly content for every city your company serves, and this would downgrade user experience and the overall quality of your website. Rather, come up with a plan for making those landing pages incredibly useful and persuasive, so that they truly do serve users, while also signalling to search engines that you have relevance to this target community.Moz.com Staff
Finally, there's the third point. Looking at other pages, I noticed something peculiar. The site has over-optimized pages with location-stuffed content. This reminds me of old-school SEO with keyword-stuffed content that makes the page unreadable and kills the user experience.
Here's an example:
Every page seems to have this issue. Every page seems to have an introductory paragraph that's stuffed with keywords, including locations. This type of SEO doesn't work anymore. Or better said, it's no longer necessary. Google is now intelligent enough to understand the context and content of the page.
Of course, it's helpful to include pointers that help Google along, such as schema code, alternative text for images, proper internal linking, appropriate descriptions (without repeated keywords), and so on.
But filling the site content with locations is bad for the user experience — and your rankings. Avoid stuffing your page with too much of the same thing (e.g., the same links, keywords, locations, photos, whatever).
In that initial crawl, and based on my discovery above, I wanted to see how similar or dissimilar was the content. I found several redundant pages.
Here's just one example.
There are five topics (e.g., hair loss, hair restoration, hair transplant, hair transplant clinic, and hair transplant surgery), which are obviously used as keywords. But each of the five has nine separate locations. All nine appear to be the same duplicated page with maybe just one distinct paragraph.
Therefore, there are 45 pages in total when five pages covering the five topics, and perhaps nine for each location, would have sufficed. This means there are 30-ish pages that are redundant and useless, diluting ranking signals and likely causing the site as a whole to lose rankings.
After removing all the redundant pages, duplicate pages, 404s errors, and redirects, I'm left with 31 total pages. Some are very thin in terms of content, too. In my experience, this is inadequate. This site needs more content.
In fact, the blog shows only 10 blog posts that are over five years old. Frequency, recency, and consistency are three key SEO signals that help Google to notice, crawl, and hopefully rank your content. Fresh content posted regularly and often (at minimum one new post a week) is a good practice.
SEO Analysis Estimate
I don't have access to this site's Google Search Console to determine if the site is getting poor traction because of the issues I mentioned above — such as duplicate content, stuffed locations, over-optimizations, and so on. But looking at their estimated traffic in Ahrefs.com, I can make some fair assumptions:
The site only gets about 50-60 visitors a month on average.
This is relatively low for a plastic surgeon's website (which typically averages around 500-2,000 visitors monthly in my experience). It may be because of content that's over-optimized, duplicated, unusable, inadequate, or something else. However, I'm certain the issues I've discovered are not helping.
One final thought about locations.
Having multiple locations can be a good practice for a service provider having a large enough demand within those areas and offering a repeat service. For example, plumbers, exterminators, restaurants, car dealers, even dentists may benefit from ranking for specific locations.
But it's not so much the case with plastic surgeons, particularly a surgeon who only does hair transplants. It unnecessarily reduces visibility.
In my experience, the best and most renowned surgeons have patients that come from near and wide, even well outside their main geographic areas. Some fly from all over the world to receive treatments from these experts.
When claiming your Google My Business listing, you can only claim your actual, physical location. This will help rank your clinic or practice in the local pack (i.e., the pack of Google Map listings that sometimes appear at the top of on search results). But location-specific pages can rank in the main results.
By focusing all your pages on specific locations, which can be helpful for many service providers, can be limiting and counterproductive (particularly if you want to expand your reach), and may hurt your rankings in other locations.
I'll stop here since I've covered so much already.
In essence, the initial crawl revealed some major issues, and this site needs work. I recommend a complete revamp with a new content architecture to fix all the issues I found, along with properly rewritten content.
Short of redoing the site architecture, I recommend creating a location listings page and area-specific landing pages, and killing off all the redundant ones. I suggest fixing all the redirects, removing the 404s, choosing a single sitewide protocol (i.e., trailing slash), and removing all the repetitious content.
Finally, I recommend adding more quality content — both to the main pages to beef up the thin content and as articles to the blog section.
Again, please remember that I base my recommendations on just an initial crawl. I didn't do a keyword audit, a technical SEO audit, or a competitive audit. There's so much more that I could analyze, which I typically do when I perform a comprehensive 360° SEO Audit service. But hopefully this was helpful.