Advertising on the Internet «Dr.

Whether full lips, defined cheekbones, or a beautifully shaped snub nose—anyone can have a lot of changes to their face with Botox or hyaluronic acid. Some providers advertise these so-called minimally invasive beauty treatments with photos showing their clients before and after the procedure. But is this permitted? The question is now before the Federal Court of Justice (BGH) in Karlsruhe.

In this specific case, the North Rhine-Westphalia Consumer Advice Center is suing the company Aesthetify, owned by the well-known doctors and influencers "Dr. Rick and Dr. Nick." The beauty practice's treatments were advertised with before-and-after photos on its website and on Instagram. The consumer advocates from North Rhine-Westphalia consider this a violation of the German Medicines Advertising Act and are suing for an injunction.

German law imposes strict advertising rules for "surgical plastic surgery procedures" that are not medically necessary. According to the German Medicines Advertising Act, these procedures may not be advertised outside of professional circles, for example, "by comparing the physical condition or appearance before and after the procedure." The question at issue in Karlsruhe is whether minimally invasive treatments such as Botox or hyaluronic acid injections are also subject to this ban.

Aesthetify hasn't used before-and-after photos to advertise beauty treatments for "some time now," said Dominik Bettray ("Dr. Nick") in an interview with the German Press Agency before the hearing. This is a shame, however, as they play a huge role for consumers. "It's important that the patient knows what to expect," Bettray says.

"We receive a lot of messages from our patients requesting before-and-after pictures." Bettray himself wouldn't describe the comparison images as advertising, but rather as information for consumers. "Full transparency and full information" are important for them, adds co-managing director Henrik Heüveldop ("Dr. Rick").

According to the doctors, the minimally invasive treatments offered by Aesthetify at six locations across Germany do not fall under the legal prohibition on comparison images. Because they are not surgical plastic surgery procedures, they argue, minimally invasive treatments have "a completely different risk profile," more comparable to a tattoo or ear piercing.

However, Susanne Punsmann, attorney for the plaintiff consumer protection agency, says the Recklinghausen-based company itself lists the risks associated with the treatments on its website. These include swelling, bruising, infections, allergic reactions, and embolisms. However, if before-and-after photos only show the positive end result, there's a risk that consumers will completely ignore the risks of the treatment, Punsmann says.

"Before-and-after pictures are also very common among other providers," explains the lawyer. The market for hyaluronic acid or Botox injections is "huge." Nowadays, other providers are even selling the procedures as "hyaluronic acid to go" in shopping centers, making them seem as harmless as a visit to the hairdresser. But they are not, Punsmann emphasizes.

The Higher Regional Court of Hamm granted the consumer center's lawsuit in August of last year and ordered Aesthetify to cease and desist. It classified the minimally invasive treatments, like the plaintiffs, as surgical plastic surgery procedures within the meaning of the German Medicines Advertising Act. No scalpel or knife is required for this procedure. Any instrument capable of altering the shape and form of organs or the body surface is sufficient, the court stated.

But even if the Federal Court of Justice were to follow the lower court's assessment, attorney Punsmann sees little reason to breathe a sigh of relief. "The market for cosmetic procedures is large and highly competitive," she says. Providers without proven expertise, such as appropriate specialist training, are particularly creative and do not shy away from advertising violations if it allows them to sell their services.

"I therefore assume that, even if the ruling is positive for us, we will soon have the next issues where we will take action against illegal advertising for beauty treatments," says Punsmann. The Conference of Consumer Protection Ministers decided in May to further restrict advertising for cosmetic surgery. "This would be desirable in order to decisively counteract the proliferation of advertising online, and not just by clarifying individual legal issues," the lawyer believes.