A post on Instagram shows the back of a woman in tight blue leggings, her lower body taking up most of the frame. The words “Temptingly sexy curves ahead … Ready to turn heads and break hearts?” are written in the caption. It is from a company offering Britons the chance to get a Brazilian butt lift while enjoying a luxury holiday abroad.
The advert is one of thousands on social media promoting cosmetic surgery tourism by companies in Turkey to UK residents, including gastric band operations, hair transplants and Brazilian butt lifts (BBL) – a process that involves fat taken from elsewhere on the body being injected into the buttocks – in a trend that has triggered safety concerns among doctors in Britain.
Guardian analysis of the Facebook ad library found almost 2,700 adverts promoting BBLs alone since May 2022. Many adopted a similar format: advertising the trips as part of a holiday.
It has become such a problem that the Advertising Standards Agency (ASA) has issued a warning to cosmetic providers abroad, setting out strict rules on promoting them. The watchdog said it had recorded an increase in ads targeting UK consumers for these services, with many examples of advertising rules being broken.
Hammered by the coronavirus pandemic, workforce shortages and a chronic lack of social care capacity, the UK health system is under acute strain. Record numbers are paying for private healthcare, including spending up to £3,200 to have a cataract removed and £15,075 on a new hip, amid growing frustration at NHS waiting lists.
Hundreds of thousands are choosing to go abroad. The Office for National Statistics estimates that in 2019, 248,000 UK residents travelled overseas for treatment, up from 120,000 in 2015.
Turkey is the number one destination. In 2022, the country welcomed 1.2 million people for healthcare procedures; medical tourism is to bring £2bn into the country every year.
On the cosmetic surgery side of things, social media and reality TV shows such as Love Islandhave promoted a certain aesthetic. People are keen to improve their looks, but at a cheaper price than available in Britain. In June last year, as Love Island aired, searches for “Turkey teeth” – slang for dental veneers gained on a cosmetic holiday to the country – reportedly increased by 10,000% overnight. It came after the contestant Jess Harding described her type as a “pretty boy with Turkey teeth”.
As a result, adverts are increasingly appearing on Instagram and Facebook to appeal to consumers. But experts are concerned.
Nora Nugent, the vice-president of the British Association of Aesthetic Plastic Surgeons, said: “Turkish clinics advertise package deals including hotel and flights, and patients see what looks like a reasonable package. But what you are not supposed to do is promote it as a holiday or trivialise what it’s about. You are not meant to trivialise risk and advertise these operations as holidays.”
She added: “It’s not meant to be glamorised … or promise unrealistic outcomes, such as a guaranteed breast size.”
The ASA advises that adverts should bear in mind that linking surgery to a holiday may trivialise the decision to undergo the procedure.
The Committee of Advertising Practice (CAP) – the industry body responsible for the UK’s advertising codes, which is administered by the ASA – has also begun enhanced monitoring to identify and tackle irresponsible ads. Shahriar Coupal, the CAP director, said: “Every year, many people go abroad and have positive experiences undergoing cosmetic surgery. But as more companies are advertising to UK customers, we’re also seeing more examples of the rules being broken. This needs to stop.”
One advert from Clinichub – a company promoting itself as “your trusted health tourism agency in Turkey” – which started running in January, reads: “Transform with confidence through BBL, breast surgery, tummy tuck, rhinoplasty and more. Experience the pinnacle of service where your journey is not just a procedure, but a luxurious stay in five-star hotels, surrounded by the enchanting beauty of Istanbul.” The Clinic Hub did not provide a comment.
Another post publicised in February by Dr Süleyman Özer, who advertises online as “Best Doctor Turkey”, asked consumers: “Wouldn’t you like to feel happy as well?” It continues: “With modern technology and reliable surgical methods, you can achieve the appearance you’ve always dreamed of.” The advert also includes a photograph that promotes BBLs, tummy tucks and rhinoplasty at 30% off. Özer did not reply to attempts to contact him for comment.
In 2022, the ASA upheld a complaint about an email ad for cosmetic surgery that stated a procedure could improve wellbeing and skin condition, increase energy levels and help customers get more sleep.
The health minister Maria Caulfield said: “All cosmetic procedures carry risks, and this is an important step in cracking down on irresponsible adverts aimed at vulnerable people in the UK.”
At least 25 British citizens have died during medical tourism trips to Turkey since January 2019, according to the Foreign Office. BBLs carry the highest risk of all cosmetic surgeries – at least one death occurs for every 4,000 procedures.
Last year UK government officials met their Turkish counterparts after the death of a woman prompted concerns that people may underestimate the risks of pursuing cosmetic surgery overseas. Melissa Kerr, 31, from Gorleston in Norfolk, travelled to the private Medicana Haznedar hospital for buttock enlargement surgery in 2019. She died at the hospital on the day of the surgery.
Nugent welcomed the ASA warning about cosmetic surgery tourism ads but questioned how enforceable action by the UK advertising watchdog would be against companies based overseas “and outside of their area of jurisdiction”.
She said: “These ads have a big influence, particularly on Instagram and especially with younger patients as they use these platforms to research procedures … There are also private Facebook groups with previous and prospective patients running. Companies set them up and people request to join. They are run for UK patients as well, and it’s another way social media influences decision-making when it comes to cosmetic surgery.”
