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:
Three issues were investigated, all of which were Upheld.
Ad description
A paid-for Facebook ad for ClinicHaus Health, promoting cosmetic surgery in Turkey, seen in May 2023, featured the caption “Rhinoplasty surgery, one of the most successful doctors in the world […] Fill out the form now for the big summer campaign VIP transfer 5 star package Holiday in the most beautiful city in the world […]”. An image underneath showed a woman in profile.
Issue
The ASA challenged whether the:
1. claim “Fill out the form now for the big summer campaign” implied a time-limited promotion and therefore irresponsibly pressured consumers into purchasing a cosmetic intervention;
2. ad, including the reference to a “Holiday in the most beautiful city in the world”, trivialised the decision to undergo cosmetic surgery and was therefore irresponsible; and
3. ad 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. Ersoy Health Services Tourism Ltd t/a ClinicHaus Health said they had legal certification and authorisation from the Turkish government. As part of the medical tourism industry they had summer offers from time to time, and highlighted that their clinic was in Turkey.
They said that for ads relating to aesthetic procedures it was usual to include an image demonstrating the procedure’s effects. If people had searched online for information about certain procedures, they would see ads for those procedures, with related images.
Meta said they did not have any comments.
Assessment
1. Upheld
The ASA considered that although it would not necessarily be irresponsible to offer promotions for surgical procedures, marketers must take particular care when executing and administering them. Cosmetic surgery should be portrayed as something that required time and thought from consumers before proceeding, because of the seriousness of a decision to undertake an invasive medical procedure.
The ad encouraged consumers to “Fill out the form now for the big summer campaign” followed by ticked bullet points that included “VIP transfer” and “5 star package”. We considered consumers would understand that the advertiser was offering a summer promotion on a ‘VIP’ 5-star package that included rhinoplasty surgery. In the absence of information about a specific time frame during which that promotion would be available, we considered consumers would understand that the opportunity to take advantage of it was time limited.
In that context, we considered that consumers could be rushed into making an important decision about having cosmetic surgery without having sufficient time to consider the consequences. Because it created a sense of undue urgency to respond quickly, we concluded the ad had not been prepared in a socially responsible manner and therefore breached the Code.
On that point the ad breached CAP Code (Edition 12) rule 1.3 (Responsible advertising).
2. Upheld
The CAP Code required marketing communications to be prepared with a sense of responsibility to consumers and to society.The ad stated “Holiday in the most beautiful city in the world”, and the ticked bullet list also included reference to “VIP transfer” and “5 star package”, which people would closely associate with holidays. We considered the ad was clearly for cosmetic surgery abroad rather than for a holiday. However, because the ad encouraged people to view travelling abroad for cosmetic surgery as a holiday, it was likely to detract from the seriousness of the surgery offered.
That seriousness was compounded because there were additional potential risks associated with having surgery abroad, such as whether the doctors and treatment providers would have the same standards of care and safety as in the UK and how any arrangements for follow-up care and dealing with any complications would be managed.
We considered that the ad could be interpreted as suggesting that surgery was a decision that could be undertaken lightly as part of a holiday, without serious consideration of the nature of the intervention. We therefore concluded that the ad was likely to be seen as trivialising cosmetic surgery and was therefore irresponsible.
On that point the ad breached CAP Code (Edition 12) rule 1.3 (Responsible advertising).
3. Upheld
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 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 surgery would take place in Turkey and the “most beautiful city” in the world the ad contained no further details about the rhinoplasty procedure or the location where it would take place. The ad omitted information regarding the need for a pre-consultation to assess the patient’s potential contraindications and suitability for rhinoplasty, including where such a pre-consultation would take place. We understood that a pre-consultation would be necessary in order to discuss the patient’s concerns and suitability for the procedure, outline the complexity or duration of the operation, the pain during or after the operation, the length of recovery time and the potential risks and side effects.
While the advertiser had not provided any information to us about pre-consultations, we understood it was likely that one 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 a pre-consultation and where it 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 concluded that the ad was misleading.
On that point the ad breached CAP Code (Edition 12) rule 3.1 and rule 3.3 (Misleading advertising).
Action
The ad must not appear again in the form investigated. We told Ersoy Health Services Tourism Ltd t/a ClinicHaus Health to ensure their future ads were socially responsible, by neither presenting the decision to have surgery as a trivial one, nor a decision that should be rushed in order to take advantage of a promotional offer. We also told them not to mislead consumers by omitting material information regarding cosmetic surgery procedures abroad and the need for a pre-consultation, including where it would take place.
