A TV for Ziering hair transplant clinic featured top–down shots of three men with thinning hair, while a different voice-over for each described their negative feelings about hair loss. The third voice-over stated, "Then a friend told me about hair transplant surgery from Ziering" and there were further top–down shots of three men with full heads of hair against the same backgrounds and scenarios as at the beginning of the ad. Voice-overs described the positive aspects of the transplant, and the faces of three men with full heads of hair were then shown against the same backgrounds as the top–down images.
The complainant, who did not believe that the before and after comparisons in the top–down shots were genuine, challenged whether the ad was misleading.
The Hospital Group Healthcare Ltd t/a Ziering stated that they did not believe the ad was misleading or that it contained any exaggeration. They stated that it was a visual representation of hair transplant surgery and encompassed the thoughts and feelings of patients following surgery, with the voice-over based upon a genuine patient's experience at their clinic. They stated that results and testimonials, all of which were provided by genuine Ziering patients, could be found on their website. The end frame of the ad directed viewers to this site in order to find out more about the procedure and view the patient gallery.
Clearcast said the characters’ stories were not genuine testimonials and it was clear that this was the case. They stated that they were not presented in a traditional 'before and after' side-by-side comparison, and the individuals were not identified as 'real' people (as opposed to actors) by inclusion of a name or similar. They said in order to ensure that claims likely to be interpreted as factual did not mislead, they had sought additional input from a consultant to ensure the claims were appropriate. Clearcast stated that, while the images were not genuine in the sense that they did not reflect the experience of an actual consumer, there was no suggestion that they were of actual customers. Clearcast were satisfied that the images were genuinely representative of an experience a consumer would have. They believed that the images were representative of what might be achievable to a typical consumer for this type of service, subject to the consultation mentioned in on-screen text. They said the 'before' images did not show completely bald individuals, but three men with thinning crown areas. They also noted that the voice-over explained that seeing results would take a considerable amount of time (four months) and made clear that patients may require more than one procedure to achieve thicker levels of coverage. Given what they considered to be the conservative nature of the voice-over, which talked about permanence of results for the individuals featured rather than guaranteeing success for everyone, Clearcast were satisfied that the ad did not over-promise. They provided a document outlining the transplant procedure and another document stating that the advertiser considered that the ad was not over-claiming, which linked to the International Society of Hair Restoration Surgery website.
The ad showed footage of men with thinning hair followed by footage of men with full heads of hair. The ASA acknowledged that the statements given by the characters were not taken from customer testimonials and the images were not actual customer 'before' and 'after' shots, and that viewers were likely to recognise this. The ad nonetheless implied that the images depicted the results that the average clinic customer was able to receive. We therefore considered that the advertiser needed to provide robust evidence to demonstrate that their patients generally obtained results akin to those shown in the ad. We acknowledged that images and testimonials could be seen on the Ziering website, but considered that testimonial evidence was insufficient to support the claims in the ad. Consumers were directed toward the site in the endframe of the ad. We considered, however, that the availability of this information, subsequent to viewing the ad, was inadequate to clarify to viewers at the time of watching what results could be achieved. We also noted that two of the characters in the ad appeared to have thicker hair over their whole heads in the 'after' shots. We understood this could not be achieved by hair transplantation because the procedure redistributed hair follicles and did not create them or affect the thickness of the hair strands. In light of the above we concluded that the ad was misleading, because the advertiser had not provided evidence to demonstrate that the results shown in the ad were representative of those generally achieved by their patients. The ad breached BCAP Code rules 3.1 3.1 Advertisements must not materially mislead or be likely to do so. (Misleading advertising), 3.9 3.9 Broadcasters must hold documentary evidence to prove claims that the audience is likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation), 3.12 3.12 Advertisements must not mislead by exaggerating the capability or performance of a product or service. (Exaggeration) and 3.45 3.45 Testimonials or endorsements used in advertising must be genuine, unless they are obviously fictitious, and be supported by documentary evidence. Testimonials and endorsements must relate to the advertised product or service. Claims that are likely to be interpreted as factual and appear in advertisements must not mislead or be likely to mislead. (Endorsements and testimonials).
The ad must not appear again in its current form. We told The Hospital Group Healthcare Ltd to ensure that in future they only used before and after images that they could demonstrate were representative of patient outcomes.