# Med Spa Before-and-After Photos and the FTC Guides

> Can a med spa post before-and-after photos in its marketing? Here is what the FTC Guides actually say, and how to advertise results without the legal risk.

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# How Med Spas Can Advertise Before-and-After Results Within the FTC Guides
The rule everyone repeats, that a "results not typical" line makes before-and-after photos safe, stopped being true in 2009. Here is the actual record, and what to do with it.

By [Jamie Kloncz](https://seoagencynaples.com/jamie-kloncz/), Founder and CEO, SEO Elite Agency ** 15 min read ** Published August 8, 2026

Med spas can publish before-and-after photos. The FTC Endorsement Guides do not ban them. What the Guides do is attach conditions to the claim those images make: hold substantiation for the result, disclose the generally expected performance when the pictured outcome is not representative, and disclose any connection between you and the person shown that the audience would not expect.
Getting this right is a trust problem as much as a compliance one. BrightLocal's consumer research finds only about 4 percent of consumers never read reviews, so effectively every prospective patient is already assessing your evidence [1](#ref-1), and third-party review presence now correlates strongly with whether AI assistants mention a business at all, from roughly 1 percent citation without a profile to 53.5 percent with even a handful of reviews [2](#ref-2). Overclaiming does not just create legal exposure; it is also the thing modern buyers are most practised at spotting.
Two claims circulate constantly in med spa marketing and both are wrong. The first is that a disclaimer fixes atypical results. The second is that the FTC has brought enforcement against med spas over before-and-after photos. We went to the primary Federal Register record for this guide rather than to marketing summaries, and the record contradicts both.

## Before-and-after photos are conditioned, not banned
Nothing in the Endorsement Guides forbids showing a result. The Guides govern the claim an image implies, which is that a prospective patient can expect something similar. Where that is not true, the answer is disclosure of the generally expected outcome rather than removal of the photograph.
Start with what the Guides are, because it changes how to read everything written about them. Section 255.0 describes them as administrative interpretations that provide the basis for voluntary compliance with section 5 of the FTC Act [3](#ref-3). They are not regulations. Practices inconsistent with them may lead to corrective action under section 5, which is the real legal hook, so this is not a reason to relax. It is a reason to be precise, and to be sceptical of any article telling you the FTC "requires" something under the Guides.
What the Guides actually address is the implied claim. An endorsement featuring a specific result is generally read to mean the endorser's experience reflects what others can also expect. So a striking result posted without context is not a photograph in the eyes of the framework; it is a performance claim. That is the whole of the issue, and it is why the fix is contextual rather than a matter of deleting your gallery.
The practical consequence for a med spa is that your best outcomes are still usable. You simply cannot present an exceptional outcome as though it were the ordinary one. Most of the compliance work is therefore about what sits next to the image rather than about the image itself.

## What the Guides actually ask for: substantiation, typicality, disclosure
Three obligations sit behind results advertising. Hold proof for the claim being made, including scientific evidence where appropriate. Where the depicted result is not representative, clearly and conspicuously disclose what consumers generally achieve. And disclose any material connection the audience would not expect.
On substantiation, section 255.2 says advertisers should possess substantiation for claims conveyed by an endorsement, including competent and reliable scientific evidence where appropriate [3](#ref-3). In practice that means you should be able to explain, before publishing, what evidence supports the outcome the images imply and over what number of patients and what timeframe.
On typicality, the same section says that where an endorser's experience is not representative of what consumers will generally achieve, the advertisement should clearly and conspicuously disclose the generally expected performance in the depicted circumstances, and the advertiser should have substantiation for that disclosure too [3](#ref-3). That last clause is the one people miss. You need evidence for the typical result, not just a sentence claiming one.
On disclosure of connections, section 255.5 addresses material connections between an endorser and the advertiser, called for where the audience would not reasonably expect the relationship, and specifically where a significant minority of the audience would not understand it [3](#ref-3). Helpfully, it does not demand you publish commercial details. It asks for enough to communicate the nature of the connection so a consumer can weigh the endorsement properly.
This guide is general compliance education from a marketing agency, and it is not legal advice. It describes federal FTC materials and does not attempt any state-law overlay. If you are making specific claims about a treatment, have them reviewed by a qualified attorney before publishing. If the marketing side is what you need help with, our [med spa SEO](https://seoagencynaples.com/seo-for-med-spas/) work is built around claims that can survive this kind of scrutiny, and you can [ask us what we would and would not publish](https://seoagencynaples.com/contact/) for you.

Source: FTC Guides Concerning the Use of Endorsements and Testimonials, 16 CFR Part 255 Download SVG

## Why a generic disclaimer alone does not solve the typicality problem
The "results not typical" safe harbor was removed in 2009, not 2023. Under the 1980 Guides, an unusual result could be shown with such a disclaimer. The revised Guides removed that automatic protection, on the Commission's view that a generic line does not change what a consumer takes away.
The date matters because so much published advice gets it wrong. The revised Guides appeared at 74 FR 53124 and took effect on 1 December 2009 [4](#ref-4). That is when the safe harbor went. The 2023 revision, published at 88 FR 48092 and effective 26 July 2023, is the most recent edit to the same Guides [3](#ref-3), not the moment the disclaimer stopped working. If an article dates the change to 2023, it is fourteen years late, which tells you how carefully the rest of it was researched.
Now the correction that runs the other way, because the myth cuts both directions. The 2009 notice says plainly that the revised Guides would not prohibit the use of disclaimers of typicality [4](#ref-4). Disclaimers are permitted. What the Commission removed was their automatic protective effect, having expressed doubt that a generic line changes consumer takeaway. So "the FTC banned disclaimers" is as wrong as "a disclaimer makes it fine".
The accurate formulation is narrow and worth memorising: a generic disclaimer alone does not cure a claim of atypical results. The Guides leave two workable routes, which is what the 2009 notice describes. Either hold substantiation that the depicted experience is representative, or clearly and conspicuously disclose the generally expected performance and hold substantiation for that [4](#ref-4).
For a med spa that translates into something concrete. Replace "results may vary" with what the typical patient can actually expect, in the same visual weight as the claim itself, based on evidence you hold. It is more work than a footer line, and it is also considerably more persuasive to a sceptical buyer than a disclaimer nobody believes.

## Testimonials, influencers, and material connections
Any endorsement from someone connected to you carries a disclosure question: staff, family, a patient given a discounted or free treatment, or an influencer being paid. The test is whether the audience would expect the relationship, and disclosure should be clear enough to communicate its nature.
Section 255.5 frames this around audience expectation rather than around payment specifically, which is broader than most people assume [3](#ref-3). A gifted treatment counts. A staff member counts. A friend of the owner counts. The question is not whether money changed hands but whether a reasonable viewer would understand the relationship, and disclosure is called for where a significant minority would not.
There is a separate and harder-edged instrument sitting next to the Guides now, and the distinction matters. The FTC rule on the use of consumer reviews and testimonials, 16 CFR Part 465, effective 21 October 2024, is a binding rule rather than an interpretation. It prohibits fake or false consumer reviews and testimonials, buying positive or negative reviews, and undisclosed insider reviews, requiring owners, officers, managers, employees and their relatives to clearly disclose their relationship [5](#ref-5).
So for a med spa the practical division is this. How you present a genuine patient result is governed by the Guides, which are interpretive. Whether the review or testimonial is genuine at all, and whether insiders disclose, sits under a binding rule. The second category is where the sharper legal exposure lives, and it is also the easier one to comply with, because it asks only for honesty and a sentence of disclosure. We covered the same discipline on the review side in [how to earn Google reviews without breaking the FTC rules](https://seoagencynaples.com/blog/more-google-reviews-ftc-rules/).

- Disclose staff, family and owner relationships in any testimonial or before-and-after feature.
- Disclose gifted, discounted or comped treatments, not only cash payments.
- Place the disclosure where the endorsement is, not in a footer or a linked page.
- Keep signed consent for every patient image you publish, separately from the compliance question.
- Never publish a testimonial you cannot trace to a real, identifiable patient.

## The enforcement myth worth retiring
Med spa marketing articles frequently warn about FTC enforcement over before-and-after photos. We could find no public record of such an action. The med spa warning letters that surface in searches are COVID-19 claims letters from 2020 and 2021, which concerned disease claims rather than results advertising.
This one is worth being careful about in both directions. We are not asserting that no such action exists anywhere; that would be proving a negative. What we can say is that we looked for the public record behind the claim and did not find one, and that the med spa letters which do surface concern COVID-19 treatment claims from 2020 and 2021, a different subject entirely.
The reason to correct it is not pedantry. Fear-based compliance advice tends to produce the wrong response, which is usually removing all results marketing rather than fixing how it is presented. A med spa that deletes its gallery because of an enforcement story that nobody can source has given up its most persuasive asset for no reason, while leaving the actual issues, substantiation and disclosure, untouched.
The genuinely useful posture is to take the primary record seriously and the marketing folklore lightly. The Guides are interpretive but sit on top of section 5 liability [3](#ref-3). The reviews rule is binding [5](#ref-5). Those two facts justify doing this properly without needing an invented enforcement story to motivate it.
A note on how to read any compliance article, including this one. Check whether it cites the Federal Register or the CFR directly, and whether the dates match. On this topic the fastest tell is the safe harbor date: an article saying 2023 rather than 2009 has not read the source.

## How to advertise med spa results safely
The workable version is a short standard applied consistently: publish results you can substantiate, state the generally expected outcome beside the exceptional one, disclose every connection, and keep consent and evidence on file. None of it requires giving up your best cases.
Build the evidence before the campaign rather than after a complaint. For each treatment you advertise, write down what a typical course of treatment produces, over what timeframe, across how many patients, and what evidence supports that. If you cannot complete that sentence, you are not ready to advertise the outcome, and that is a useful gate rather than an obstacle.
Then fix the presentation. Standardize photography so the comparison is honest, meaning consistent lighting, angle, distance and interval, since an inconsistent pair can imply a result the treatment did not produce. Put the expected-outcome statement adjacent to the images in comparable visual weight, not in a footer. Disclose connections inline. Keep written consent for every image.
Finally, review it on a schedule. This is an area where the record moves: the Guides were revised in 2009 [4](#ref-4) and again in 2023 [3](#ref-3), and a binding reviews rule arrived in 2024 [5](#ref-5). A yearly review of your claims against the current primary sources is proportionate, and it is far cheaper than discovering a problem through a complaint.

- **Define the typical result first.** For each advertised treatment, document the generally expected outcome, the timeframe and the evidence behind it.
- **Standardize the photography.** Same lighting, angle, distance and time interval, so the comparison reflects the treatment rather than the camera.
- **Put the expected outcome next to the exceptional one.** Clear and conspicuous means comparable prominence, not a footer line.
- **Disclose every connection inline.** Staff, family, gifted or discounted treatment, paid influencer. At the endorsement, not on a separate page.
- **Keep consent and substantiation on file.** Written patient consent for each image, and the evidence supporting your typical-result statement.
- **Review annually against primary sources.** The Guides changed in 2009 and 2023, and a binding reviews rule took effect in 2024.

Test yourself
## Do you know what the FTC Guides actually say?
Five questions answered from the primary Federal Register record, not from marketing summaries. Every source is linked in this guide.

- 1 Has the FTC banned before-and-after photos in med spa advertising? Yes, since 2023 Yes, for injectables only No, but results claims carry conditions Only for photos of the face **Answer:** No, but results claims carry conditions There is no ban. The Endorsement Guides do not forbid showing results; they set conditions on the claim those results imply. The advertiser should hold substantiation for the claim, and where an endorser's experience is not representative of what consumers generally achieve, should clearly and conspicuously disclose the generally expected performance. Conditioned is a very different thing from prohibited, and the difference decides whether you can market at all.
- 2 When was the "results not typical" safe harbor removed? 1980 2009 2023 It still exists **Answer:** 2009 The safe harbor was removed by the revised Guides published at 74 FR 53124 and effective 1 December 2009. The 1980 version had allowed unusual results to be shown with a disclaimer such as "results not typical". A great many marketing articles date this change to 2023, which is fourteen years late; the 2023 revision at 88 FR 48092 is simply the most recent edit to the same Guides.
- 3 Did the FTC prohibit typicality disclaimers? Yes, they are now forbidden No, but a generic one no longer provides safe harbor Only in healthcare advertising Only for paid endorsements **Answer:** No, but a generic one no longer provides safe harbor The 2009 Federal Register notice is explicit that the revised Guides would not prohibit the use of disclaimers of typicality. What disappeared was the automatic protection they used to provide. The Commission expressed doubt that a generic disclaimer changes what a consumer takes away from the advertisement, so the burden moved to substantiating typicality or disclosing the generally expected result. Disclaimers are allowed; they are simply no longer a shield on their own.
- 4 A staff member appears in a testimonial about a treatment. What do the Guides address? Nothing, employees may endorse freely Disclosure of the material connection A ban on employee endorsements Only their job title must appear **Answer:** Disclosure of the material connection The Guides address material connections: a connection between endorser and advertiser should be disclosed where the audience would not reasonably expect it, and disclosure is called for when a significant minority of the audience would not understand the relationship. Employment is the clearest example. You do not need to publish the full commercial details, only enough to communicate the nature of the connection so a consumer can weigh the endorsement.
- 5 Are the Endorsement Guides binding law? Yes, they are regulations No, they are administrative interpretations Yes, since the 2023 revision Only for businesses over a certain size **Answer:** No, they are administrative interpretations Section 255.0 describes the Guides as administrative interpretations that provide the basis for voluntary compliance with section 5 of the FTC Act. They are not themselves regulations, and that distinction matters when you read marketing articles claiming the FTC "requires" this or "bans" that under the Guides. Practices inconsistent with them may lead to corrective action under section 5, which is the actual legal hook.
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- **Can med spas legally post before-and-after photos?** Yes. The FTC Endorsement Guides do not ban before-and-after photos; they attach conditions to the claim those images make. The advertiser should hold substantiation for the claim conveyed, and where the depicted experience is not representative of what consumers generally achieve, should clearly and conspicuously disclose the generally expected performance and hold substantiation for that disclosure as well. Any connection between you and the person shown that the audience would not expect should also be disclosed. So the compliance work is mostly about what sits beside the image, not about whether you may publish it.
- **Does a "results not typical" disclaimer make before-and-after photos compliant?** Not on its own. The safe harbor that once made this work was removed by the revised Guides published at 74 FR 53124 and effective 1 December 2009. Under the earlier 1980 version, an unusual result could be shown with such a disclaimer. The Commission removed that automatic protection because it doubted a generic line changes what consumers take away. Importantly, disclaimers were not prohibited, and the 2009 notice says so directly. The workable approach is to substantiate that the result is representative, or to disclose the generally expected outcome with evidence behind it.
- **Did the FTC change the rules on testimonials in 2023?** The Guides were revised in 2023, published at 88 FR 48092 and effective 26 July 2023, but that revision is not when the typicality safe harbor disappeared. That happened in 2009. A lot of med spa marketing content attributes the disclaimer change to 2023, which is fourteen years late and is a quick way to judge how carefully an article was researched. Separately and more significantly, a binding FTC rule on consumer reviews and testimonials, 16 CFR Part 465, took effect on 21 October 2024, and unlike the Guides that one is a rule rather than an interpretation.
- **Has the FTC taken enforcement action against med spas over before-and-after photos?** We looked for the public record behind that frequently repeated claim and could not find one. The med spa warning letters that surface in searches are COVID-19 claims letters from 2020 and 2021, which concerned disease treatment claims rather than results advertising. That is not the same as proving no such action exists anywhere, and it is a reason to treat the warning as unsourced rather than as established fact. The better motivation for doing this properly is the primary record itself: the Guides sit on top of section 5 liability, and the reviews rule is binding.
- **Do I have to disclose that a testimonial came from an employee?** The Guides address exactly this. A material connection between an endorser and the advertiser should be disclosed where the audience would not reasonably expect it, and disclosure is called for where a significant minority of the audience would not understand the relationship. Employment is the clearest case, and so are family relationships, gifted or discounted treatments and paid influencer arrangements. You do not need to publish commercial details, only enough to communicate the nature of the connection. Separately, the binding 2024 reviews rule addresses undisclosed insider reviews directly, including relatives of owners and managers.
- **Are the FTC Endorsement Guides actually law?** Not in themselves. Section 255.0 describes them as administrative interpretations that provide the basis for voluntary compliance with section 5 of the FTC Act. That is why it is inaccurate to say the FTC "requires" or "bans" something under the Guides, a phrasing you will see constantly. The practical exposure is real nonetheless: practices inconsistent with the Guides may result in corrective action under section 5, which is the actual legal hook. The distinction matters most when judging advice, because a writer who gets the legal status wrong usually gets the details wrong too.
- **What is the safest way to show results if my best cases are unusual?** Show them, and put the ordinary result beside them with equal prominence. Document for each advertised treatment what a typical course produces, over what timeframe and across how many patients, with the evidence that supports it. Standardize your photography so lighting, angle, distance and interval are consistent, because an inconsistent pair can imply a result the treatment did not deliver. Disclose any connection inline, keep written patient consent for every image, and review the whole standard annually. Exceptional cases are usable; presenting them as ordinary is the part that creates exposure.

## References

- BrightLocal. Local Consumer Review Survey. 2025 to 2026 editions. [https://www.brightlocal.com/research/local-consumer-review-survey/](https://www.brightlocal.com/research/local-consumer-review-survey/)
- Seer Interactive. Study of 800K AI responses: how review profiles shape brand presence in AI search. March 2026. [https://www.seerinteractive.com/insights/study-of-800k-ai-responses-how-reviews-shape-brand-presence-in-ai-search](https://www.seerinteractive.com/insights/study-of-800k-ai-responses-how-reviews-shape-brand-presence-in-ai-search)
- Federal Trade Commission. Guides Concerning the Use of Endorsements and Testimonials in Advertising, 16 CFR Part 255, 88 FR 48092, effective 26 July 2023. July 2023. [https://www.govinfo.gov/content/pkg/FR-2023-07-26/html/2023-14795.htm](https://www.govinfo.gov/content/pkg/FR-2023-07-26/html/2023-14795.htm)
- Federal Trade Commission. Guides Concerning the Use of Endorsements and Testimonials in Advertising, 74 FR 53124, effective 1 December 2009. October 2009. [https://www.govinfo.gov/content/pkg/FR-2009-10-15/html/E9-24646.htm](https://www.govinfo.gov/content/pkg/FR-2009-10-15/html/E9-24646.htm)
- Federal Trade Commission. Rule on the Use of Consumer Reviews and Testimonials, 16 CFR Part 465, effective 21 October 2024. August 2024. [https://www.govinfo.gov/content/pkg/FR-2024-08-22/html/2024-18519.htm](https://www.govinfo.gov/content/pkg/FR-2024-08-22/html/2024-18519.htm)

Written by
## [Jamie Kloncz](https://seoagencynaples.com/jamie-kloncz/)
Founder and CEO, SEO Elite Agency
Jamie Kloncz is the founder and CEO of SEO Elite Agency, the firm behind SEO Agency Naples. An engineer who scaled his own plumbing business to 3 million dollars in revenue and led growth for over 200 teams, he built this agency on one principle: every SEO action must connect directly to revenue, not vanity metrics.
[More about Jamie →](https://seoagencynaples.com/jamie-kloncz/)

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