The marketing of medical and cosmetic tourism services: time for a facelift?


The marketing of medical and cosmetic tourism services: time for a facelift?  

Regulators are likely to increase their focus on the regulation of the cosmetic and ‘wellness’ sector; not least on how this sector is increasingly fusing with medical tourism and package holidays. According to the British Beauty Council, the cosmetic and personal care sector supported a total GDP contribution of £24.5 billion in 2022.

In April 2022, the Health and Care Act 2022 introduced the power to introduce a licensing regime for non-surgical cosmetic procedures in England. The purpose of the scheme is to ensure that consumers can be confident that the treatment they receive is of a high standard.  

With this domestic background and increasing concern about poor quality cosmetic treatments both home and abroad, travel operators should heed the enforcement picture and take particular care when offering cosmetic package holidays or packages linked to the provision of cosmetic interventions.

Indeed, the Advertising Standards Authority (ASA) has recently turned its attention to the marketing of cosmetic treatment abroad – and issued an enforcement notice threatening action against providers who breach advertising codes and standards after 29 February 2024.

Recent ASA decisions highlight how travel operators could find themselves subject to criminal enforcement action under the Package Travel Regulations (PTR) 2018 or the Consumer Protection from Unfair Trading Regulations 2008 (CPRs) by involving themselves in any marketing of cosmetic tourism services which could be regarded as misleading.

Advertising is regulated by reference to the UK Code of Non-broadcast Advertising, Sales Promotion and Direct Marketing (the CAP Code) and associated guidance which sets out a number of principles. The following are key here:

  • Ads must not mislead as to what an advertised intervention is likely to achieve for the average consumer. 
  • Marketers should not imply that invasive surgery is a “minor procedure” or similar if that claim is 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. Marketers wishing to make secondary claims about an intervention, such as that it is “suitable for all”, “pain-free”, “without side-effects” or similar will need to hold evidence to that effect.

The ASA Enforcement Notice sets out the following guidance:

Guidance #1 - Do not trivialise the decision to undergo cosmetic surgery: The decision to undertake an invasive medical procedure is a serious one. Marketers must therefore ensure that cosmetic surgery is always be portrayed as something that requires time and thought from consumers before proceeding: 

  • Avoid the focus of your ad being on aspects such as hotel stays or flights, rather than the surgery or intervention itself; this could have the effect of trivialising the decision to undergo cosmetic surgery. 
  • Similarly, do not focus the shift onto ancillary aspects, such as by making references to going on “holiday”, “vacation” or “5-star package”, as this may have the effect of detracting from the seriousness of any surgery and should therefore be avoided. This is particularly important given that those phrases are closely associated with holidays. 
  • Avoid focusing purely on any “feel good” element of physical transformation or suggest that the decision to have cosmetic surgery could be undertaken lightly, for instance by suggesting that it could form part of a New Year’s resolution or a summer holiday; this might also detract from the seriousness of any surgery. 
  • Take care with your imagery, wording, and even use of emojis. All of these can make a difference to the overall tone and therefore acceptability of an ad; the more invasive the procedure, the less trivial, flippant, and light-hearted the ad should be.

Guidance #2 Manage expectations: ensure transparency around any packages, consultations, and potential risks & results of cosmetic surgery: Advertisers must be careful not to mislead by omitting any material information that consumers would need in order to make an informed decision in relation to undertaking cosmetic surgery. 

  • Ensure that you make the basis of any “all inclusive” packages suitably clear. Although the nature of cosmetic surgery means that it isn’t always possible to calculate a final cost upfront, clinics must avoid advertising misleadingly low headline prices to attract consumers, only for costs to unexpectedly escalate further down the line. Whether you are advertising package prices or providing itemised price lists, be clear on exactly what is and isn’t included within your advertised costs. 
  • Ensure that you provide information about any pre-consultations to assess any potential contraindications and general suitability for patients, and any additional consultations which might take place before or after surgery, including where those consultations will take place. This is particularly important where services are offered abroad rather than in the UK because of the potential for additional risks, such as whether the doctors and treatment providers have the same standards of care and safety as in the UK, and how any arrangements for follow-up care, or dealing with any complications, might be managed. Information about pre-consultations must be included within the ad itself and not just on your clinic website or within information provided separately to prospective patients.  
  • Do not imply that invasive surgery is a “minor procedure” or similar if that claim is 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 similarly not mislead as to the likely time commitment required for pre-consultation, surgery, recovery, and post-operative assessments. 
  • Similarly, do not offer to “Guarantee safety” or refer to procedures as “safe”. Any cosmetic surgery carries inherent risks; to claim otherwise is irresponsible and misleading. 
  • Do not exaggerate the effectiveness or imply an unrealistic result of any particular cosmetic surgery, through visual means or otherwise. Care should be taken to ensure that any imagery accurately depicts any physical transformations as a result of a particular procedure, and any images representing people “before” and “after” surgical procedures as part of customer testimonials should be genuine. Similarly, marketers should avoid claims such as “get the body you always dreamed of” or “99% success rates”; these could also create unrealistic expectations, and as such, would be likely to mislead. 
  • Avoid making superiority claims or comparisons with unidentifiable competitors (e.g., “Leading Experts” or “No.1 Clinic”) without suitably clarifying the basis of such claims (as well as ensuring that you hold appropriate substantiation).

Guidance #3 Ensure you advertise in a socially responsible manner: Advertisers must ensure that cosmetic surgery procedures are advertised in a socially responsible manner: 

  • Do not market cosmetic interventions to under-18s in the UK.
  • Avoid exploiting consumers’ body insecurities in general terms; ads for cosmetic surgery which portray individuals as only being confident or happy because of surgery are unlikely to be acceptable. 
  • Avoid using gender stereotypes which are likely to cause harm, or serious or widespread offence. For example, care should be taken not to exploit the potential concerns and anxieties that new mothers might experience after giving birth; for this reason, marketers are advised to avoid “mommy makeover” style packages or promotions, because it’s likely that these will have the effect of exploiting body insecurities in new mothers and perpetuate pressure on them to conform to body image stereotypes. 
  • Marketers must not use imagery which is likely to be seen as degrading, objectifying or gender stereotyping. Similarly, whilst a degree of nudity may be acceptable due to the subject matter, gratuitous nudity is very unlikely to be acceptable, and marketers should ensure their ads do not sexualise or objectify the model/s within them.

Guidance #4 Exercise caution around promotions The CAP Code does not prohibit promotional marketing in this sector – cosmetic surgery advertisers are allowed to offer discounts and even sales on their products and services, whether abroad or in the UK. That said, care should always be taken with any promotional marketing for cosmetic surgery: 

  • Avoid pressuring potential customers with time-limited offers, for instance by using phrases such as “Summer Sale”, “Grab this opportunity” or “Fill out the form now for a big Summer campaign”. 
  • Similarly, do not advertise treatments as being discounted for a “limited time only” if this is not actually the case; consumers must not be pressured into making a rushed decision to purchase cosmetic surgery due to apparent time-limitations.
  • Avoid irresponsibly pressuring potential customers into undertaking more cosmetic surgery interventions than necessary, for instance by offering discounts on multiple procedures e.g., “Up to 30% discounts on combined operations”.
  • Take care to clearly outline all significant Terms and Conditions associated with any promotions. For the purposes of the CAP Code, T&Cs are considered significant if they are likely to affect a consumer’s purchasing decisions.

Trading Standards have the responsibility for enforcing PTR 2018 and CPR 2008 and travel providers should be aware of their criminal liabilities should they be found guilty of providing inaccurate or misleading information to consumers. The CPRs prohibit misleading descriptions that cause, or are likely to cause, the average consumer to take a 'transactional decision' they would not have taken otherwise. This does not only relate to pre-shopping but includes after-sales. Reference is likely to be made to the ASA decisions and Enforcement Notice Guidance when considering action.

Whilst cosmetic and medical tourism thrives, supporting businesses and no doubt making some people very happy – there is an urgent need for marketing to be realistic and responsible.  Time for travel operators to give their adverts something of a facelift perhaps.  

For further information please contact Seray Genc or Tom Walker.