Harley Medical Group Ltd 11 Queen Anne Street London W1G 9LG Number of complaints: 33

Date: 5 December 2007 Media: Poster Sector: Health and beauty

Ad
A poster ad, for cosmetic surgery, displayed beside London Underground station escalators that was made up of three panels repeated in sequence.

a. The first panel showed an unsmiling woman form the waist up wearing a bikini top. Text stated "Meet Amy before her breast enlargement".  

b. The second panel showed the same woman in the same pose as before but smiling.  Text stated "Meet Amy after her breast enlargement".

c. Text on the third panel poster stated "Gorgeous breasts just got easy with cosmetic surgery ... ".

Issue
1. Thirty-three complainants objected that the ad was offensive and irresponsible because it implied larger breasts would make people happier and could undermine young womens self-esteem;

2. two complainants, one a doctor, challenged whether the "before" and "after" pictures were genuine, because she believed the "after" picture had been digitally enhanced; and

3. some complainants, including one who was a doctor, complained that it was misleading and irresponsible to promote a surgical operation to young women as "easy" without a warning that there were risks attached.

The CAP Code:

2.2;5.1;5.3;7.1;50.6

Response
1. The Harley Medical Group (THMG) said they were surprised and concerned by the complaints about the ad.  They said over 750,000 people had seen the campaign and that the number of complainants was only a small percentage of that total.  They said it was not their intention to offend with the ad and pointed out that there were groups of people who campaigned against cosmetic surgery.

THMG explained that they had been established for 24 years and had always taken a responsible approach to marketing that promoted the confidence that cosmetic surgery could bring to patients.  They explained that "Amy" was a real patient who, like many of their patients, wanted to restore her body to how it was before having her baby, by replacing the fullness she had lost in her bust.  They explained that her story was told in the panels and that she had chosen to enhance her bust by one cup size to achieve a natural looking shape; they maintained that this depicted a responsible approach to enhancement through cosmetic surgery.  They said many women, including Amy, felt renewed confidence and self-esteem after cosmetic enhancement.  They asserted that the ad had not implied that only big breasts could make someone happy but, that for certain people, having cosmetic surgery may improve confidence and restore what nature had taken away.

CBS Outdoor, on behalf of London Underground, said they had received three complaints about the ad, but also pointed out that the number of complaints may be higher than would normally be expected because there was an internet networking group that encouraged people to complain about ads they considered inappropriate on London Underground.  They said they took great care to ensure that the images used were suitable for public display and they believed the images were appropriate for the service being offered.

2.  THMG said the images were real photographs of Amy taken before her surgery in July and then about a month after her operation in August.

3.  THMG said the word "EASY" described the consultation process and their offer of flexible finance.   They explained that they offered free initial nurse consultations and aimed to guide the patient through the process of making a decision that was right for them.  They explained that all patients had at least three consultations prior to surgery, over an average time period of 60 days, and that only patients who were suitable for surgery were referred to one of their surgeons, who had total autonomy as to whether to accept or reject the patient for treatment.  They said all their patients were fully informed prior to their consent for surgery and that they did not encourage operations to be taken lightly.  They said they did not believe the ad was misleading or irresponsible, but said they would not repeat the claim in future.

Assessment
1.  Not upheld
The ASA noted the comments of both THMG and CBS Outdoor.  We acknowledged that there was public concern about the effect of advertising "the body beautiful" on the body image and self-esteem of young girls and women and that some people objected to the idea of cosmetic surgery itself.  We noted the "before" and "after" images of Amy were very similar to other ads for cosmetic surgery that were generally published in women's magazines and acknowledged that some people would be more comfortable if cosmetic surgery ads were confined to the back pages of such magazines and not used in poster format. We noted the posters in the underground would be seen by a wide section of the general public, including young women and girls, but considered that the images in themselves were unlikely to make women feel dissatisfied with their body.  We concluded that the ad was unlikely to cause serious or widespread offence or undermine young women's self esteem.  

On this point, we investigated the ad under CAP Code clauses 2.2 (Responsible advertising) and 5.1 and 5.3 (Decency) but did not find it in breach.

2. Not upheld
We noted THMG's comments and accepted that the photograph in the second panel had not been digitally enhanced.

On this point, we investigated the ad under CAP Code clause 7.1 (Truthfulness) but did not find it in breach.

3. Upheld
We noted THMG's comments in relation to the claim "EASY" and their consultation procedure, particularly in regards to the average length of time and number of consultations required.  We considered, however, that readers could infer from the claim that the procedure was "EASY" and without risk and therefore that they did not need to seek independent medical advice.  Because we understood that surgery always carried a risk to the patient, we concluded that, by promoting a surgical operation as "EASY", the approach was irresponsible and misleading.  We welcomed THMG's assurance that they would not repeat the claim.

On this point, the ad breached 2.2 (Responsible advertising), 7.1 (Truthfulness) and 50.6 (Health & beauty products and therapies - General).

Action
The ad should not be repeated in its current form.

Adjudication of the ASA Council (Non-broadcast)