An ad published in Index Magazine, distributed in Tonbridge and Tunbridge Wells, for rtwskin, a clinic providing procedures including dermal fillers, seen on 29 October 2018, showed a photograph of three young women looking at a magazine together. Text stated "We understand, it's concerning, but Dermal fillers are very quickly becoming as commonplace as getting your hair done these days and even more so within the younger age group. Is your daughter beginning to take an interest in LIP FILLERS? Recently, we have seen an increase in young girls visiting our clinic for procedures such as Dermal Filler. In many cases, these girls have been brought in by their own mothers, who would rather help them find somewhere safe and suitable with experienced and accredited practitioners than simply telling them 'no' and letting them go behind their backs, blindly searching for the cheapest practitioner without realising the risks involved with these types of procedures ... Education is key when it comes to cosmetic enhancements which is why we offer complimentary consultation [sic] for mothers and their daughters - so together you can discuss your concerns with an experienced professional". Another photograph showed a woman having a filler injected into her lip.
The complainant challenged whether, by encouraging children to undertake cosmetic procedures and by undermining their body image, the ad was irresponsible.
Royal Tunbridge Wells Skin Clinic t/a rtwskin said their establishment was doctor-led and employed 12 people, four of whom were health professionals. They said that, as well as enquiries from younger people about dermal filler for lips, they also dealt with dermal filler revisions on young people who had experienced poor outcomes from treatment carried out by untrained and inexperienced therapists. They had been approached by a 20-year=old member of staff who was aware of such concerns in her peer group and who suggested and wrote the ad, which was then signed off by the Director of the clinic. They said that of those consulted as a result of the ad, approximately 30% had gone ahead with treatment, which rtwskin described as minimal and subtle, with the rest being given information to make an informed decision. rtwskin considered the decision to run the ad had been a responsible one, with a positive outcome. They said the images used in the ad were representative of those they wished to engage with and that images of children were not used. They believed the ad had fulfilled a need and intended to run similar ads in future.
rtwskin supplied a statement by the author of the ad, in which she expressed concern at what she considered to be the nonchalant attitude she had seen among those choosing a practitioner and a clinic for their treatment. She believed her peer group (aged 15–25 years old) to be particularly vulnerable to the messages put out by reality TV shows and social media, and believed education and discussion of the subject was important.
Index Magazine said they had not considered at time of publication that the ad would raise concerns. On receipt of a complaint made direct to them, they contacted rtwskin, who told them that in many cases they had talked clients out of having the procedure as a result of discussions with mothers and their daughters together. On receipt of a second complaint, they told rtwskin that they would not run the ad in future. Index Magazine also removed it from their online edition.
The ASA noted that the prominent photograph of the three young women looking at a magazine together was overlaid at the bottom of the image with text which stated "We understand, it's concerning, but Dermal fillers are very quickly becoming as commonplace as getting your hair done these days and even more so within the younger age group". This was followed a little further down by the sub-heading "Is your daughter beginning to take an interest in LIP FILLERS?" and further text which stated "In many cases, these girls have been brought in by their own mothers, who would rather help them find somewhere safe and suitable ...". While the ad made two references to "the dangers of cosmetic enhancements", both were immediately contextualised with the words "if they aren't carried out by a suitable practitioner". We considered those elements created the impression that the risks of lip fillers were associated only with procedures carried out by unsuitable practitioners; that it was normal for teenagers to correct perceived "imperfections" with lip fillers and that, due to their growing popularity, the only choice for parents was between supporting their daughters in seeking treatment from a clinic like rtwskin or leaving them to undertake the procedure themselves somewhere else.
We noted that, while a prescription was not required for lip fillers and that it was not a legal requirement to be over 18 to be given them, the NHS was cautious in the advice it gave to consumers. The NHS advice listed, among other considerations, risks which included rashes, swelling, itching, bruising and infection; the filler moving away from the intended area over time; the filler forming lumps under the skin (in rare cases); and the filler blocking a blood vessel (in rare cases), possibly leading to tissue death, permanent blindness or pulmonary embolism. While the ad warned against going to unsuitable practitioners, it made no reference to the risks that would always be attached to lip filler treatment, wherever one went for it.
We considered that, by presenting lip fillers as normal and safe (if carried out at the right clinic) for young women and teenagers, and something that responsible parents should support, the ad was irresponsible.
We therefore concluded that the ad breached CAP Code (Edition 12) rules 1.3 1.3 Marketing communications must be prepared with a sense of responsibility to consumers and to society. (Responsible advertising), 4.5 4.5 Marketing communications, especially those addressed to or depicting a child, must not condone or encourage an unsafe practice (see Section 5: Children). (Harm and offence) and 5.1 5.1 Marketing communications addressed to, targeted directly at or featuring children must contain nothing that is likely to result in their physical, mental or moral harm: (Children).
The ad must not appear again in the form complained of. We told rtwskin to ensure future ads did not present lip fillers as normal and safe for young women and teenagers and something that responsible parents should support.