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.
Summary of Council decision:
Two issues were investigated, both of which were Upheld.
Ad description
A paid-for Google search ad for MAYCLINIK, seen on 6 September 2023, stated “All Inclusive Packages – Tummy Tuck Prices in Turkey”. Further text below stated “Get Rid of Your Excess Abdominal Fat [...] Safe Surgery. Airport Transfer, 5 Stars Accommodation, Book Your Free Consultation, Free…”.
Issue
The ASA challenged whether:
1. the claim “Safe Surgery” was misleading and irresponsible; and
2. the references to “All Inclusive Packages” and “5 Stars Accommodation” were irresponsible, because they trivialised the decision to undergo cosmetic surgery.
Response
1. & 2. May Health Tourism Services t/a MAYCLINIK said they were a health tourism company that had operated for over five years. They were a member of the Association of Turkish Travel Agencies, which was a regulatory body of the Turkish government relating to health tourism. They collaborated with hospitals that were strictly regulated by the Turkish Ministry of Health, akin to the Care Quality Commission (CQC) in the UK. They understood the concerns surrounding ads for cosmetic surgery abroad and took them seriously to achieve the highest standards of care.
They considered that it was noteworthy that they maintained their status as an accredited and regulated entity, having published a multitude of ads. Their accredited status was a commitment undertaken to safeguard the well-being of patients. Furthermore, their ads adhered to Google's guidelines.
Regarding the term "Safe Surgery", they said that it directly related to their commitment to patient safety and well-being. They collaborated exclusively with regulated, qualified and fully equipped hospitals, as well as experienced anaesthesiologists. All surgical procedures were conducted within hospital settings, adhering to rigorous safety protocols specified in patient consents. Patient safety remained their paramount concern, and they took all necessary precautions to provide a secure surgical environment.
The references to "All Inclusive Packages" and "5 Stars Accommodation" were used to reassure their patients and their companions by addressing any potential concerns regarding the quality of their accommodations, transportation and overall experience. They considered that by offering all-inclusive packages with five-star accommodation options, they provided a seamless medical tourism experience that allowed patients to focus solely on their medical services.
They said they were fully committed to adhering to Google Ads policies and the guidelines established by Google. Their commitment included ensuring the accuracy and compliance of their ads, without any use of behaviour or language that contravened these guidelines.
Google UK said that Google Ireland had confirmed the ad was served through Google Ads, a self-administered system. Under the terms agreed to by advertisers, it was the advertiser’s responsibility to abide by applicable laws and regulations, including the CAP Code. The ad in question was found to be in breach of Google’s policies and had been disapproved.
Assessment
1. Upheld
The ad featured the claim “Safe Surgery”. The ASA considered that consumers would understand this claim to mean that undergoing abdominoplasty at MAYCLINIK could not result in any detriment to the patient.
We acknowledged that the credentials and certifications the advertiser had referenced related to the quality of care and conditions at the hospitals and laboratories with which they worked. However, we understood that all cosmetic surgery procedures, including abdominoplasty, carried some level of risk to the patient, including when carried out at appropriately certified institutions.
We therefore concluded that the claim “Safe Surgery” was misleading and that it was also irresponsible.
On that point the ad breached CAP Code (Edition 12) rules 1.3 (Social responsibility) and 3.1 (Misleading Advertising).
2. Upheld
The CAP Code required marketing communications to be prepared with a sense of responsibility to consumers and to society. The ad included references to "All Inclusive Packages","5 Stars Accommodation" and “Airport Transfer”, items of the cosmetic surgery package which people would closely associate with holidays. 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 the overall tone of the ad focused on the travel, together with the use of the colloquial term “Tummy Tuck” to describe abdominoplasty, 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).
Action
The ad must not appear again in the form investigated. We told May Health Tourism Services t/a MAYCLINIK not to claim that a cosmetic intervention was safe or to trivialise the decision to undergo cosmetic surgery.
