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
A paid-for Facebook ad for GETDHI, promoting cosmetic surgery in Turkey, seen in May 2023.
The caption stated “Get DHI Hair transplant in Antalya, add strength to your hair! [...] – Holiday and treatment same price – Better than UK prices – DHI technique – Maximum grafts in one session…”. The ad included a cartoon image of a man with a full head of hair, and an image behind of the same man with a very receded hairline and stubble on the rest of his head. Additional text stated “DHI HAIR TRANSPLANT”, “HOTEL + VIP TRANSFER £1.350” and “APPLY NOW Promotion valid in May”.
When clicked on, the “…” in the caption expanded to further text which stated “– 99% successful results – VIP service: transfer, 5* hotel, medicines – Personal accompaniment and translator – Natural Looking – Unshaven System […] #hairtransplant - #hairtransplantation - #hairtransplantation - #dhi - #fue - #dhihairtransplant - #turkeyhairtransplant […]”.
Issue
The ASA challenged whether the:
1. cartoon images of the man misleadingly exaggerated the effectiveness of the procedure;
2. reference to “99% successful results” was misleading and could be substantiated;
3. ad trivialised the decision to undergo cosmetic surgery and therefore was irresponsible; and
4. 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. & 4. Get DHI Hair Clinic t/a GETDHI 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 GETDHI’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. & 2. Upheld
The ad included a cartoon image of a man with a full head of hair, and an image behind of the same man with a very receded hairline and stubble on the rest of his head. While this was presented as a cartoon, we considered that consumers would interpret the images as indicative of the transformation they would experience by undergoing the procedure, and therefore would expect similar results as those depicted. We further considered that consumers would understand the claim “99% successful results” to mean that 99% of the patients who had undergone DHI hair transplants at the clinic had experienced hair growth as depicted in the ad. The ad also included the claim “Maximum grafts in one session” which we considered would be read together with the “99%” claim and the images to mean that the results could be achieved after one procedure.
We therefore expected to see evidence substantiating the above claims.We received no evidence from GETDHI to substantiate the efficacy of the procedure in achieving the claimed results. We therefore considered that the ad exaggerated the effectiveness of the hair transplant, and the likely success of the operation, and concluded that it was misleading.
On those points the ad breached CAP Code (Edition 12) rules 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.
The ad made reference to “Holiday and treatment same price”. It also gave emphasis to items of the cosmetic surgery package which people would closely associate with holidays such as: “HOTEL + VIP TRANSFER” and “VIP service: transfer, 5* hotel” together with an image of a hotel and swimming pool. We considered that the ad was not likely to be interpreted as promoting a holiday; rather, its purpose was clear that it was for cosmetic surgery abroad.
However, because there was an emphasis on the travel as well as the cosmetic intervention, it was likely to detract from the seriousness of the surgery offered. It was also relevant that the surgery would take place abroad which raised the potential for additional risks 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 which arose 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 overall presentation of the ad was likely to be seen as trivialising cosmetic surgery.
On that point the ad 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 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 Antalya, Turkey, and that the hair transplant would be done using the DHI technique, the ad contained no further details about the procedure advertised. The ad omitted information regarding the need for a pre-consultation to assess the patient’s potential contraindications and suitability for the DHI 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 the ad 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 GET DHI Hair Clinic t/a GETDHI to ensure that their ads were socially responsible and did not trivialise the decision to undergo cosmetic surgery. We told them not to make claims about the effectiveness of the procedures, in either images or text, if they did not hold evidence to substantiate them. 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.
We referred the matter to CAP’s Compliance team.
