Germans nip over the border to take advantage of cheap tummy tucks

Sabille Brixner had always dreamt of having larger breasts. But she couldn't afford plastic surgery in Germany. So she recently popped over the border to Poland to have them done there instead.

"The prices I was quoted in Germany were absolutely ridiculous," said Ms Brixner, a former nurse. "So I thought: off to Poland I go." Ms Brixner is a jolly yet sanguine 46-year-old from a small village near the northern German city of Rostock - just one of an increasing number of Germans now opting to have plastic surgery in Poland and other former Communist countries. Treatment in the ex-Ost Bloc can be as much as 70 per cent cheaper than in Germany, and doctors at private clinics say business has never been better.

"I now operate on up to 40 German patients a month," says Dr Maciej Pastucha, director of Artplastica one of Poland's biggest plastic surgery clinics in Szczecin. The city where Ms Brixner paid €2,700 (£1,880) for her new 34B silicone implants, is a mere two-hour drive or train ride from Berlin. And, like the rest of Poland, low wages and a low cost of living mean prices are still cheap. "Whatever the Germans charge, I can do it for half," says Dr Pastucha, who says most Germans come for facelifts (Artplastica price €3,250), breast enlargements and liposuction (€1,000-€4,000).

"Medical tourism", one of the new faces of the newly enlarged European Union, extends to the entire range of health treatments and medical care - boosted in the Germans' case by a new law allowing those with state health insurance a free choice of doctor across the EU.

The move has led to good business for Czech surgeries and Polish fertility clinics - IVF costs around half the German rate. Dentistry in the new EU member states is also booming. In Hungary, where dentists have always enjoyed a good reputation, some clinics claim 99 per cent of their patients are German. Polish clinics, too, are doing a roaring trade.

"The number of Germans coming to get their teeth done has definitely gone up since Poland joined the EU," says Dr Malgorzata Domanska, who says she treats up to 40 German patients a month at the Aestheticdent clinic in Szczecin. Prices are, yet again, half those in Germany: a dental lab-created implant and crown costs on average €1,400; a fixed bridge starts at €140.

There is a downside, however. In Eastern European countries many plastic surgeons do not have personal liability insurance, so if an operation goes wrong the patient has no redress. Post-operative care, a crucial stage of any procedure, can also be risky. Almost all patients who undergo surgery in Poland return to Germany within days of the operation, leaving German GPs to take out stitches and deal with any post-op problems.

The British Association of Aesthetic Surgery also recently warned British residents against travelling to Eastern Europe for cheaper plastic surgery. One council member, Douglas McGeorge, recalled having to pick up the pieces for two patients who had undergone abdominoplasty or "tummy tuck" surgery there. He frowns on "holiday surgery," and is "amazed that people go for these so-called deals".

But Ms Brixner had no such qualms. In fact, she even took her best friend, Krista Bleck, with her. "I wasn't afraid at all," she said. "I went and checked it all out: the sterile areas in the operating theatre, the instruments they were using, the surgeon's qualifications ... By the time the operation came round, I was completely satisfied everything would be fine."