In 2025, the intricacies of aesthetic treatments took their biggest step yet into the mainstream vernacular, as has the number of individuals who wish to explore, have explored, or publicly endorse such treatments – whether surgical or non-surgical – with the marked rise of (in particular) public figures taking to social media to disclose previously undiscussed procedures.
In millennial and Gen Z circles, a flashpoint was Kylie Jenner’s June disclosure on social media in which she provided the exact details of her 2019 breast augmentation to a fan (having revealed that she had undergone this procedure in 2023)[1]. Other celebrities who have reportedly disclosed having undergone, stopped or reversed aesthetic treatments in 2025 include pop star Sam Smith, reality star Molly-Mae Hague, and decorated Olympian Simone Biles.
Naturally, with increased public debate about aesthetic treatments, comes increased criticism and concern. Articles[2] and investigations published late last year by ITV News[3] and The Telegraph[4] lay bare these wider concerns (including from the Health Secretary Wes Streeting) about the need for increased regulation in the industry and cracking down on so-called ‘cosmetic cowboys’, i.e. those who are not suitably qualified performing high-risk procedures such as Brazilian butt lifts[5].
For those practitioners in medical aesthetics, one’s reputation is therefore already – and has always been – inherently vulnerable and exposed to attack – not only due to the industry’s uniquely competitive nature but also because this reputation hangs on a relationship of complete trust between a patient and the practitioner. This fragility is only compounded by burgeoning public debate as to how much trust one can, and should, have in their practitioners. Practitioners should expect such debate to continue to grow in 2026.
It is against this backdrop, and the realities of a 24-hour news cycle and the fact that ‘citizen journalists’ are increasingly publishing reviews of treatments, practitioners or clinics in real-time on social media, that a growing number of practitioners and clinics are finding themselves, often entirely unfairly, at the receiving end of sophisticated and / or sustained campaigns of defamation by former patients or even former colleagues.
This article outlines how such a campaign of defamation might be broadly triaged, and examines some practical steps that clinics and practitioners can (and should) take in response to media enquiries and to proactively mitigate reputational crises from arising.
Tackling a campaign of defamation
Reputational attacks can range from the publication of a single Google review containing provably false statements of fact to a complex and sophisticated campaign waged across several different review and / or social media platforms, involving numerous anonymous publishees or even through the use of third-party ‘pay to post’ entities (who are often based outside of the jurisdiction of England and Wales) which bad actors can pay to publish content which is untrue and defamatory about a clinic or practitioner.
It should go without saying that, with clinics and practitioners so stringently regulated by the General Medical Council (GMC), Care Quality Commission (CQC) and other bodies, allegations of this nature can be devastating to reputations and brands overnight. This is why we would always recommend engaging the experts early so that they can assist immediately where it appears that an allegation or review goes beyond reasonably held opinion. Such experts may not only be specialist reputation management lawyers; in these cases, lawyers may often work with specialist digital investigators (where posts have been made anonymously) and / or PR firms to gather the necessary evidence and ensure a holistic approach is followed.
With the above being said, there are four general principles to consider when tackling a campaign of defamation:
- Whether engaging directly with the parties in question will assist: including whether this engagement should come from the clinic / practitioner or from lawyers, weighing up the likely risk of the allegations gaining further traction or publicity in the process. If the clinic or practitioner practices good customer service recovery techniques, direct engagement with a patient complaint can be sufficient. However, if a campaign of defamation is extensive and sophisticated, engaging directly with the alleged perpetrator may not be appropriate and could even worsen matters.
- Any public response: including an ‘on the record’ statement on the clinic’s / practitioner’s website of any action being taken and the true position. This is where PR teams can provide effective assistance.
- Sending a formal letter of claim: where appropriate and advised, a firm letter from specialist lawyers such as Carter-Ruck, particularising the unlawful conduct and requesting appropriate remedies, is often an effective deterrent in itself.
- Pursuing legal proceedings: which must be subject to the other principles outlined above, and any response to a formal letter of claim. Pursuing proceedings is always a last resort (and is therefore rarely pursued) due to the inherent risks of litigation as well as the significant time, costs and stress of the same. Defamation is, by its very nature, a public vindication of one’s reputation and a public legal action is not always in the best interests of either party.
How to handle press enquiries
With a public reputational onslaught can also come press interest if the allegations are particularly widespread or serious, or otherwise if a clinic or practitioner has a public profile.
It is commonplace for specialist media lawyers and / or PR teams to deal with press enquiries on behalf of clients, with the clear objective of seeking to prevent the publication of false, defamatory and / or inaccurate allegations being published. Such engagement can result in no article at all or failing that, a more balanced piece. It is, however, sometimes appropriate for lawyers to draft a response behind the scenes to be sent by a client.
Should you receive a press enquiry, however, it is good to keep the below three principles in mind:
- Time is of the essence: journalists tend to work against and give short deadlines (sometimes mere hours), which often (particularly with a newsworthy / topical piece) they will not extend;
- It is rarely a good idea to ignore a media enquiry: the journalist is otherwise able, and likely, to report that you could not be reached for comment and invite the reader to draw their own inference about this; and
- Always ask for the questions in writing and respond in writing: to prevent being misquoted and / or misunderstood, which can naturally happen if you are bounced into quick, ill-thought out answers on the phone.
Tips on proactive reputation management and brand protection
As set out above, it is crucial to practice proactive reputation and brand management, particularly in such a dynamic and changing industry, when thinking about safeguarding your brand long-term. This is unfortunately often forgotten, but is ultimately fairly straightforward to engage with.
Indeed, such proactive steps include:
- Undertaking a “reputation audit”: e.g. a review of a clinic’s or practitioner’s digital footprint / online presence. Such audits can be conducted by a clinic or practitioner themselves, or in conjunction with specialist reputation management lawyers, digital investigations firms and / or PR teams to advise on current risk factors and formulate a comprehensive media strategy. An easy ‘at-home’ step is manually keeping a close eye on review sites and developing a consistent approach with this, which can be a very effective means of proactive reputation management. For instance, although setting up Google alerts for your name / brand are helpful, these do not pick up social media or Trustpilot reviews.
- Considering your data protection and privacy obligations: whether this is ensuring (or taking advice to ensure) that: (i) consent forms are up-to-date and adequately protect your rights; (ii) privacy notices are compliant; (iii) proper procedures and safeguards are in place to protect highly sensitive medical information; and / or (iv) you are confident in handling and responding to patient or employee data subject access requests (or “DSARs”).
A strong reputation is paramount in such a competitive industry, with an ever-growing number of practitioners and / or clinics offering the ‘latest’ or the ‘safest’ procedures, particularly amidst a cacophony of traditional and citizen journalists, as well as critics ranging from government officials to beauty influencers. A strong reputation is therefore also hard-won and warrants robust protection, both proactively and (if necessary) reactively, whether you are a franchise or practitioner with decades of experience, or are more junior in your career and looking to carve out a unique identity and patient base.
If you have found yourself at risk of, or are currently experiencing, reputational challenges similar to those outlined above, please do feel free to call or email us at any time. We have a 24-hour, 365 days of the year crisis management response team for urgent enquiries.
Isabella is an Associate at Carter-Ruck, and has a particular interest and experience in reputation management strategies for medical practitioners, and specifically those in aesthetic medicine. She was a key speaker at both the 2024 Aesthetics Conference & Exhibition (ACE) for Alma Lasers UK and the Teoxane XPAND Conference in October 2024. Isabella has also organised and participated in a two-part webinar series run by Teoxane UK Limited for medical professionals.
The guidance note above is provided for information only and is not intended to represent legal advice.
[1] Kylie Jenner Just Told TikTok Everything About Her Breast Implants | British Vogue
[2] Botched fillers left Hull woman ‘looking like a gargoyle’ – BBC News
[3] Health Secretary pledges to clamp down on cosmetic surgery ‘cowboys’ operating abroad – Latest From ITV News
[4] I visited five Botox clinics in one day. Three of them were willing to break the law
[5] Crackdown on unsafe cosmetic procedures to protect the public – GOV.UK
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