Cosmetic Surgery in France--A Shift in Emphasis for Women

According to a survey done by IFOP for the newspaper le Parisien late last year, 14% of women reported that they have used esthetic medicine or esthetic surgery for significant procedures. This is up from 6% in 2002. Younger women account for the fastest growth in use of esthetic medicine; 9% of females 18-24 reported they had already had at least one procedure.

The most common surgical interventions are breast enhancement (19% of those reporting a procedure). Wrinkle treatments are second, (18%), followed by “remodelisation of the thighs and/or buttocks via liposuction" which comes in third (13%). This is s shift from 2002 when the most common surgical procedures were hair-removal, nose reshaping and belly reduction. Breast enhancement surgery was reported only rarely 7 years ago.

Most of the French women, 64% of those responding who have had this surgery, say they do this for their own confidence with only 6% saying they did this to please their partner. This, again, represents a change from 2002 when 21% of women said it was for their significant other.

These kinds of medical treatments are not covered by the French health national insurance system and the cost of the work can be significant. For wrinkle injections the charges are between 380€ and 650€ ($490-$610) depending on the parts of the body being treated. A breast augmentation will cost between $4,000 and $5,000 with a “lifting” of the buttocks up to $14,000. The only cases the state insruance will cover are reconstruction of the breast(s) after cancer treatment.

Patients’ Rights in France

There is an emerging movement to promote patients’ rights and the French Ministry of Health is promoting best practices through a recognition system. The University Hospital of Brest won the “Jury Prize for the work of its ethics committee in developing a mechanism for counseling patients making them aware of advance directives and applying them in all the units of the hospital. The National Union of Association of Parents of Children with Cancer (UNAPECLE) which held a national stakeholder conference to discuss the challenges faced by children and adolescents with cancer. The program included a series of debates involving parents and peers along with caregivers.

A national law outlining patients’ rights was passed in 2002 with three major goals:

To develop a “sanitary democracy” recognizing the rights for all persons in their relations with the health system by instilling the rights of the users as they relate to the health system and creating consistent national and regional policies.
To improve the quality of the health care system by improving the skills of all practitioners, medical training and prevention policy.
To reduce the risk of illness by improving access to health insurance and establishing a system of medical liability that allows for compensation for victims of medical accidents.

I will describe some of the details of this law and its implementation in greater detail, but one section, the last, stands out. Article 61 Creates a presumption of “imputability” for infections of blood by hepatitis C during blood infusions. This is a further response to the tainted blood scandal of the 1980s and 1990s that resulted in a conviction of a former health minister, Edmond Herve of manslaughter in 1999. He received no sentence.