The company Aesthetify, known for its influencer doctors “Dr. Rick and Dr. Nick,” had promoted its services using before-and-after photos. However, Germany’s Federal Court of Justice (Bundesgerichtshof, or BGH) has now ruled that such image comparisons are prohibited in advertising for minimally invasive aesthetic procedures.
BGH: Hyaluronic Treatments Count as Surgical Procedures
In its ruling against Aesthetify, headquartered in Recklinghausen, the BGH determined that hyaluronic acid injections—even though they do not involve a scalpel—must still be classified as surgical, plastic-cosmetic procedures. As such, they are subject to advertising restrictions outlined in Germany’s Therapeutic Products Advertising Act (Heilmittelwerbegesetz), which prohibits promotional content for cosmetic surgeries that are not medically necessary.
Aesthetify operates six locations across Germany and offers treatments such as non-surgical nose reshaping and lip enhancements using hyaluronic acid or Botox. The company had posted side-by-side before-and-after images of patients on Instagram and its website—an advertising method the BGH has now found to be unlawful.
Consumer Advocates Cite Legal Violation
The North Rhine-Westphalia Consumer Protection Agency filed the lawsuit, arguing that the use of before-and-after photos clearly violates the Therapeutic Products Advertising Act. This law forbids visual comparisons for plastic surgery procedures unless there is a valid medical reason. The central legal question was whether minimally invasive treatments using a needle—but no scalpel—also fall under this regulation.
The BGH answered with a clear “yes.” Injecting hyaluronic acid to alter the appearance of facial features like the nose or chin qualifies as a surgical intervention. The court emphasized that the purpose of the advertising ban is to protect the public from downplaying the seriousness of such procedures and to reduce associated health risks.
Court Dismisses Company’s Arguments
Aesthetify had argued that the treatments were not surgical, as they were not performed by surgeons and did not require surgical instruments. They claimed the risks were minimal and comparable to getting ears pierced or tattoos. However, the BGH rejected this view, stating that piercings and tattoos only affect the skin’s surface, while hyaluronic injections penetrate deeper tissue layers and must therefore be classified as surgical procedures.
The court’s decision upholds an earlier ruling by the Higher Regional Court of Hamm (Case No. I ZR 170/24).
Hyaluronic Treatments Remain Popular Despite Criticism
Despite legal restrictions, hyaluronic acid treatments continue to enjoy widespread popularity in Germany. According to the International Society of Aesthetic Plastic Surgery (ISAPS), approximately 280,000 such procedures are performed annually in Germany. Hyaluronic acid is a gel-like substance that plumps skin tissue, reduces wrinkles, and improves firmness and elasticity. It is especially popular for lip enhancements, although the results typically last only a few weeks or months. While demand continues to grow, critics warn about possible long-term side effects and stress the importance of thorough medical counseling.
Sources: dpa, AFP, KNA
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