French plastic surgeon compares practices in his country to those in U.S.

Publish date: Dec 1, 2011
By: Ilya Petrou, M.D.


Cosmetic surgery is booming in France, and the palette of procedures performed is very similar to what is offered in the United States. The major differences between these two countries can be seen in the subtlety (or lack thereof) of cosmetic augmentations and the legal ease with which patients can undergo the many procedures available, a French surgeon says.

Dr. Mole

"The aesthetic market in France is very similar to that in the U.S. in terms of the procedures performed, as well as the trend for increasingly younger patients to have a given cosmetic procedure performed, whether it be a breast augmentation or a botulinum toxin or filler treatment," says Bernard Mole, M.D., a plastic surgeon in Paris. "However, the aesthetic goals of cosmetic patients in France are geared towards more subtle changes."

According to Dr. Mole, many French cosmetic patients often prefer smaller breast-augmentation procedures, choosing smaller increases in cup size than their U.S. counterparts. In France, a typical breast augmentation patient may choose a 300 cc implant per breast, which may be considered too small for cosmetic patients in the North America, as the breast implants often selected in the United States are closer to 400 cc to 500 cc per breast, he says.

IDEALS OF BEAUTY "There is a fundamental difference in the perception of ideal beauty when comparing the French and American societies," Dr. Mole says. "Moreover, I believe that the reason why many patients may choose larger implants is because they want the cosmetic augmentation performed to be very visible. They pay for it, so they want the change or augmentation to be clearly seen."

This way of thinking is in stark contrast to the French philosophy of "less is more," Dr. Mole says. French patients do not consider cosmetic surgery to be taboo; however, most place a great amount of emphasis on a natural-looking final result. The sizes of implants ultimately chosen in France reflect this philosophy, Dr. Mole says.

Facelift procedures in France also are less extreme in terms of the degree of tissue lifting compared to those performed in the United States, Dr. Mole says.

"Recently, I believe that the ‘less is more’ philosophy seen in France and many other European countries is slowly but surely becoming more popular in the United States," Dr. Mole says. "There is a definite trend toward more natural-looking aesthetic results in the U.S., as more and more patients are requesting smaller procedures and more subtle changes in their looks. This change may also be fueled by the increase in complications associated with larger-volume implants."

FRENCH REGULATIONS In order to better protect the well-being of cosmetic patients, Dr. Mole says the French health authorities ("Haute Autorité de Santé," or HAS) has instituted legislation requiring potential cosmetic surgery patients to complete psychological profiling prior to undergoing a cosmetic surgery procedure. Would-be cosmetic surgery patients must wait a minimum of 15 days before going through with a given cosmetic procedure, allowing the patients time to think about their choice and help them avoid rash decisions.

"The law in France is quite restrictive for cosmetic surgery regarding the ease at which patients can have procedures done. This is for the sole purpose of protecting the consumer and helping them avoid little-thought-out or ill-advised choices regarding cosmetic surgery," Dr. Mole says.

The 15-day window is required for the gamut of cosmetic surgery procedures, from more invasive surgery such as breast augmentation to simpler procedures such as botulinum toxin and filler treatments. To further protect potential patients, botulinum toxin injections in France may only be performed by physicians belonging to one of five medical specialties, Dr. Mole says. These are dermatology, plastic surgery, ophthalmology, neurology and ENT.

"In France, botulinum toxin is considered a drug and therefore has restricted use. The consideration from the authorities is that the potential adverse events and complications that could result from botulinum toxin injections can best be addressed and managed by physicians of these specialties. Many physicians disagree with this stance. However, it is the law here in France," Dr. Mole says.

Fillers are considered a medical device in France, so physicians of any specialty can administer these injections — but only after the mandatory 15-day waiting period.

"Cosmetic patients in France have allowed cosmetic surgery into their lives and do not hide from this new norm," Dr. Mole says. "They begin with anti-aging techniques and minimally invasive treatments at a younger age and have accepted the fact that they will require other and perhaps more invasive procedures as time passes in order to better maintain their once-youthful appearance. It is a conscious and welcomed decision."



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