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Federal Court of Justice: Before-and-after photos of injections are taboo

Technical article on medical device law

Federal Court of Justice: Before-and-after photos of injections are taboo

Anyone using "wow"-effect photos to advertise beauty treatments on social media will have to exercise significantly more restraint in the future: The Federal Court of Justice has ruled that before-and-after images are inadmissible even for minimally invasive procedures such as hyaluronic acid injections when they concern aesthetic treatments that are not medically necessary.

The trigger was a legal dispute between the Consumer Advice Center NRW and the clinic/practice brand Aesthetify GmbH, who had advertised injections via Instagram using before-and-after photos.

What exactly did the Federal Court of Justice (BGH) decide?

The Federal Court of Justice (BGH) clarifies: Even a treatment “with an injection” can be considered a surgical-plastic procedure within the meaning of the law governing advertising of medical products if it alters the form or shape – for example, in nose or chin corrections using hyaluronic acid. The decisive factor is not the scalpel, but the instrumental intervention (e.g., cannula/syringe) to alter the body.

The Federal Court of Justice (BGH) has thus upheld the decision of the lower court (among others). Higher Regional Court of Hamm).

What does the law on advertising medicinal products say about this?

The core provision is Section 11 of the German Act on Advertising of Therapeutic Products (HWG): Before-and-after pictures are prohibited when advertising medically unnecessary cosmetic surgery procedures to laypersons. The law aims to prevent people from being induced to undergo procedures through particularly suggestive presentations without realistically assessing the risks.

Why is before-and-after advertising so problematic?

The legislator (and now also the Federal Court of Justice) aims primarily at protection against deception:

Before-and-after photos quickly create the impression of a virtually guaranteed success.
Risks, side effects and complications are typically not communicated in the image format.
In practice, results are individual (skin type, anatomy, healing process) and cannot be reliably “copied”.

The case of "Dr. Rick & Dr. Nick" – what was it about?

The focus was on the controversy surrounding Aesthetify's online advertising. Consumer Advice Center NRW He saw the comparison images as a violation of the German Advertising Act for Medicinal Products (HWG) and sued for an injunction – successfully up to the Federal Court of Justice (BGH).

In connection with the proceedings, reports also addressed the self-presentation of the two as "Dr." and their communication regarding their qualifications; these points were present in the public debate, but are to be separated from the Federal Court of Justice's ruling on the advertising ban on the images.

Impact on medical practices, clinics and influencers

For providers of aesthetic treatments, the decision represents a significant restriction of current advertising practices. Before-and-after images on websites, social media channels, or in online advertisements may now have consequences under competition law.

At the same time, the consumer protection agency points out that practical enforcement remains a challenge. Controls are limited, so tips from the public will continue to play an important role. Nevertheless, the ruling is intended to send a clear signal.

What consumers are advised to do

Anyone considering cosmetic injections should not be guided by idealized portrayals on social media. Crucial factors are qualified medical advice, transparent information about the risks, and realistic expectations regarding the potential outcome.

Consulting experienced doctors and having a detailed personal conversation remain the most important protection against wrong decisions.

Conclusion

With its ruling, the Federal Court of Justice draws a clear line for advertising in the field of aesthetic medicine. Before-and-after photos are inadmissible for purely cosmetic procedures – regardless of how "gentle" or "minimally invasive" they are portrayed. For consumers, this means greater protection against misleading advertising; for providers, it means a stronger obligation to communicate objectively and responsibly.