On May 31, 2023, Instagram published "Instagram Ranking Explained" by Adam Mosseri. It said there is no single algorithm, that Feed, Stories, Explore and Reels each rank content differently, and listed the most important signals and predictions for each. For Reels, the key predictions included reshares, full watches, likes and visits to the audio page, and reels that were low resolution, watermarked or recycled could be shown less. For med spas, the lesson was to build content for each surface and focus on what people genuinely engage with.
Few platforms matter more to med spas than Instagram. It is where many clients first discover a practice, check its work and decide whether its look and feel match what they want. For years, though, Instagram strategy at many practices was driven by rumors about “the algorithm” and fears of shadowbans.
In May 2023, Instagram offered a clearer picture. Its head, Adam Mosseri, published an updated explanation of how ranking works across the app. For med spas, it was a chance to replace guesswork with a strategy grounded in what Instagram actually said.
This retrospective covers what Instagram published and what it means today. It connects to our coverage of Instagram trial reels in 2024, Instagram’s 2025 changes for aesthetic practices and the day TikTok went dark in 2025.
What actually happened in 2023
May 31: the explainer. Instagram published “Instagram Ranking Explained” by Adam Mosseri, updating an earlier post to explain how ranking works across the app.
No single algorithm. Instagram said it uses “a variety of algorithms, classifiers, and processes,” and that Feed, Stories, Explore, Reels and Search each rank content in their own way.
Feed signals. The most important Feed signals, roughly in order, were the viewer’s activity, information about the post, information about the person who posted and the viewer’s history of interacting with that person. Instagram said the five interactions it looked at most closely in Feed were how likely someone was to spend a few seconds on a post, comment, like, share and tap the profile photo.
Explore and Reels. Explore and Reels mostly show content from accounts people do not follow. For Reels, the most important predictions were how likely someone was to reshare, watch all the way through, like and visit the audio page. Instagram said it aims to make low-resolution, watermarked, muted, bordered, mostly text and previously posted reels less visible.
Shadowbanning. Instagram said it does not suppress content to encourage people to buy ads.
Why it mattered for med spas
For med spas, the explainer clarified that Instagram is several channels in one. Feed and Stories mostly serve people who already follow the practice. Explore and Reels are discovery surfaces where new clients find it. Each needs a different kind of content, and a single generic post rarely serves all of them well.
It also confirmed that engagement signals matter, but genuine ones. Saves, shares, full watches and comments signal value. Recycled videos with watermarks from other apps, mostly text graphics and low-quality uploads were explicitly called out as less visible in Reels.
Finally, it addressed a common fear. Many med spa owners believed reach dropped to push them toward ads. Instagram said directly that it does not suppress content to sell ads, and that it is in its interest for creators to reach their audiences. Paid promotion still has a role, but as a deliberate choice rather than a reaction to imagined penalties.
What typical agencies did
Many agencies posted the same content everywhere, often repurposed videos with watermarks or heavy text overlays. Others chased hashtags and posting times instead of content quality. Some blamed weak results on shadowbans rather than examining what they posted, and few connected Instagram activity to booked consultations.
The better approach used Instagram’s own explanation as a brief: original, high-quality video for discovery, relationship content for Stories and clear paths from Instagram to booking.
What it means for a med spa today
These steps turn the 2023 explainer into a working content plan.
1. Plan by surface
Treat Reels and Explore as discovery, and Feed and Stories as relationship channels. Instagram said most of what people see in Explore and Reels comes from accounts they do not follow, so those surfaces are where new clients meet the practice. Feed and Stories reach people who already chose to follow, so they should deepen trust and move followers toward a consultation.
2. Post original video
Film in the practice and avoid reposting watermarked clips from other apps. Instagram named watermarked, low-resolution, muted and previously posted reels as less likely to be shown. A simple workflow of shooting vertical video natively, editing cleanly and uploading in high quality addresses most of those issues.
3. Make content worth saving and sharing
Educational, specific posts earn saves and shares. Short explanations of how a treatment works, what recovery looks like, how to prepare for a first visit or how to choose a qualified injector give people a reason to keep a post or send it to a friend. Those actions are exactly the ones Instagram said it weighs most.
4. Use Stories for connection
Show the team, the space and everyday moments. Instagram said Stories ranking leans on viewing history, engagement and closeness. Consistent, personal Stories that invite replies, such as polls and questions, keep the practice near the front of a follower’s tray.
5. Connect to booking
Make it easy to book from the profile and from content. A clear profile link to an online scheduler, a concise bio and highlights that answer common questions turn interest into appointments. Every extra step between a reel and a booking loses people.
6. Stay compliant
Follow advertising, endorsement and privacy rules in every post. Before-and-after content needs consent, accurate context and no misleading edits. Influencer and employee posts need clear disclosures, as the 2023 FTC Endorsement Guides update made explicit.
Before-and-after content done right
Results content is among the most engaging material a med spa can post, and it is also the most sensitive. It should show real clients who gave written consent, use consistent lighting and angles, avoid filters or retouching that change the result, and include context such as the treatment and the number of sessions. Presenting an exceptional result as typical can mislead, so balanced captions matter.
Done well, results content earns saves and shares because people use it to research. Done poorly, it erodes trust and can create regulatory risk. A clear internal review process protects both the practice and its clients.
Education that earns saves
Instagram said saves and shares are among the most important signals in Explore. For med spas, the most saveable content usually answers a specific question: how long a treatment lasts, what to avoid before an appointment, how two options differ or what a consultation involves. These posts work because they are useful later, not just entertaining in the moment.
Educational carousels and short videos also build authority. A client who learns from a practice’s content arrives at a consultation better informed and more confident. Our med spa marketing guide covers how to build a content library that does this consistently.
The look and feel of a premium feed
Instagram is often the first impression of a med spa’s brand. A coherent visual style, with consistent color, lighting, typography and composition, signals quality before anyone reads a caption. That does not mean every post must be polished studio work. Authentic behind-the-scenes video can sit alongside refined imagery if the overall feel is consistent.
The same visual standard should carry through to the website and booking experience. A client who moves from an elegant Instagram profile to a dated website feels the disconnect. Our custom website service is built to keep that experience seamless.
Using the controls Instagram described
The 2023 explainer also listed ways people can shape what they see, including Favorites, a Following feed, muting, “Not Interested” and a “Why you’re seeing this post” option. For med spas, this is a reminder that followers have more control than ever. People who feel overwhelmed by constant promotional posts can mute or unfollow quietly. Content that respects attention, with a healthy mix of education, team and results rather than nonstop offers, keeps followers engaged and makes them more likely to add the practice to Favorites.
Measuring what matters
Instagram’s own signals suggest which metrics deserve attention. Saves, shares, full watches and profile visits say more about value than raw likes or follower counts. Med spas should track those along with what happens next: link taps, direct messages, consultation requests and booked appointments. That connects social activity to revenue and shows which content actually brings clients in, so the team can do more of what works.
Reels for discovery
Reels are the main way new clients find a med spa on Instagram. Instagram said it predicts whether someone will watch a reel all the way through and reshare it, so the first seconds need to earn attention and the content needs to be worth passing along. Short, clear videos that answer a question or show a process often perform better than long, unfocused clips.
Instagram also said it surveys people about whether a reel was worth their time. That is a reminder that tricks rarely last. Content that genuinely helps or delights the viewer is what the system is designed to reward.
Turning followers into clients
Followers do not pay the bills. Bookings do. A med spa’s Instagram should lead naturally to a consultation, with a clear call to action, a fast booking link and a team that responds quickly to direct messages. Many practices lose interested people in their DMs because replies are slow or inconsistent.
A defined response process, with templates for common questions and a target response time, turns messages into appointments. Our booking engine service and guide to call handling and lead leakage cover those systems.
Instagram and search together
Instagram rarely works alone. Many people who discover a med spa on Instagram search for it on Google, check reviews and look at the Maps listing before booking. A strong Google Business Profile, consistent reviews and a clear website complete the journey Instagram starts. Our med spa Google Business Profile guide and reputation and premium pricing guide explain how those pieces fit together.
What 2023 does not tell us
The explainer described signals and predictions, not exact weights, and Instagram said it adds and removes signals over time. It did not guarantee reach for any type of content, and it is not a formula. Instagram has also changed significantly since 2023, so current features and priorities should be checked against its latest guidance. What 2023 does show is Instagram’s own account of how ranking worked at the time.
The premium practice advantage
Premium med spas use Instagram as part of a complete client journey. Visit our med spa marketing service, our services, who we help and our approach to Google Maps and AI search visibility. Our team works from Austin with practices nationwide.
The bottom line
Instagram’s 2023 ranking explainer gave med spas a clear brief. Practices that create original, useful content for each surface and connect it to a premium booking experience grow steadily. The platform will keep changing, but the principle Instagram described in 2023, rewarding what people genuinely value, has held up well.
Check if your market is open. We take one practice per specialty per market. Request a market check or call (716) 400-0084.
Frequently asked questions
What did Instagram publish in May 2023?
On May 31, 2023, Instagram published an updated "Instagram Ranking Explained" post by Adam Mosseri describing how Feed, Stories, Explore and Reels rank content.
Does Instagram have one algorithm?
No. Instagram said it uses a variety of algorithms, classifiers and processes, and that each part of the app uses its own ranking tailored to how people use it.
What matters most for Reels?
Instagram said its most important Reels predictions were how likely someone is to reshare a reel, watch it all the way through, like it and go to the audio page.
What makes reels less visible?
Instagram said it aims to make certain reels less visible, such as low-resolution or watermarked reels, muted reels, reels with borders, reels that are mostly text and reels already posted on Instagram.
Does Instagram suppress posts to sell ads?
Instagram said it does not suppress content to encourage people to buy ads.
What should med spas take from this?
Create content suited to each surface, prioritize original video people want to watch and share, nurture relationships through Stories, and connect Instagram to booking and reviews.