Medical tourism: ‘Luck of the draw’ according to plastic surgeons in Germany, France

Dozens of plastic surgeons from France and Germany joined in Estheticon’s research regarding the much-discussed topic of people traveling abroad to receive medical treatment, also known as “medical tourism.” Doctors from both countries agree on the main risk factors – it is difficult to verify the expertise of foreign surgeons, and it is not possible to properly deal with potential complications during a short stay abroad. We discovered interesting differences in the origins of international patients, and in the countries that German or French patients have traveled to for medical tourism. The types of procedures desired by foreign patients also differ.

medical turism

According to the study, it seems that in Germany the problem with medical tourism is more prominent than in France. Last year, 70% of German plastic surgeons taking part in the study reoperated on German patients who had gone abroad for plastic surgery. On average, a German surgeon has performed a corrective surgery on four patients in the last year. This number is slightly lower in France, where 58% of plastic surgeons taking part in the study reoperated on French patients. The average for them is three corrective surgeries in the last year.

“The main problem with medical tourism is that patients are often attracted by very low prices for cosmetic procedures abroad. This is forbidden and monitored in Germany. If there are complications afterward, patients must seek out medical help at home which local doctors cannot refuse. Of course, local prices are charged for corrective procedures, and often even local health care is abused to deal with medical issues resulting from operations performed abroad,” claims Dr. Johannes C. Bruck, a plastic surgeon from Berlin and the president of the German plastic surgeon association (VDÄPC). Pavel Hilbert, one of the founders of, confirms that low prices are the most common reason behind people choosing a plastic surgeon abroad. He adds, “People often forget the additional costs such as travel, insurance and accommodation. The final price can often exceed the price of a local surgeon.”

German surgeons get more patients from abroad than French surgeons do

There are clearly other reasons why people travel abroad for plastic surgery. For instance: the perception of high-quality care or surgeons’ reputations. A large number of foreigners specifically seek out destinations such as Germany or France, which are certainly not known for low prices in Europe. According to our study, in the last year 77% of German surgeons operated on foreign patients, while in France 38% of surgeons received patients from abroad. Last year on average a German plastic surgeon had 4.8% of foreign patients while a French surgeon 2.3%. The most common procedures in Germany are breast enlargement, liposuction and eyelid surgery; in France it is breast enlargement, breast reduction and rhinoplasty (nose job).

Main risks – short post-operative care and bad communication

In Germany or in France, after an operation with general anesthesia, patients spend an average of 5-13 days in post-operative care, which should be a sufficiently long enough time to deal with potential post-operative complications. This period is not prescribed anywhere and can be significantly shorter in other countries. Surgeons from Germany and France see this—and the difficulty in verifying foreign surgeons’ expertise—as the main risks related to plastic surgery abroad. There is not enough time for proper pre and post-operative care, which also results in insufficient communication between doctors and patients. Doctors agree that a close surgeon-patient relationship is absolutely essential for the overall success of the procedure. 32% of German doctors strongly believe that a potential language barrier can play a negative role in surgery results. French doctors don’t perceive this as such a big issue because most patients who choose to be operated on in France come from previous French colonies and other French speaking countries. German surgeons mostly deal with patients from Russia, the Ukraine, Switzerland and the Near East. Initial operations that needed to be corrected later at home in France had taken place—according to the surgeons taking part in the study—in Tunisia, Morocco or the Near and Middle East, meaning French-speaking countries. In Germany this linguistic connection does not apply – German patients requiring corrective procedures were initially operated on in the Czech Republic, Poland or Turkey.

Transparent and objective information simplifies surgeon choice

What should a patient look for when choosing a plastic surgeon in order to prevent complications? We asked Pavel Hilbert to share his experience with us: “On, we recommend the following seven rules for our clients to abide by and check off:

  • A surgeon’s medical license
  • A surgeon’s membership in professional associations
  • Experience, number of procedures performed, years of practice
  • Quality of care and the clinic’s facilities, modern equipment and medical standards
  • Thorough pre-operation check-up
  • Adequate cost. Beware of very low prices!

Doctors registered on our portal have all that key information contained in the profiles.”

Is there an ideal solution? According to Dr Mohamed Cherif, plastic surgeon from Nîmes, “Medical tourism can be a good alternative for people who do not have sufficient funds for surgery at home. Of course, only under the condition that the same surgeon provides the initial consultation, the operation itself and post-operative care once the patient returns back home.” Pavel Hilbert from adds that the choice of a surgeon is the key to a successful procedure and should not be underestimated. “Patient safety is the motto of our portal. That is why we strive to provide our visitors with information that will help them make the right choice regarding plastic surgery. Doctors can help with patient education by actively taking part in creating the content of our portal – writing descriptions of the individual procedures, publishing articles or contributing to discussion forums”.

This study was conducted in October and November of 2013 using an electronic questionnaire. 53 licensed surgeons from Germany and 29 from France took part in the research.

Respondents were asked to provide estimates, rather than exact data.

pdf Medical Tourism: France Versus Germany

About Estheticon provides complete information about aesthetic medicine and plastic surgery. Doctors practicing plastic surgery or aesthetic medicine may register on the portal ( and contribute to patient information by joining in discussion forums or writing articles. is designed as an information and contact portal for users who are interested in aesthetic and plastic surgery procedures. They can find expert, comprehensible information in an easily accessible format.

Patients can look at detailed descriptions of all procedures, videos or before/after photos in order to quickly acquire information about the procedure they are interested in.

Each procedure description also includes contact details and pricing policies of surgeons and clinics that perform the procedure.

Doctors can communicate directly with potential patients via the portal, either by contributing to public discussion forums (which are also divided into sections related to individual procedures) or privately through contact forms available on each doctor’s profile.

Patients can publicly share their positive experiences with other visitors, and they can evaluate and recommend doctors and clinics. Doctors can also rate the work of their colleagues. All of this is available in 14 different language versions.

With the average of 1,000,000 visitors per month on all language versions, is the largest internet portal for aesthetic medicine and plastic surgery in the world. Annually, records 28,000 public enquiries from patients and 24,000 answers from doctors.

For more information:

Lucie Splichalova,
Tel.: +420 773 591 117

Updated: 2014-04-15

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