Plastic surgeons refuse surgery to some patients

Cosmetic surgery: health insurances rarely cover the costs


For aesthetic operations that are not medically necessary, the statutory health insurances do not cover any costs. Depending on the procedure, these are quite considerable. In some cases, the interventions also entail additional operations and costs. If complications arise after an intervention that is not medically necessary and which require further medical treatment, the statutory health insurance company must share the costs with the insured in an appropriate amount and refuse or reclaim sickness benefits in whole or in part for the duration of this treatment (Section 52 subs . 2 SGB V).

Qualified doctors

Most aesthetic operations are performed by plastic surgeons, dermatologists and gynecologists. The term "cosmetic surgeon" is not protected by law, as there is no public law qualification for this from the medical associations. Doctors who have a recognized additional qualification for aesthetic operations can be recognized by the designation "Specialist in plastic and aesthetic surgery".

But be careful: Even doctors without this additional qualification and without trained medical staff can offer aesthetic operations. In addition, many beauticians offer beauty treatments. However, they are not allowed to invasive interventions. In addition, apparently minor interventions can cause damage if carried out incorrectly. So keep your eyes open when choosing a practitioner!

Liability and special duty of the doctor to provide information

For doctors who perform cosmetic surgery, the same liability rules apply as for other medical professionals, sometimes in a more stringent form: Because there are usually no medical reasons for intervening in the patient's body, stricter requirements apply to the Obligation to provide information of the doctor than for medically justified operations.

You must relentlessly and clearly inform patients about all risks associated with the procedure, including a possible cosmetic failure and the risk of postoperative disfigurements, and give the patient at least one day to think about the actual effects to be expected. Advertising for cosmetic surgeries that are primarily or exclusively aimed at children and young people has been banned since 2020 (Measles Protection Act). This also applies to advertising on social networks.

Doctors are liable if they use surgical methods for which they are not trained and which they therefore do not master sufficiently. You can also be held liable if you use methods that no longer correspond to the state of the art. Beauticians are not allowed to perform wrinkle injections. There are several fundamental rulings on this (e.g. OLG Münster 2006 and OLG Karlsruhe from February 17, 2012). Hyaluronic acid is also a medical product of the highest risk class 3 - an implant pass should be issued for this so that it can later be traced which product was injected under the skin by which manufacturer.

If problems arise after an operation and there is a suspicion of a treatment error, patients can inspect the patient file (Section 630g BGB) and have copies made of it. In this way, possible deficiencies in documentation can be identified and the work of a lawyer who may be appointed can be accelerated. If you are unsure whether there is a medical malpractice, you can usually contact the expert commissions and arbitration boards at the medical associations free of charge.

Aesthetic plastic surgery doctors mostly use contracts that regulate services, claims and remuneration. Liability may not be contractually excluded. The situation is different if the patient waives their claims after a failed cosmetic operation due to a compensation payment or after an offered surgical correction.

Cosmetic surgery abroad

Often, cosmetic operations are also offered abroad at significantly more favorable terms. However, additional caution should be exercised; because the quality of the services offered there by doctors or clinics as well as the medical standards can usually hardly be assessed in advance. It should also be noted that the follow-up treatment is usually difficult due to the spatial distance or is not available in the offers.

Anyone planning an operation abroad should therefore find out in detail both the medical qualifications and the quality standards of clinics. In addition, German law does not automatically apply. If an operation fails abroad, you cannot automatically hold the clinic liable for it - and you will incur high follow-up costs. The guarantee - for example in the event of complications - must therefore before the treatment in writing if possible according to German law be determined. For this it is essential to conclude a private treatment contract with the foreign doctor and / or the clinic.

Further information can be found under: Doctor visits and hospital stays abroad

Tips for dealing with cosmetic surgery

Before the procedure

  • Ask im consultation for possible side effects, risks and complications and let them explain them to you in detail!
  • Clarify with the health insurance company whether this is the Plastic surgery cost takes over! However, this is only possible in the rarest of cases and when there is a medical need. To do this, it is to your advantage if you contact the health insurance company directly with the help of a statement from the treating physician.
  • Ask if that Result of the procedure is permanent or limited in time and must therefore be repeated if necessary!
  • Inquire about which ones Qualifications the treating physicians have and how often the planned procedure has already been carried out by you.
  • Also, you should assure in writing let that the consulting doctor will also take care of the operation and not one of his colleagues who may be unknown to you.


In the consultation

  • Take one if possible Witnesses and prepare basic questions about the planned operation. In the preliminary discussion, the successes of an intervention are extensively praised and documented with corresponding glossy photos as proof, while the possible risks are not sufficiently pointed out. If the risks are not discussed sufficiently, the doctor is liable in the event of damage, even if no other mistakes have been made. If questions remain unanswered after the first consultation, they should be clarified in a second or third consultation.
  • Both the Operational sequence as well as the Healing process and the risks should be clearly explained. The question of which one is also important Emergency care can be offered. A previous inspection of the treatment rooms is useful.
  • You should not sign a treatment contract in the first consultation. A reputable doctor will give patients an opportunity Check the contract in peace and obtain other offers for comparison.
  • Definitely get before signing a contract several offers one and compare prices.
  • Be sure to ask for one after the consultation detailed cost estimatewhich, in addition to the operation costs, also provides information about the costs for anesthesia, laboratory and accommodation.
  • Do it no advance payments.
  • Ask for Copies of records and photoswho can document the course of treatment or surgery.


After the procedure

  • Depending on how difficult the medical procedure is, the Aftercare the more important. This should therefore be guaranteed by the operating doctor.
  • Insist on a correct one Invoice based on the fee schedule for doctors (GoÄ).
  • Wait for one failed intervention not too long for changes that are supposed to be occurring. Seek advice from another doctor.
  • Customize one Log of events secure the addresses of witnesses - for example those of neighbors - and document the situation with your own photos.
  • After a failed operation It is advisable to only negotiate with the doctor or the responsible insurance company with legal assistance.
  • they should under no circumstances a waiver or sign something like that.