OLYMPIA, WA – A major plastic surgeon in Seattle has been sued by Washington State Attorney General Bob Ferguson for allegedly inflating its ratings on online rating platforms such as Yelp and Google. The federal lawsuit against Allure Esthetic and its owner, Dr. Javad Sajan, was filed today. At a press conference, Ferguson said the company intimidated patients into removing negative reviews and ordered its employees to post fake positive reviews.
Over 10,000 people signed these NDAs. Meanwhile, Ferguson says Allure Esthetic’s owner also ordered employees to post doctored before and after photos of patients, beyond basic touch-ups.
“Allure Esthetic is a large, highly profitable Seattle-area plastic and cosmetic surgery business with offices in Lynnwood, Kirkland, and Seattle. Allure Esthetic does business under several names, including Allure Esthetic, Alderwood Surgical Center, Gallery of Cosmetic Surgery, Seattle Plastic Surgery, Northwest Nasal Sinus Center, and Northwest Face & Body,” Ferguson’s lawsuit says. It asserts Allure and its owner broke the law in other ways, including by:
- Threatening to take legal action against patients, telling some patients it would sue them for monetary damages if they refused to delete their negative reviews.
- Offering patients cash and free services or products for taking down their negative reviews.
- Requiring patients who accepted these bribes to sign a second non-disclosure agreement stating they could face a $250,000 lawsuit if they continue to post negative reviews.
- Editing “before and after” photos to make the results of its procedures look better than they actually were.
- Applying for rebates on behalf of its patients without their consent and keeping those rebates. Allure used hundreds of fake email accounts to register for rebate programs intended for real patients. Allure received thousands of dollars every month from these rebates — rebates that should have gone to patients.
Ferguson filed the lawsuit in the U.S. District Court for the Western District of Washington.
“Threatening and bribing customers to prevent them from sharing the truth about their experience isn’t just wrong — it’s illegal,” Ferguson said. “Patients rely on reviews to determine if a healthcare provider is right for them, and using legal threats and bribes to manipulate those reviews is deceptive and harms Washingtonians. We are taking action to stop these unethical and illegal practices.”
One former employee, a videographer, said she quit her job at Allure because she “felt it was unethical and deceptive to alter photos to that extent, especially knowing that most consumers rely on before and after photos when choosing a surgeon for cosmetic surgery.” She was not the only employee who quit over ethical concerns. One of Allure’s in-house attorneys left her job over concerns that Allure’s NDA practices were unlawful and unethical.
The Attorney General’s Office received four complaints from patients alerting the office to Allure’s practices. One Seattle woman who accompanied a family member to a consultation for gender-affirming care wrote in a complaint to the Attorney General’s Office that she was “greatly troubled by the practice of forcing patients to sign a NDA before they even see the doctor.”
Allure is a major provider of plastic and cosmetic surgery procedures in the Seattle area, with offices in Seattle, Lynnwood and Kirkland. Allure does business under several names, including Allure Esthetic, Gallery of Cosmetic Surgery, Seattle Plastic Surgery, Alderwood Surgical Center, and Northwest Face & Body. The company conducts both surgical and non-surgical treatments, ranging from Botox to gender-affirming procedures. Allure has prominently displayed its “5-star” Google and Yelp ratings on its website.
Individuals rely on online reviews to help them find a doctor. According to a 2020 survey, over 70 percent of patients use online reviews as the first step to finding a new doctor. Patients need accurate information about their doctors to make an informed choice about their medical care.
Allure used NDAs, legal threats and bribes to suppress negative reviews
From 2017 to 2019, Allure required patients to sign a non-disclosure agreement that required them to contact the business if they had any concerns instead of posting a “negative review.” The NDAs required patients to “not say anything” that would “damage the reputation” of the office. The agreement stated that Allure considered anything under four stars a “negative review.”
Allure gave these NDAs to prospective patients in a stack of pre-procedure paperwork that they were required to sign before receiving any services from Allure. In many cases, Allure required patients to pay a $100 consultation fee before disclosing that they must sign the NDA.
Under this “pre-service” NDA, Allure required patients to agree to “pay monetary damages to the practice for any losses” if they did not take down a negative review. These NDAs also required consumers to waive health privacy rights, stating consumers must “allow a response [to the review] from the practice with any personal health information” if they post a negative review. Ferguson’s lawsuit asserts this provision is a violation of the Health Insurance Portability and Accountability Act (HIPAA).
Allure updated the NDAs in 2019 to remove this language, but they still required patients to contact Allure to “reach a resolution” directly with Allure instead of posting a negative review. They used these “pre-service” NDAs until March of 2022.
These were not empty threats — Allure in fact followed up with patients who posted negative reviews after their treatments, offering them money and free services to “make it right” if they took down their review. Sajan’s former assistant called the clinic’s efforts to get people to take down negative reviews “relentless.”
If bribes didn’t work, Allure threatened to sue consumers.
If a patient accepted Allure’s offers of cash or services, Allure then required the patient to sign a second NDA requiring them to remove any negative reviews and to refrain from posting negative reviews in the future, with a $250,000 penalty if they fail to comply.
Allure began using this second “post-service” NDA in September 2017, and Ferguson asserts the company still follows this practice. Allure sent cease-and-desist letters to two patients over these NDAs, both threatening to enforce the NDA for monetary damages.
Allure used a VPN to post fake reviews and pocket rebates intended for consumers
Allure and Sajan directed employees to post fake positive reviews. Former web designers who worked there from 2018 to 2021 said they regularly posted fake reviews by creating fake email accounts and fictional online personas. At Sajan’s direction, employees used stock photos and built a “persona” to create a more realistic profile to post reviews from.
These employees told Sajan that they believed the practice was unethical, and refused to continue creating fake reviews. In response, Sajan said he would get another employee to continue posting the reviews.
Below are two examples of the fabricated reviews posted by Allure’s web designers.
Allure used a Virtual Private Network, or VPN, to conceal the IP addresses of reviews. Allure posted the fake reviews while signed on to the VPN so they couldn’t be traced back to the Allure Esthetic offices or be flagged by review sites as false.
One web designer said, “Whenever we were to do something that was immoral or illegal, we would sign into the VPN… and then when we were done, we would sign off of the VPN.”
Allure employees also used the same VPN, and hundreds of fake email accounts, to allow the clinic to take skincare rebates intended for patients. The company used real patient names and birthdates, without those patients’ consent, to register for rebate programs through a skincare brand Allure used on its patients. Allure received thousands of dollars every month from these rebates — rebates that should have gone to patients.
Allure altered “before and after” photos to make the results seem better than they actually were
Allure posted altered “before and after” photos on social media that were edited beyond basic photo touch-ups and removal of identifying features. Allure directed its employees to make major alterations to photos.
One former employee said, “I was asked to move a nipple several inches on the ‘after’ photo to make it appear symmetrical with the other. I was asked to manipulate the ‘after’ photograph of a patient to make it more symmetrical with the other. I was asked to manipulate the ‘after’ photograph of a patient who had hair plugs to cover a bald spot. And I was asked to Photoshop the photos of patients who had tummy tuck procedures and make them look curvier and flatter.”
Ferguson’s lawsuit asserts that Allure and Sajan violated HIPAA, the Washington State Consumer Protection Act (CPA) and the Consumer Review Fairness Act (CRFA), a federal law that protects consumers’ rights to post truthful reviews about a business.
Allure violated the CRFA each time it required patients to sign NDAs restricting negative reviews. Allure required over 10,000 patients to sign the “pre-service” NDAs, and hundreds of patients signed the “post-service” NDAs. All of Allure’s and Sajan’s violations of HIPAA and CRFA are also violations of the CPA.
The lawsuit asks the court to:
- Order that all NDAs Allure required patients to sign are void and unenforceable, and require Allure to inform its patients in writing that these NDAs are invalid;
- Block Allure from enforcing or threatening to enforce the NDAs;
- Require Allure to pay penalties up to $7,500 per violation; and
- Require Allure to pay restitution to patients for the $100 pre-service consultation fee and any cash rebates Allure kept that were owed to patients. The exact amount of restitution owed to each patient will be determined in further discovery.
Assistant Attorneys General Matt Geyman, Camille McDorman and Zorba Leslie, Investigator Victoria Suner, Paralegal Miranda Marti and Legal Assistant Christopher Kiefer are handling the case for the Attorney General’s Office.
If you see any business trying to restrict online reviews, or any other potential deceptive business practices, report it to the Attorney General’s Office by filing a complaint at https://www.atg.wa.gov/file-complaint.
Photos courtesy TVW & Allure Esthetic