ASA Adjudication on The Norton Clinic Ltd

Ad

A national press ad, for Lipo Smart treatment, read "Remove fat, without dieting, willpower! Not even surgery! ... The Norton Clinic Group are one of the UK's leading cosmetic surgery providers and have opened Lipo Smart centres nationwide, manned by registered Doctors and Surgeons carrying out the new revolutionary Lipo Smart fat removal procedure ... Unlike other fat removal techniques Lipo Smart is NON surgical, painless, scar free and carried out in minutes. Lipo Smart involves no overnight stay, is carried out using only a local anaesthetic and is effective on most parts of the body. HOW? It is simple and very effective. By inserting a fine laser probe under the skin, the fat membranes break down releasing liquid fat for the body to naturally dispose. SOUNDS GREAT! BUT IS IT? Norton Clinic patient, Lee (West Yorkshire) recently spoke about her Lipo Smart treatment 'I seemed to spend my life continually dieting, the Norton Clinic carried out the Lipo Smart treatment, and I have to say I was sceptical, however the Consultants and Doctors were extremely professional ... The results were amazing everyone noticed a difference in only a few weeks ... I still have to watch my weight but if the pounds creep back, I know where to go.' The Norton Clinic Group have clinics nationwide ... LOSE FAT the smarter way with LIPO smart The affordable, new, safe, revolutionary, non surgical, laser fat reduction technology. Discover the global phenomina [sic] that gives incredible results after just one treatment." The ad also featured the claim "As Seen on TV". Text at the bottom of the ad read "Clinics in the North and Harley Street, London".

Issue

1. The Harley Medical Group challenged the description of the procedure as "NON surgical", because they understood that the insertion of the laser probe under the skin required an incision to be made in the skin and therefore constituted a surgical procedure.  

A member of the public challenged:

2. whether the ad made an implied comparison to the efficacy of cosmetic surgery procedures by claiming that doctors and surgeons were carrying out the procedure, even though it was "NON surgical";

3. the efficacy of the procedure;

4. whether the claim "the fat membranes break down releasing liquid fat for the body to naturally dispose" could be substantiated;

5. whether the claims "painless" and "scar free" could be substantiated;

6. whether the claim "revolutionary" could be substantiated;

7. the veracity of the testimonial and whether it misleadingly implied efficacy;

8. whether the ad could be seen to encourage using Lipo Smart as an alternative to dieting and exercise and was therefore irresponsible and

9. whether the ad misleadingly implied they had clinics "nationwide", whilst text at the bottom of the ad claimed they had "Clinics in the North and Harley Street, London".

CAP Code (Edition 11)

Response

1. The Norton Clinic Ltd (NC) conceded that the Lipo Smart procedure was a "surgical treatment" because it involved the use of medical instruments but said it was no more surgical than tooth extraction.

2. NC said Lipo Smart was a cosmetic procedure that would be carried out by doctors and nurses as suggested in the ad.

3., 4., 5. & 6. NC sent the ASA two journal articles: "Analysis of Laser Lipolysis Effects on Human Tissue Samples Obtained from Liposuction" and "Laser Lipolysis: Flaccidity Under Control" which they said confirmed the process of the treatment and supported the claims for Lipo Smart.  They also sent an article written by a research and development company, "Laserlipolysis. Liposuction with Nd: YAG laser" and a booklet titled "Laserlipolysis Body Modelling in the new millennium".  

7. NC submitted a copy of the letter from which the testimonial was extracted; it was signed, dated and included a contact address.   

8. NC said the ad did not imply that the procedure should replace a balanced diet and exercise; they said they actively encouraged their patients to follow a healthy lifestyle.

9. NC said they had clinics for consultation in Glasgow, Newcastle Upon Tyne, Wakefield, Birmingham, London and Dublin.  They said they had treatment rooms in London, Wakefield and Dublin.

Assessment

1. Upheld

The ASA noted NC's comments but considered that, because an incision needed to be made in the skin in order to insert the cannula, a narrow tube, and laser probe, and because that could disturb subcutaneous tissue, the procedure was invasive.  We understood that NC used the term in order to convey to potential customers that major surgery was not required.  We concluded that to describe the procedure as "NON surgical" was nevertheless misleading.

On this point, the ad breached CAP Code clause 7.1 (Truthfulness).

2. Upheld

We noted the ad claimed Lipo Smart was carried out by doctors and surgeons but did not consider that that alone implied results were comparable to cosmetic surgery.  However, we considered that readers would infer that the procedure could be used on large areas and was suitable for the removal of relatively large volumes of fat; statements such as "unlike other fat removal techniques... " and the references to the relative ease of the procedure reinforced that impression.  We considered therefore that the overriding impression of the ad was that Lipo Smart was an effective alternative to other methods of cosmetic surgery and to liposuction in particular.

We understood from the evidence sent to us that Lipo Smart was not a substitute for conventional liposuction but a complement to it.  Also, Lipo Smart was suitable for only small areas of fat and certain areas of the body could not be tackled as effectively as with liposuction.  Although we recognised that the ad stated the procedure was "effective on most parts of the body", we considered that the ad implied Lipo Smart was as effective on all parts of the body as other forms of cosmetic surgery including liposuction, and because that was unsupported by evidence, we concluded that the ad could mislead.

On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and beauty products and therapies - general).

3. Not upheld

We noted the evidence submitted by NC suggested that Lipo Smart was an effective method of fat removal.  We were concerned that NC did not hold and provide us with controlled studies that would have conclusively proved that, but noted more in-depth evidence for the same laser procedure had been submitted to the CAP Executive by another advertiser.  We were satisfied that that evidence showed laserlipolysis was an effective method of fat removal.

On this point, we investigated the ad under CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and beauty products and therapies - general) but did not find it in breach.

4. Upheld  

We understood that, in some cases and depending on the volume of fat involved, fat would be removed from the body using an aspirator or other suction method.   We therefore concluded that the claim "the fat membranes break down releasing liquid fat for the body to naturally dispose" could mislead because the body would not "naturally dispose" of fat in all cases.

On this point, the ad breached CAP Code clauses 3.1 (Substantiation) and 7.1 (Truthfulness) and 50.1 (Health and beauty products and therapies - general).

5. Upheld

We noted there was no evidence to support the notion that patients of the Lipo Smart procedure would not experience pain, nor were there any studies to determine the extent of scarring experienced by patients.  However, we noted the authors of one article, "Laser Lipolysis: Flaccidity Under Control", stated that, in their experience, the procedure proved to be less traumatic, with less bruising and swelling, and improved skin retraction than conventional liposuction.

We considered that pain was subjective and would vary between patients.  To describe the procedure as "painless" was therefore potentially misleading as some patients were likely to experience some degree of pain or discomfort with an invasive procedure.  We noted the evidence did not support the implication that all patients who underwent the Lipo Smart procedure would be "scarfree".  We concluded that the claims could mislead.

On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness), 50.1 and 50.4 (Health & beauty products and therapies).

6. Not upheld

We considered that the claim "revolutionary" implied that Lipo Smart was a breakthrough or new procedure.  We understood that the methodology was relatively new and, given that we were satisfied with the evidence supporting its efficacy as a fat removal technique, we did not object.   

On this point, we investigated under CAP Code clauses 3.1 (Substantiation) and 7.1 (Truthfulness) but did not find it in breach.

7. Upheld

We noted that, when NC consulted the CAP Copy Advice team before publishing the ad, the same testimonial was attributed to "Lyn".  We asked NC to explain why the same testimonial was now attributed to "Lee".  They told us that there had been a typographical error which they had corrected before publication.  We noted, however, that the letter from which the testimonial was extracted post-dated both NC's submission to the Copy Advice team and the date on which one of the complainants saw the ad.  We were not persuaded that the testimonial was genuine and furthermore considered that NC should have held a copy of the signed and dated letter before submitting the ad for publication.

We considered that the claim "The results were amazing everyone noticed a difference in only a few weeks" was an implied endorsement as to the efficacy of the procedure.  While we were not persuaded that the testimonial itself was genuine, because we were satisfied that Lipo Smart was an effective method of fat removal, we considered that the claim expressed within the testimonial was supported.

On this point, the ad breached CAP Code clause 14.4 (Testimonials) but did not breach 14.3 (Testimonials).

8. Upheld

We noted NC's comments.  We considered, however, that the claim in the testimonial " ... if the pounds creep back, I know where to go" and the general emphasis on the speed and ease of the procedure could suggest to readers that the Lipo Smart procedure could be used as an alternative to dieting and exercise.  Because we understood that the Lipo Smart procedure was invasive, and all surgical procedures carried risks, we concluded that the approach was irresponsible.

On this point, the ad breached CAP Code clause 2.2 (Responsible advertising).

9. Upheld  

We noted NC made a distinction between clinics for consultation and those clinics with treatment rooms.   

We considered that readers were likely to infer from the claim "nationwide" and the statement "The Norton Clinic Group ... have opened Lipo Smart centres nationwide, manned by Doctors and Surgeons carrying out the new revolutionary Lipo Smart fat removal procedure" that NC had treatment rooms nationwide where the procedure would be carried out.  Because we understood that only three treatment rooms existed, one of which was outside the UK, we concluded the claim "clinics nationwide" could mislead.

On this point, the ad breached CAP Code clause 7.1 (Truthfulness).

Action

We told NC to remove the claims "NON surgical", "painless", "scarfree" and "clinics nationwide" and to make clear that not all of their clinics were equipped to carry out the Lipo Smart procedure.

We told NC not to compare, either directly or indirectly, the Lipo Smart procedure to cosmetic surgery and to avoid giving the impression that Lipo Smart could be used as an alternative to dieting and exercise.

Adjudication of the ASA Council (Non-broadcast)