It's often said that the Internet is where information just wants to be free. That may be, but it's also where -- just as in print and on the air -- commercial information had better be factual. Fraud is fraud, even on the Internet, as New York Attorney General Andrew Cuomo has reminded the cyberworld.

Cuomo is slicing $300,000 out of the hide of Lifestyle Lift for posting phony reviews on Internet sites. The case is thought to be the first of its kind involving the growing problem of "astroturfing" -- and it is causing consternation throughout the "reputation management" business, which uses tricks and deception to counter legitimate consumer reviews.

In the New York case, Lifestyle Lift employees published positive reviews and comments about the company to trick Web-browsing consumers into believing that satisfied customers were posting their own stories.

Actual reviews from consumers are much less laudatory. "J" of Elkridge, Md. told in a recent complaint that she was told by a Lifestyle Lift doctor that her facelift would be a "minor one-hour procedure" involving "two small incisions." In fact, it turned into much more than that, she said.

"I was given approximately 15-20 shots in my face ... and was horrified to realize I was being cut from the front of each ear to the back. I later learned that what I was given was an entire lower facelift without anesthesia!" J said. "I had NO IDEA that I would have my earlobes cut off my face and sewn back on. I had no idea that I would suffer with extreme pain and numbness for up to nine months later. I didn't know that there was a possibility that I would suffer with numbness on both sides of my face and itching that becomes unbearable, one and a half years after the procedure.

J also said she was shown a video presentation which included supposed news reports from Fox, NBC and other news outlets extolling the virtues of the procedure.

A health-oriented site,, carries negative comments from doctors as well as consumers.

"The advertisements show pictures of patients who have achieved excellent results. From the patients I have seen who have had LSL procedures, these results are not at all typical," said Brent Moelleken, MD, a plastic surgeon in Bevely Hills, Calif.

"When a facelift is performed with minimal undermining (as with a LSL), the skin does not advance properly. You haven't reached the tissues to pull on them. Instead, you are pulling on adjacent tissues, and the force to the target tissues (i.e. loose skin of the jowl area) is reduced. Surgically speaking, you're not there yet," Moelleken said.

In 2008, Lifestyle Lift sued alleging trademark infringement. The suit ended in a confidential settlement. A similar suit against -- no longer active on the Internet -- was dismissed by a Detroit court.

Among the more disgruntled consumers who have complained to is Brian of Chicago. He had the Lifestyle Lift procedure performed in 2003 and said it left a visible scar that he has not been able to hide with sideburns, as his Lifestyle doctor, Robert Schaeffer, originally suggested.

"During my follow-up visit Dr Schaeffer suggested I wear large earrings!," said Brian who, as his name suggests, is a man. He rejected the notion.

FTC probe

Cuomo said the tactics constitute deceptive commercial practices, false advertising, and fraudulent and illegal conduct under New York and federal consumer protection law. While Cuomo's action is the first on the state level, the Federal Trade Commission (FTC) has also been investigating the use of word-of-mouth marketing online and may issue new or revised rules on the practice.

For more than 30 years, the FTC has regulated the use of endorsements and testimonials in advertising. While phony reviews are not traditional paid advertisements, they may be targeted by prosecutors if any goods, services or money changes hands in enticing customers, employees and paid agents to create marketing content they know to be false.

Those who are compensated to promote or review a product using these techniques are not exempt from the laws of governing truthful advertising, said Richard Cleland, assistant director, division of advertising practices at the FTC, in a statement.

Cuomo's action won support from legitimate marketing industry organizations. The Direct Marketing Association said Cuomo's action was supported by ethical business best-practices. According to the association's guidelines, Testimonials and endorsements should be used only if they are: Authorized by the person quoted; Genuine and related to the experience of the person giving them both at the time made and at the time of the promotion and; Not taken out of context so as to distort the endorser's opinion or experience with the product.

Other marketing gurus agreed. "Having a company force its workers to anonymously blog about its products, regardless of whether they use them or like them, and attack others is pathetic," said Edward Barrera, editor of ADOTAS, a newsletter focused on Internet advertising.

But at, an anything-goes forum where shady practices such as "search engine optimization" are discussed and debated, the reaction was more mixed.

"I think the overall message here is that reputation management needs to be an at-arms-length transaction with an unconnected third party rather than an in-house campaign," said one posted. "Yes, absolutely, and bank robbers need to wear masks," shot back another.

Lifestyle Lift Company president Gordon Quick said in a statement that Cuomo's complaints "stem from a period prior to the present management team's leadership" and that all existing Web content meets acceptable business standards. The company also characterized some of the reviews as "representative of patient testimonials and comments rather than actual verbatim comments."

"Reputation management"

Besides posting phony rave reviews, reputation management companies often promise businesses that they can remove or somehow modify negative comments on third-party sites.

SERM Internet, LLC, advertises that it can "remove" negative comments appearing on "Removing complaints involves search engine marketing and optimization," the company's Web site claims.

Another company, Reputation Armor, claims that it can remove complaints appearing on from Google, Yahoo and other search engines. The company says its "average fee" is $995-$2500.

The "removal" process usually consists of producing large numbers of pages designed to crowd out legitimate reviews form the search engine indexes -- similar to the Lifestyle techniques Cuomo objected to.

Lifestyle Lift, which has more than 40 locations across the U.S., engaged in a concerted effort to bombard Internet message boards with positive stories about themselves, Cuomo said. Lifestyle Lifts president believed that negative Internet postings had significantly hurt the companys reputation and thought the success of the company hinged on controlling messages posted online.

Company employees were directed to create accounts with various Internet message boards and pose as satisfied customers of Lifestyle Lift. Employees also attacked legitimate message board posters who criticized Lifestyle Lift and tried to get those posts removed from message boards.

Internal emails uncovered in Cuomos investigation show that Lifestyle Lift employees were given specific instructions to engage in this illegal activity.

One e-mail to employees said: Friday is going to be a slow day - I need you to devote the day to doing more postings on the web as a satisfied client. Another internal email directed a Lifestyle Lift employee to Put your wig and skirt on and tell them about the great experience you had.

In addition to posting on various Internet message board services, Lifestyle Lift also registered and created stand-alone Web sites, such as, designed to appear as if they were created by independent and satisfied customers of Lifestyle Lift. The sites offered positive narratives about the Lifestyle Lift experience.

Some of these sites purported to offer forums for users to add their own comments about Lifestyle Lift. In reality, however, Lifestyle Lift either provided all the user comments themselves, or closely monitored and edited third-party comments to skew the discussion in favor of Lifestyle Lift.

According to the Attorney Generals settlement, Lifestyle Lift employees will no longer pose as consumers when publishing on the Internet. The company will not promote Lifestyle Lifts services on the Internet without clearly and conspicuously disclosing that they are responsible for the content. The company will also pay $300,000 in penalties and costs to New York State.