“The cosmetic surgery industry needs to grow up before it is forced to do so by law,” warns Steven Taylor, marketing director at the Transform Cosmetic Surgery Group, which has overhauled its marketing strategy in light of increased pressure from lobby groups to ban cosmetic surgery advertising altogether.
The sector, which is set to be worth £3.6bn by 2015 according to Mintel, has exploded in recent years, fuelled by TV shows such as The Only Way is Essex, whose characters talk about cosmetic surgery as freely as others might talk about make-up. But it has also been dogged by scandal.
Cosmetic surgery has long been blamed for promoting an unhealthy body image among impressionable teens, but it was the lack of product quality and adequate record-keeping exposed by the PIP breast implant crisis in 2011 as well as the widespread use of “misleading” and “inappropriate” advertising that caused the Government to launch an independent review into the sector. Carried out by NHS medical director Sir Bruce Keogh, the results were published earlier this year (see box, below).
It’s a big money business, which has even lured in electronics tycoon Lord Sugar, who is to invest £250,000 in The Apprentice winner Dr Leah Totton’s proposed chain of cosmetic treatment clinics.
But the newly qualified doctor, who only received her General Medical Council registration last August, has been slammed by industry bodies and clinicians for her dangerously inadequate credentials for the project.
Transform’s Taylor agrees that “she almost certainly would not qualify by Transform’s standards” but believes Totton and Sugar are coming at the venture with the right motives and have helped highlight the importance of clinical standards to a wider audience.
However, he is sceptical about how far the £250,000 investment will go.
“In the first year it costs Transform £300,000 to set up a clinic, which involves fitting it out to meet Care Quality Commission (CQC) standards and having appropriate levels of infection control, air conditioning and staffing,” he says. “I’m sure they will make it a success but if they’re making it a success for £250,000 they must be compromising on clinical care somewhere along the way.”
That it has been suggested Totton should be the face of the brand has also caused outrage among lobby groups, who say the use of celebrities to front marketing material for cosmetic surgery is irresponsible.
As part of its marketing code of practice Transform has pledged it will never use celebrities to promote the virtues of cosmetic surgery. It does, however, work with what it calls “role models” including TV presenter Melinda Messenger and Daybreak doctor Hilary Jones, who are members of the group’s Clear panel which strives for better patient care and more transparency.
The fact that some competitors are using celebrities in their marketing is reprehensible
“We don’t use Dr Hilary to promote cosmetic surgery,” says Taylor. “We use him to convey the message that people should do their research and look behind the veneer of the glossy world of celebrities before signing on the dotted line.”
MYA Cosmetics, which backs all the recommendations outlined in the review, counts glamour model Imogen Thomas and several TOWIE cast members among its clients, and has used celebrities to front ad campaigns in the past. But it is a practice marketing manager Michael Tilley says the brand is trying to move away from.
As part of this transition the company created an online campaign for its Vaser liposuction procedure featuring “real women” pinching extra flesh around their stomach and thighs but the ads were reportedly rejected by a number of big publishers as they were not “aesthetically pleasing”.
“We don’t plan on using celebrities as our main ambassadors anymore and this ad campaign was an attempt to move away from that,” he says. ”I wasn’t expecting the reaction it got at all – far from it. We then tried recreating the images as illustrations but they still weren’t happy so in the end we just went with text.”
Although Tilley admits he is loath to change the brand’s marketing strategy he concedes “we will obviously need to adapt our approach slightly to get ads out in the first place but we’re not going to compromise our views for the sake of a publisher”.
Sceptics have suggested MYA’s claim could be a PR stunt to help distance itself from the use of celebrities in light of the review, with one exclaiming “imagine the outcry if Cosmopolitan rejected Dove’s real women”, but no publishers would confirm whether they had rejected the advertising.
Transform’s Taylor says more could be done by media owners to ensure they only run ads from reputable companies.
“Perhaps they could say they will only carry ads from responsible providers that have a clean bill of health from the CQC,” he suggests.
Taylor also believes it is a case of ’the left hand not knowing what the right hand is doing’ with some media owners, and highlights a recent feature in the Mail on Sunday that questioned whether cosmetic surgery advertising should be banned but was followed by an ad for liposuction.
One of the recommendations outlined in the Keogh review was that time-limited deals and other sales promotion activities should be abolished.
“People should be making their decision based on who offers the best clinical care and after-care, the qualifications of the practitioner and whether the treatment will take place in a regulated environment,” says Taylor. “As soon as you start muddying the waters with promotional offers it undermines the things that should be really important to patients.”
Transform no longer offers promotions of this kind and, as instructed by the Independent Healthcare Advisory Service’s voluntary marketing code, also omits pricing from all press and TV advertising, instead inviting those interested to visit its website.
However, these measures do not go far enough, according to feminist group UK Feminista, which has called for a ban on all cosmetic surgery advertising – as there has been in France since 2005 – as it says it “ruthlessly preys on women’s body anxieties to generate profit”.
Since launching its Cut It Out petition the group has racked up significant support in its quest to outlaw advertising in the sector, with signatories including the British Association of Aesthetic Plastic Surgeons (BAAPS).
BAAPS council member Charles Nduka says: “In the UK it is illegal for a company to advertise prescription treatments to the public because they can do harm. The same should apply for cosmetic surgery, especially when it is being advertised in a way that gives the impression these are simple procedures with no risks or complications.”
At the very least BAAPS is urging the Government and the Committee of Advertising Practice to enforce stricter regulations including the prohibition of all advertising aimed at under-18s, advertising in public places where children could see it, discounted offers and financial incentives, and the use of models or real-life patients that raise unrealistic expectations.
Nduka adds: “It’s reasonable for potential clients to be informed about their options but it must not be done in a way that coerces, misleads or influences minors or the impressionable. We can’t have this reactive approach where companies are allowed to put out an inappropriate ad that is then taken down weeks later. This process is clearly not appropriate for the cosmetic surgery industry and therefore it should not be governed by the same rules as those who are selling toilet cleaner.”
The Keogh Review
The Government enlisted Sir Bruce Keogh, medical director of the NHS, to undertake a review of the cosmetic surgery industry, including its marketing practices, following the PIP breast implant scandal, the results of which were published in April this year.
Key recommendations include:
- Existing advertising recommendations and restrictions must be updated and better enforced.
- The use of financial inducements and time-limited deals to promote cosmetic treatments should be prohibited to prevent vulnerable consumers from being inappropriately influenced.
- Legislation should be introduced to classify cosmetic fillers as a prescription-only medical device.
- All those performing cosmetic interventions must be registered.
- A breast implant registry should be established within the next 12 months and extended to other cosmetic devices as soon as possible to provide better monitoring of patient outcomes and device safety.
- A Department of Health spokesperson says: “The stories that emerged from the PIP scandal revealed some examples of extremely bad practice in the cosmetic interventions industry. The independent panel has made some far-reaching recommendations, the principles of which we agree with entirely. We will consider the report carefully and respond in detail in the autumn.”
Marketing Week (MW): How have TV shows such as The Only Way is Essex affected the cosmetic surgery industry?
Steven Taylor (ST): There’s no doubt they have raised the profile of cosmetic surgery, and particularly non-surgical treatments like Botox and fillers. So on one level you could say it’s good for the sector as there’s greater awareness but it’s only good if the patients getting the procedures are doing their research and getting them done in regulated premises by qualified people.
MW: Do you think the use of celebrities to promote cosmetic surgery is acceptable?
ST: We will never use a celebrity in our advertising to promote the virtues of cosmetic surgery, which is in our marketing code. We are conscious of how high-profile [TOWIE] is and how influential all the characters are but we think it’s wrong they are being used as a voice to encourage younger people to undertake cosmetic surgery. The fact that some of our competitors use them in their marketing is reprehensible. We hope that, when the Government legislates, this will be one of the things it clamps down on.
MW: Cosmetic surgery is often seen as a female-focused industry, so how do you look to target men?
ST: Four years ago just 2 per cent of Transform’s clients were men, which was hardly surprising as the marketing wasn’t set up for men in any way. By doing simple things we’ve managed to turn that around and men now account for 15 per cent of our client base. We now have a dedicated brochure for men, we have pictures of men on the website and we make sure we talk about procedures that are important to men. We also try to be more factual and numerical in our tone rather than emotional, as we find that’s what appeals to men.