Background
In June 2023 the United Nations confirmed that, following a request from their government, that the Republic of Turkey would henceforth be identified as the Republic of Türkiye. Although the change has been implemented, we have used the former here because it is currently more commonly understood by consumers.
This Ruling forms part of a wider piece of work on cosmetic surgery abroad. The ads were identified for investigation following intelligence gathering by our Active Ad Monitoring system, which uses AI to proactively search for online ads that might break the rules.
Summary of Council decision:
Four issues were investigated, all of which were Upheld.
Ad description
Two paid-for Facebook ads for Clinicexpert Hospital, promoting cosmetic surgery in Turkey, seen in May 2023:
a. The caption in the first ad stated “Have defined and strong hair in just one day”. The ad included a photo of a young man running his fingers through his hair and smiling, with superimposed text that stated “70% Monthly Discount Opportunity for Hair Transplant” and in smaller font “Istanbul, Turkey”. Text underneath stated “DHI Pro and FUE hair transplant in Turkey. Hair transplant operations performed with the latest technologies in the field” with a button labelled “Get Quote”.
b. The caption in the second ad stated “Waste no more days letting hair loss makes [sic] you lose confidence”. The ad included the photo of a young man running his fingers through his hair, with superimposed text that stated “70% Monthly Discount Opportunity for Hair Transplant”. Text underneath stated “Take the first step now Get your natural looking hair back” with a button labelled, “Get Quote”.
Issue
The ASA challenged whether the:
1. reference to a “70% Monthly Discount Opportunity” in ads (a) and (b) pressured consumers into purchasing cosmetic interventions and was therefore irresponsible;
2. claim “Defined and strong hair in just one day” in ad (a) was misleading and could be substantiated, because it exaggerated the effectiveness of the procedure;
3. claim “Waste no more days letting hair loss makes [sic] you lose confidence” in ad (b) was irresponsible because it exploited insecurities surrounding body image; and
4. ads (a) and (b) misleadingly omitted information regarding the need for a pre-consultation to assess the patient’s potential contraindications and suitability for the procedures, including where such pre-consultation would take place.
Response
1., 2., 3. & 4. Dakik Saglik Medikal Turizm A.S. t/a Clinicexpert Hospital did not respond to the ASA’s enquiries.Meta had no comments in relation to the ASA’s investigation.
Assessment
Upheld
The ASA was concerned by Clinicexpert Hospital’s lack of response and apparent disregard for the Code, which was a breach of CAP Code (Edition 12) rule 1.7 (Unreasonable delay). We reminded them of their responsibility to respond promptly to our enquiries and told them to do so in future.
1. Upheld
We considered that although it would not necessarily be irresponsible to offer promotions for surgical procedures, marketers would need to take particular care when executing and administering them.The ads referred to a “70% Monthly Discount Opportunity” for hair transplants. We considered that the claim was not clear in its meaning, but that consumers would interpret the reference to “Monthly Discount Opportunity” to mean either that there was a time-limited opportunity to take up the offer of a 70% discount within the month or that the 70% discount opportunity was available every month to a limited number of people.
We considered that cosmetic surgery should be portrayed as something that required time and thought from consumers, because of the seriousness of a decision to undertake an invasive medical procedure. By advertising the “70% Monthly Discount Opportunity”, with no indication of a specific time frame or availability, consumers could be rushed into making an important decision without having sufficient time to consider the consequences. We considered that the pressure to respond quickly to the discount opportunity was particularly amplified by the significant amount of the advertised discount of 70%.
Because it created a sense of undue urgency to respond quickly, we considered that the ad had not been prepared in a socially responsible manner, and therefore concluded that it breached the Code.
On that point, ads (a) and (b) breached CAP Code (Edition 12) rule 1.3 (Social responsibility).
2. Upheld
Ad (a) included the claim “Defined and strong hair in just one day” together with a photo of a young man with a full head of hair, running his fingers through his hair and smiling. We considered that consumers would interpret the image as indicative of the final result they would achieve by undergoing the procedure, and therefore would likely expect similar results as those depicted, in just one day. We therefore expected to see evidence that the results depicted could be achieved in one session.
We received no evidence from Clinicexpert Hospital to substantiate the efficacy of the procedure in achieving the results shown in ad (a). We considered that the ad exaggerated the effectiveness of the hair transplant and therefore concluded that it was misleading.
On that point, ad (a) breached CAP Code (Edition 12) rule 3.1 (Misleading advertising), 3.7 (Substantiation), 3.11 (Exaggeration) and 12.1 (Medicines, medical devices, health-related products and beauty products).
3. Upheld
The CAP Code required marketing communications to be prepared with a sense of responsibility to consumers and to society.
Ad (b) featured the claim “Waste no more days letting hair loss makes [sic] you lose confidence”, together with the photo of a young man with a full head of hair running his fingers through his hair and looking into the camera in a confident pose. We considered that the wording and image would be interpreted by consumers as suggesting that experiencing hair loss was a source of concern, because it would impact self-confidence, and that it should be rectified by cosmetic surgery.
We therefore considered ad (b) was likely to encourage consumers to focus on concerns about their hair loss as a reason for cosmetic surgery and therefore that the ad exploited those insecurities. We concluded the ad was therefore socially irresponsible.
On that point, ad (b) breached CAP Code (Edition 12) rule 1.3 (Social responsibility).
4. Upheld
The CAP Guidance on Cosmetic interventions stated that marketers should not imply that invasive surgery was a “minor procedure” or similar if that claim was likely to mislead as to the complexity or duration of the operation, the possible pain experienced either during or after the operation, the length of the recovery time or the potential side-effects. Ads should not mislead as to the likely commitment required for pre-consultation, surgery, recovery and post-operative assessments.
Aside from referencing that the operation would take place in Istanbul, Turkey, and indicating in ad (a) that they would be using the DHI Pro and FUE hair transplant techniques, the ads contained no further details about the procedure advertised. The ads omitted information regarding the need for a pre-consultation to assess the patient’s potential contraindications and suitability for the hair transplant, including where such a pre-consultation would take place. We considered that a pre-consultation would be necessary in order to also discuss the patient’s concerns and suitability for the procedures, outline the complexity or duration of the operation(s), the possible pain during or after the procedure, the length of recovery time and the potential risks and side effects.
We understood it was likely that those pre-consultations might sometimes need to take place in person rather than remotely. We considered that in the context of an ad for cosmetic surgery abroad, information regarding the necessity for pre-consultation and where those would take place was material information necessary for consumers to make a considered decision and should have been included in the ad. Because that material information was not included, we considered that the ad was misleading.
On that point, ads (a) and (b) breached CAP Code (Edition 12) rules 3.1 and 3.3 (Misleading advertising).
Action
The ad must not appear again in the form investigated. We told Dakik Saglik Medikal Turizm A.S. t/a Clinicexpert Hospital to ensure that their ads were socially responsible and did not pressure consumers into purchasing cosmetic interventions or exploit insecurities surrounding body image. We also told them not to mislead consumers by exaggerating the effectiveness of a procedure or by omitting material information regarding cosmetic surgery procedures abroad and the need for a pre-consultation, including where it would take place.
We referred the matter to CAP’s Compliance team.
