Practice-management software is infrastructure, not a commodity. For a medspa owner, the platform choice shapes how you bill, track inventory, manage staff workflows, integrate with devices, and scale. Boulevard, Aesthetic Record, PatientNow, and Symplast occupy different positions in the market: some are cloud-native and consumer-forward; others are clinical-first and device-integrated. Some charge per provider; others per location. Some excel at small independent practices; others at multi-location groups and DSOs. This guide maps the real tradeoffs so you can match software to your practice model, not the reverse.