Note: This advice is given by the CAP Executive about non-broadcast advertising. It does not constitute legal advice. It does not bind CAP, CAP advisory panels or the Advertising Standards Authority.
The ASA has long received complaints about cosmetic surgery advertising. In 1997, CAP issued a Help Note which contains, amongst other things, advice on surgeon’s qualifications and general superiority claims (such as “leading clinic” etc). Over the years, CAP and the ASA have considered a range of claims, including statements about the quality of advertisers’ facilities, the training and qualifications of those who carry out procedures, the types of treatments offered, efficacy claims (whether through images or text), ‘before’ and ‘after’ photos, prices, etc.
Marketers should hold evidence before making objective claims and, where relevant, should hold robust substantiation for claimed effects on humans (Rules 3.7 & 12.1).
Marketers should also take care to ensure claims for the achieved results are not exaggerated and can be supported by robust clinical evidence. In 2009 a consultant surgeon challenged whether ‘before’ and ‘after’ pictures for an endoscopic brow lift were genuine and accurately reflected achievable results. Because the advertiser proved that the photographs were genuine, not retouched and provided further support with a peer-reviewed article, the ASA did not uphold the complaint (Advantech Surgical Ltd, 22 April 2009). In 2010, one advertiser used ‘before’ and ‘after’ photographs to support claims for “scar and stretch mark removal”. The advertiser submitted photographs to substantiate the claims but because the ‘after’ photograph for scar removal was on a different part of the treated arm, the ASA concluded that it was not an accurate representation of the treatment results. The photographs of the stretch marks were also deemed misleading because the ‘before’ image was a close-up of the stretch marks on the untreated side of the patient’s stomach and the ‘after’ image was a close-up of the treated side of the patient’s stomach (The Harley Medical Group Ltd, 24 November 2010).
Advertising should avoid referring, either directly or indirectly, to prescription-only medicines, for example Botox, because this is prohibited by law and under the CAP Code (Rule 12.12), (MyCityDeal Ltd,14 March 2012).
To date, the ASA has rejected a number of complaints that ads for cosmetic surgery exploit consumers’ insecurities about their bodies (The Harley Medical Group Ltd, 12 March 2008) but marketers should be careful not to trivialise surgery. A poster, in the style of a magazine cover, and which featured the claims “Boob Jobs... More affordable than you think... Get more, pay less... Same day surgery”, was criticised as being socially irresponsible (Spire Healthcare Ltd, 7 December 2011). This case also illustrates that marketers should be particularly careful when using untargeted media. More specifically, marketers should be cautious when using media aimed at, or seen by, a significant proportion of under 18 year olds.
As many cosmetic procedures are physically invasive, marketers should encourage consumers to take independent medical advice before committing themselves to significant treatments (Rule 12.9). To ensure they can, and to avoid being accused of acting irresponsibly, marketers should allow consumers ample time to consider surgery and make an informed decision. This is particularly relevant to marketers offering cosmetic surgery on a sales promotion basis. In late 2011, the ASA considered a promotion that encouraged consumers to financially commit to cosmetic surgery within 24 hours, was socially irresponsible (MyCityDeal Ltd, 23 November 2011). But in spring 2012, the ASA concluded that 72 hours was long enough to make a decision to purchase a voucher for facial injections. As part of its consideration, the ASA noted that the promoters now offered a refund if consumers changed their mind about having the procedure (MyCityDeal Ltd, 21 March 2012).
In early 2012, the ASA considered a competition offering a “free tummy tuck for one of our lucky readers” and described the promotion as a “plastic surgery giveaway”. The ASA rejected the complaint that the promotion was irresponsible and trivialised cosmetic surgery. Because it considered the selection process was robust, entrants were given enough time to consider entering the competition, the promotion included information about the procedure and entrants’ were assessed for their suitability, the ASA considered the promotion was not inherently irresponsible (Hubert Burda Media UK, 7 March 2012).
Although the ASA has, to date, rejected many of the complaints it has received that cosmetic surgery is simply not an appropriate product to be offered as a prize or time-limited offer, some trade bodies believe or advise otherwise. The Independent Healthcare Advisory Service (IHAS) recommends, for example, that promotional discounts are offered only to prospective consumers who have already contacted the provider. It also recommends that its members do not participate, directly or indirectly, in competitions for cosmetic surgery. Similarly, the British Association of Aesthetic Plastic Surgeons (BAAPS) is critical of promotions that offer surgery as a prize.
Marketers should avoid the implication that treatments are safe, risk free or easy. One advertiser claimed that their breast enhancement procedure was ‘safe and natural’. Because invasive surgery may carry risks, the ASA upheld the complaint (My Aesthetics Ltd, 17 December 2008). Other advertisers have not been quite so explicit but have nevertheless been found to have implied surgery was a straight-forward and risk-free lifestyle choice (Spire Healthcare Ltd, 7 December 2011).
Additionally, advertisers should not underplay the nature of a procedure. In 2008, one advertiser claimed that their Lipo Smart treatment was non-surgical and pain and scar free. Because the procedure involved the insertion of a medical instrument and the advertiser could not provide evidence that it was pain free and produced no scarring, the claims were deemed misleading (The Norton Clinic Ltd, 5 March 2008).
Advertisers have also made claims that they have top ranking in the field of cosmetic surgery. In 2009, one advertiser claimed to be “Britain’s number one cosmetic surgery group”. The ASA concluded that consumers would be likely to infer from the claim that the advertiser had a higher turnover and performed more procedures than its competitors. Because the advertiser could provide comparative turnover figures but not comparative procedure figures, the ASA considered the claim unsubstantiated (Transform Medical Group (CS) Ltd, 6 May 2009).
Advertised prices should also avoid misleading consumers. In 2009 an advertiser quoted prices without making clear they were lead-in prices and did not state that those prices were for surgical procedures carried out in Cyprus. The ASA considered those omissions were significant and considered the ad misleading (Koulwick Ltd t/a Burford Medical, 21 October 2009). If they are advertising medical tourism, marketers should be upfront about factors likely to affect a consumer’s understanding of the offer (such as where surgery will take place and associated costs).
Last modified : 10 April 2012