An ad for the London Bridge Plastic Surgery clinic, published on 9 February 2016 in the London Metro, stated “LABIA RESHAPING” and further text underneath stated “Achieve a more natural appearance” and “Relieve the discomfort caused by enlarged Labia”.
Five complainants challenged whether the ad, and particularly the references to "a more natural appearance” and “enlarged labia”, was socially irresponsible by encouraging women to be dissatisfied with their bodies and to undertake unnecessary cosmetic surgery.
London Bridge Plastic Surgery Ltd said the ad was for labiaplasty, also known as labia reduction, labia reshaping or female genital plastic surgery. They said labiaplasty was a specialist plastic surgery procedure to reduce the size of and reshape the labia minora (inner lips) and labia majora (outer lips). An abnormally enlarged labia minora and majora could be a source of physical discomfort and psychological distress for women and could be caused by pregnancy and childbirth or even some sports or hormonal effects. They said that 100% of women undergoing labiaplasty were concerned about the aesthetic appearance and were looking for a more ‘natural’ appearance, 91% reported discomfort from clothing, 69% reported discomfort when doing sports and a significant number reported discomfort during intercourse. They did not believe it was socially irresponsible to advertise the availability of such surgery. They said the women undergoing such cosmetic surgery did not consider it to be unnecessary surgery and that they had lived in discomfort and were self-conscious about their condition. They said that rather than encouraging women to be dissatisfied with their bodies they were letting them know that the surgery existed so they could choose to do something about the condition.
Metro said they considered the ad suitable for their readership of young professionals with disposable income and who would not take offence at this type of ad. They had not received any complaints directly.
The ASA understood that it was natural and normal for a woman to have noticeable skin folds around her vaginal opening and, in most cases, this shouldn't cause any problems. It was also natural for the labia minora to vary widely in appearance. We considered that the description of labiaplasty as achieving "a more natural appearance” implied that the pre-surgery labia might be somehow ‘unnatural’ in appearance. We considered that it was irresponsible to imply that any part of a person’s body was not natural in appearance, including because it could encourage them to be dissatisfied with their body, regardless of whether or not it encouraged them to undertake cosmetic surgery.
Regarding the claim, “Relieve the discomfort caused by enlarged Labia”, we considered that the reference to “enlarged labia” implied a medical condition where the labia had increased in size and that the term was imprecise in nature. The reference to “discomfort” made clear that this particular claim related to physical discomfort. We understood that there were some situations in which a labiaplasty might be carried out on the NHS; specifically, where the vaginal lips were obviously abnormal and causing the woman distress or harming her health. If the labia were particularly large and causing a lot of pain or discomfort, a labiaplasty may be carried out, although other measures might be recommended first. It was therefore the case that some women might suffer from labial discomfort and seek a labiaplasty, but not the case that having larger labia was abnormal or would inevitably cause discomfort. We considered that the claim risked encouraging women to view their labia as abnormal, particularly in combination with the reference to “a more natural appearance”. We therefore concluded that the ad was irresponsible.
The ad breached CAP Code (Edition 12) rule 1.3 1.3 Marketing communications must be prepared with a sense of responsibility to consumers and to society. (Social responsibility).
The ad must not appear again in its current form. We told London Bridge Plastic Surgery Ltd not to repeat the claims. We told them to take care when advertising labiaplasty to ensure that they did not encourage women to be dissatisfied with their bodies.