What will we see there? What are these people like?

First impressions. Pre-war buildings, lines of villas encased in greenery. Among these we easily find the right destination – in the widest sense of the word.

When you walk into the clinic you have the impression that time has stood still. Good! Because you come to, even just a little, slow things down.

The reception encloses us with warmth, calming us as we stop for a while. The colours are warm, the furnishings comfy, the walls covered with diplomas. It is good to know who you are dealing with. A list of references in a glance of the eye!

From their first words, we know the female attendants are the right people for the right place. Friendly, professional, totally engaged in their work. And we know already that no-one here is treated as just a nameless face. They give us detailed, honest answers to all our questions as potential patients.

So we move on to the next level.

The key person greets us at the door of his consulting room. Plastic surgeon Maciej Pastucha. We begin a long, calm conversation, which convinces us further that we are in safe hands. Step by step, he patiently explains his work, focusing on the issues that have brought us here – as, in the end, we did come to fight with nature. To the extent it allows.

We want to fix the shape of our breasts, make them as they were before the pregnancy and breast-feeding.

Good news. We can do this here. At Artplastica.

If we had more time we would have stayed with the doctor for hours.

After saying goodbye and arranging our next appointment, the attendants take us on a tour of the whole clinic, including the operation theatres, which are being prepared for surgery. They insist we change into fully sterile clothing.

We go a floor down to the post-op room, where are women in their second day after surgery. It is incredible. They are smiling. We can see the happiness, which they say is twofold. For one, they can already see the effects will be excellent. And the operation is over.

They all say that if they had known how easily it would go, they would have come here earlier.

The nurses, moving around quietly and effectively, get the doctor’s permission and take us into the theatre. It’s clearly the 21st century, the room packed with modernity and equipment. Even for the layman it’s clear that everything is top class and optimally chosen.

Leaving the satisfied smiles of the patients behind, we change back into our clothes and return to the first floor. Here is where patients go in the days after the operation, quietly getting used to their new look, and developing friendships with other patients. As the attendants tell us, these experiences bind people and relationships started in the clinic often last long after.

In the room, we see the visitors book, started not by the clinic but on the patients’ initiative, filled with their positive thoughts. There’s honesty on every page, contributors wanting only to express their respect for the doctors and the whole team.

I spent here the best days – the first days of a NEW LIFE!

German Renate Kloss had always dreamt of having larger breasts but the 53-year-old lacked the minimum 5,000 euros which surgeon in her own country demand.

So she headed across the border to Poland where the same operation was available for half the price.

Artplastica, the clinic Kloss chose on the Internet for the procedure, is located in a villa in a suburb of Szczecin, close to the German border.

Part of the building still has an opulent Polish interior fitted out with elegant dark wood furniture. The other part has been adapted to house operation halls, bedrooms, changing rooms for surgeons and a nurses station. (...)

The clinic's surgeon, Maciej Pastucha, operates on around 10 patients per week, 95 percent of them women. 

"Most women come here for breast enlargement or lifting, for liposuction or eyelid surgery," explains Pastucha, handling a number of mammary implants on his desk.

"Men come above all to have prominent ears corrected and sometimes for liposuction." 

Here in Szczecin the operation costs Kloss 2,600 euros (3,350 dollars) -- a significant savings over what she would have had to pay in. 

"It was my dream for a long time to have reasonable breasts, to be able to wear bikinis without hearing dumb remarks," she said. 

The actual operation to insert silicon implants lasts less than one hour under a general anaesthetic.

Like Kloss, thousands of women are increasingly deciding to travel to the new EU member countries to improve their appearance at a reduced price.  

Profiting from the proximity of the German and Austrian markets, clinics have opened in, and the Czech Republic.

"Since our entry to the EU, our country's image has changed and it's easier to decide to come to have an operation here," says Pastucha.  

Over the past year the number of clients at Artplastica has jumped 20 percent, three-quarters of whom are German. Germans make up the bulk of foreign clients. 

Despite everything, Czech and Polish clinics have to work hard to convince potential clients of their high standards.

Pastucha has posted photographs of all his diplomas on Artplastica's website.  

The network of the Czech clinics Cz-Wellmed wants to be even stricter than its German competition.  

"Unlike in Germany, a dermatologist or gynaecologist is not authorised to operate on breasts or carry out liposuction in the Czech Republic," the clinic states in its brochure.

To prevent accusations of medical dumping, Cz-Wellmed also makes the effort to explain why its prices are much lower.  

"The price of mammary implants is the same but the costs of personnel and premises are lower, which is why the margins are different," it said.  

Faced with rising competition, surgeons in western Europe are trying to sow doubt in the minds of customers mulling plastic surgery. 

"Cheap offers draw many patients abroad but for many of them, this journey turns into a financial and painful nightmare," warns Cologne surgeon Rainer Abel on his Internet site -- but does not back up his claims with examples.  

"Our patients find that we are good," insists Pastucha, who relies on word of mouth. 

 Kloss for one is convinced.  

"In Germany they ask you to pay, pay, pay. Here I have still not paid a single euro, which is much more human and amicable," she says.

[Text and Picture Copyright © 2005 AFP. All other copyright © 2005 EUbusiness Ltd. All rights reserved. This material is intended solely for personal use. Any other reproduction, publication or redistribution of this material without the written agreement of the copyright owner is strictly forbidden and any breach of copyright will be considered actionable.]

By Ruth Elkins in Berlin

09 January 2005

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 Germany 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 , 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 '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 , 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 let 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 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 : 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 return to 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."

From the special emissary in Szczecin

"I am in Poland to get back my smile and become again happy", says Henrik Brondum. (...)

La Pologne , fournisseur de dents neuves et de gros seins

Dentiste, chirurgie plastique: les prix imbattables attirent les étrangers.

Par Maja ZOLTOWSKA

mercredi 01 décembre 2004 (Liberation - 06:00)

Szczecin envoyée spéciale

«Je suis en Pologne pour retrouver mon sourire et être de nouveau heureux», dit Henrik Brondum. Cet ouvrier du bâtiment danois, originaire d'Alborg, est venu à Szczecin, près de la frontière avec l'Allemagne, pour y soigner le peu de dents qui lui restent. «Les dentistes danois sont des suceurs de sang. Là-bas, un implant coûte 20 000 couronnes. Ici, je peux l'avoir à moitié prix (6 000 zlotys, 1 500 euros, ndlr) pour la même qualité», explique-t-il, dans la salle d'attente d'un cabinet dentaire moderne.

Tous les lundis à 9 heures, la clinique du docteur Cezari Turostowski se remplit de patients danois. Ils arrivent la veille, en bus affrétés à des prix imbattables par des tours opérateurs danois : le trajet et quatre nuits à l'hôtel Radisson, pour 899 couronnes danoises (120 euros). Le matin, le travail à la chaîne commence. «D'abord les clichés avec un appareil radiographique ultramoderne français, puis les premières consultations ­ en anglais toujours. Les huit patients sont répartis entre les six dentistes du cabinet.» «Pas de temps à perdre, pour faire des bridges, des couronnes ou des prothèses avant leur départ, notre laboratoire doit travailler jour et nuit», poursuit le docteur Turostowski, qui a fait des stages aux Etats-Unis et en Grande-Bretagne.

Lorsqu'il a trouvé sur Internet un site faisant la promotion des soins dentaires en Pologne, Henrik n'a eu aucune hésitation. Il a tout de suite contacté l'intermédiaire danois, la société Avmintand («Aïe, ma dent», en danois). «Son patron prépare les patients, m'envoie la liste pour me prévenir à l'avance, explique Turostowski. Il prend sa commission évidemment, mais c'est tout à fait normal.» Turostowski n'est pas le seul à soigner ainsi les étrangers. Sur Internet, d'autres cliniques vantent en anglais et en allemand «la qualité européenne à des prix polonais».

Avantage. «Je ne crains pas la concurrence de mes confrères, ils ont déjà plein de travail avec les Allemands. Je crains plutôt la concurrence de dentistes hongrois, turcs ou tchèques, chez qui les Danois vont se soigner également.» Mais la Pologne a l'avantage d'être seulement à huit heures du Danemark. Henrik devra encore revenir deux ou trois fois à Szczecin . «Il nécessite un long traitement, souligne le docteur, une semaine ne suffirait pas pour faire six implants, des couronnes, un bridge, indispensables pour lui redonner le sourire.» Un tel client vaut de l'or en Pologne. «Les Polonais n'ont pas assez d'argent pour ce genre de soins, ils se contentent de soigner leurs caries, et si jamais ils se décident à un implant ils s'en paient un seul, rarement plus», ajoute sa collaboratrice. Pour la majorité des Polonais, c'est un luxe inaccessible : un implant coûte trois mois de salaire moyen.

«C'est la main-d'oeuvre qui fait que nos soins sont deux fois moins chers, alors que nous utilisons exactement les mêmes techniques et les mêmes produits», explique un autre médecin polonais, qui a trouvé un créneau juteux : la chirurgie esthétique. Sentant l'essor prometteur de ce marché, Maciej Pastucha a ouvert sa clinique à Szczecin il y a deux ans. Aujourd'hui, il ne le regrette pas, la proximité de l'Allemagne lui assure un flux régulier de patientes sur lequel il ne pourrait pas compter en Silésie, une des régions les plus touchées par la crise. En moyenne, il fait 25 opérations par mois, avec 97 % de clientèle allemande.

Annette, 20 ans, a toujours rêvé de seins volumineux. Arrivée à Szczecin avec une poitrine taille B, elle en repart trois jours après avec des bonnets taille C, et pour seulement 2 500 euros. Dans une clinique près de Düsseldorf, elle était sur le point de payer 6 000 euros, avant d'apprendre qu'en Pologne, à sept heures d'autoroute, elle pouvait n'en dépenser que la moitié. «Au début, j'ai hésité, me disant que c'était loin, que j'allais peut-être tomber sur un charlatan», mais sa mère, d'origine polonaise, l'a convaincue en lui vantant les qualités des médecins polonais.

Les étrangères d'origine polonaise constituent d'ailleurs la moitié de la clientèle d'Artplastica, dont les 20 employés parlent parfaitement l'allemand et l'anglais. Si la patiente voyage en avion, elle est prise en charge dès son arrivée à Berlin, à 140 km de Szczecin, où une voiture va la chercher gratuitement. Sur place, elle est logée et nourrie et ne se soucie de rien durant le séjour, de deux à cinq jours selon l'intervention. «Le stress est déjà énorme dans ce type d'opération. Il doit être encore plus grand quand un patient se remet entre les mains d'un étranger», reconnaît le docteur Pastucha. Pour rassurer, ses diplômes polonais et étrangers ornent les murs de son cabinet. Il touche du bois, «pour l'instant, tout se passe bien, il n'y a eu aucune plainte».

Alors que ses patientes s'offrent de nouveaux seins, des cuisses fines et un ventre plat grâce à la liposuccion, d'autres Allemandes font, elles, leurs provisions à Szczecin . A voir les voitures sur le parking du centre commercial, à 14 km de la frontière, on se croirait en Allemagne. Les plaques d'immatriculation polonaises sont en minorité. «70 % des clients sont allemands, dit un vendeur. Le week-end, même plus, 90 %. C'est facile de reconnaître un client polonais, son chariot est moins rempli.»

Formalités rapides. «Tout est moins cher ici, les produits alimentaires, les lessives, les vêtements, sont à moitié prix. Une cartouche de cigarettes est quatre fois moins chère que chez nous», dit Ingrid Helmut, retraitée sortant d'un Géant. Avec son mari et un couple d'amis, elle vient une fois par mois de Furslenberg, une ville allemande à 120 km de là. A la frontière, les formalités sont plus rapides, «plus besoin d'avoir un passeport. Depuis le 1er mai, une carte d'identité suffit», dit son mari. Ils rentabilisent au maximum le trajet et les multiples services du centre commercial : Ingrid apporte des vêtements au pressing et va chez le coiffeur, tandis que son mari fait le plein d'essence, change les pneus et fait une vidange. A midi, ils cassent la croûte assis sur un banc, avec des sandwichs achetés sur place mais «toujours du café maison apporté dans un thermos», rit Ingrid.

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