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.
A paid-for Facebook ad for AsproMED, promoting cosmetic surgery in Turkey, seen in May 2023.
The caption stated “[megaphone emoji] Are you ready to unleash your inner beauty, dear friend? [star emoji] [briefcase emoji]”, “Look no further than AsproMED, your trusted partner in the realm of medical tourism! [earth emoji] [airplane emoji]”, and “Let us guide you towards the path of radiant transformation! [sparkles emoji] [massage emoji]”.
The ad included a photo of a slim woman holding a balloon while she pointed to her stomach, together with a smaller illustration of a gastric balloon in a stomach. Text next to the image stated “BARIATRIC TREATMENT -Gastric Balloon -Gastric Bypass -Gastric Sleeve -Liposuction -Lifting” and “Get a permanent beauty with Gastric Balloon”. Text underneath stated “4, 5 Stars Hotel + Travel to Istanbul + Professional Team”. Another image featured the Hagia Sophia skyline with several boats in front of it.
The ASA challenged whether the:
1. references to “inner beauty” and “permanent beauty” were irresponsible because they exploited insecurities around body image;
2. ad, which encouraged consumers to travel abroad for cosmetic surgery, was irresponsible because it trivialised the decision to undergo cosmetic surgery;
3. claim “permanent beauty” was misleading regarding the effects of bariatric surgery; 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.
1., 2., 3. & 4. AsproMED did not response to the ASA’s enquiries.
Meta had no comments in relation to the ASA’s investigation.
The ASA was concerned by AsproMED’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.
The ad featured the claims “Are you ready to unleash your inner beauty, dear friend?” and “Get a permanent beauty with Gastric Balloon” together with a photo of a slim woman pointing to her flat stomach. We considered that the references to “inner beauty” and “permanent beauty” together with the image implied that having a body that did not conform to prevailing beauty standards of slimness was a source of concern that could be rectified by surgery. We considered the ad exploited people’s insecurities and perpetuated pressure for them to conform to body image stereotypes. We therefore concluded that it was socially irresponsible.
On that point the ad breached CAP Code (Edition 12) rule 1.3 (Responsible advertising).
The CAP Code required marketing communications to be prepared with a sense of responsibility to consumers and to society.
The ad included references to “4, 5 Stars Hotel”, “Travel to Istanbul” and “medical tourism”, combined with imagery of boats sailing across the Hagia Sophia skyline (a well-known tourist attraction) and various emojis. 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, including the wording and visuals, focused on the travel, 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).
The ad included the claim “Get a permanent beauty with Gastric Balloon”. We considered that consumers would understand the claim to mean that undergoing a gastroscopy, without any other changes, would lead to permanent weight loss.
We understood, however, that NHS Guidance on weight loss surgeries stated that an intra-gastric balloon was only a temporary measure and usually only left in for a maximum of 6 months. It further stated that all bariatric surgeries required commitment to permanent lifestyle changes to prevent weight gain, including following a diet plan, exercise and regular follow-up appointments. We therefore concluded that the claim “Get a permanent beauty with Gastric Balloon” was misleading.
On that point the ad breached CAP Code (Edition 12) rule 3.1 (Misleading advertising).
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 surgery would take place in Istanbul, Turkey, the ad contained no further details about the various procedures advertised. The ad omitted information regarding the need for a pre-consultation to assess the patient’s potential contraindications and suitability for the two procedures advertised, 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 operations, the pain during or after the operation, 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-consultations 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) rule 3.1 and rule 3.3 (Misleading advertising).
The ad must not appear again in the form investigated. We told Aspro Atlantic Medikal Turizm Ticaret Ltd ?irketi t/a AsproMED to ensure that their ads were socially responsible and did not exploit insecurities around body image or trivialise the decision to undergo cosmetic surgery. We also told them not to mislead consumers by claiming that bariatric surgeries can achieve permanent results without other lifestyle changes or 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.