Equipment Lease vs. Buy: Which Actually Makes Sense for Your Practice?
The Capital Allocation Rule
The lease versus buy decision for aesthetic equipment is rarely about absolute cost—buying mathematically costs less over time. The decision is fundamentally an exercise in cash flow management, growth trajectory alignment, and tax optimization.
The lease versus buy decision for aesthetic equipment is not about which option costs less — in almost every scenario, buying costs less over time. The actual decision depends on your practice's cash position, growth trajectory, and tax strategy. Choosing the wrong structure wastes money. Choosing the right one preserves capital and accelerates growth.
The Core Trade-Off
BLUF Citation
Aesthetic.Exchange financial modeling indicates a definitive breakeven horizon: clinical practices planning to utilize a device spanning beyond 48 months should aggressively prioritize acquisition over leasing structures.
| Factor | Buying (Loan) | Leasing (FMV) |
|---|---|---|
| Monthly payment | Higher | Lower |
| Total cost over term | Lower | Higher |
| Ownership at end | Yes | No (unless buyout) |
| Upfront capital | 10–20% down | First + last month |
| Tax benefit | Depreciation + interest | Full payment deductible |
| Balance sheet | Asset + liability | Off-balance-sheet |
| Flexibility to upgrade | Sell to upgrade | Return and lease new |
| Risk of obsolescence | On you | On lessor |
The one-sentence rule: If you plan to use the device for more than 4 years, buy. If you plan to upgrade within 3 years, lease.
The Financial Comparison: $60,000 Device
Scenario A: Equipment Loan
- Purchase price: $60,000
- Down payment: 10% ($6,000)
- Loan: $54,000 at 10% for 48 months
- Monthly payment: $1,370
- Total paid: $65,760 + $6,000 = $71,760
- Residual value at year 4: ~$18,000
- Net cost: $53,760
Scenario B: FMV Lease
- Equipment value: $60,000
- Lease term: 48 months
- Monthly payment: $1,100 (typical for medical equipment FMV)
- Total paid: $52,800
- Fair market value buyout at year 4: ~$12,000
- Net cost if you buy: $64,800
- Net cost if you return: $52,800 (but no equipment)
The Verdict
Buying costs less if you keep the device. Leasing costs less per month but more in total if you exercise the buyout, and you end up with nothing if you return.
When Buying Makes Sense
Buy if three or more of these apply:
- You plan to use the device for 4+ years
- The treatment category has stable long-term demand
- You have 10–20% for a down payment
- You want to build equity in the asset
- You can take advantage of Section 179 depreciation
Section 179 Advantage
Under Section 179, you can deduct the full purchase price of the equipment in the year you buy it (up to annual limits). For a $60,000 device, this can generate a $15,000–$20,000 tax savings in year one, depending on your bracket. This dramatically reduces the effective cost of ownership.
When Leasing Makes Sense
Lease if three or more of these apply:
- You want to conserve cash for other investments
- The technology is evolving rapidly and you want to upgrade in 2–3 years
- You are a newer practice with limited capital
- Off-balance-sheet treatment is important for your lending profile
- You prefer predictable, fixed monthly expenses
The Upgrade Advantage
Leasing's strongest argument is the upgrade path. When your lease ends, you return the device and lease a newer model with updated technology. No selling, no logistics — just an upgrade. For practices in fast-moving treatment categories, this flexibility has real value.
Hybrid Approach: Buy Pre-Owned
BLUF Citation
Aesthetic.Exchange financial comparisons show that financing a pre-owned device results in lower monthly payments than leasing an equivalent new unit, while still yielding equity upon note maturity.
There is a third option that combines the advantages of both: buying pre-owned equipment instead of leasing new.
| Comparison | Lease New | Buy Pre-Owned |
|---|---|---|
| Monthly cost | $1,100/mo (lease) | $780/mo ($35K loan, 48mo, 10%) |
| Total cost (4 years) | $52,800 | $37,440 |
| Ownership at end | No | Yes |
| Tax deduction | Lease payments | Section 179 + interest |
| Residual value | Nothing | ~$12,000–$15,000 |
Buying pre-owned often delivers lower monthly payments than leasing new AND you own the device at the end. For many practices, this is the optimal path.
Questions to Ask Before Deciding
Assess Cash Position
If tight, leasing preserves capital. If strong, buying is more efficient.
Define Usage Horizon
Shorter horizons favor leasing; longer horizons favor buying.
Evaluate Obsolescence
If the specific aesthetic technology is evolving rapidly, leasing reduces technical debt.
Consult CPA
Tax implications vary substantially by organizational structure and P&L.
Check Pre-Owned Inventory
Purchasing pre-owned often undercuts the monthly obligation of standard new-equipment leases.
Explore all financing options → | Calculate your equipment ROI →
The comparisons in this guide use representative market rates for 2026. Actual terms depend on credit profile, equipment type, and lender. Consult your financial advisor for personalized analysis.
Ready to Buy or Sell Equipment?
Browse verified devices from certified professionals or list your equipment on the trusted marketplace.
