Off to Tallinn for affordable nip and tuck

Thousands of cosmetic operations are performed each year in Estonia. These include breast augmentation and liposuction – by far the most popular – but also face lifts, tummy tucks, rhinoplasty (nose jobs), and for male patients hair transplants and penis enlargements.

In fact, Estonia has become something of a hub for cosmetic surgery since independence. While Tallinn offers a beautiful, unspoiled medieval Old Town, it also offers something else – lower prices.

That lower price is the main incentive for several Finnish-owned clinics that operate in Estonia. Most of the foreign clients they serve are Finnish, while the doctors are Estonian.

Tia Jansson does the initial consultations with patients in Helsinki for the 11-year-old Finnish-owned, Tallinn-based Christina's Clinic. Patients photos are taken and sent to the surgeons in Tallinn, where the patients arrive by ferry for their appointment.

"We operate in two places in Tallinn. Most of our clients come from Finland and some come from as far away as Africa," Jansson said. "There was a time when about 50 percent of our clients came from Sweden, but we have shut down the Stockholm office recently." Christina's Clinic handles between 300 and 1,000 clients a year.

"If you operate here in Finland the prices are twice as high, and its hard work to compete here in Finland with the other clinics," said Jansson.

While a facelift in Western Europe can run upward of $7,650, in Estonia $760 will suffice, and Christina's Clinic isn't the only one taking advantage of that option.

Reval Clinic, which takes its name from the medieval name for Tallinn, is also operated out of Helsinki, although all procedures are performed in Tallinn. Reval has been operating for 14 years and clearly seeks a foreign clientele. Its Web site is available in English, Finnish and Italian, and all initial consultations are done via e-mail, including the scheduling of surgery and prices are given in euros. The only Estonian word to be found on the site is "Tallinn."

Reval also provides a "European service packet," which pays for the patient's journey to Tallinn, including food, accommodation and trips from the harbor or airport to the clinic and back.

Its prices are extremely competitive with Finnish prices, even when travel costs are included.

However, while foreign patients in Tallinn are abundant, there are clinics that handle mostly Estonians clients. Dr. Peep Pree operates Clinica, a cosmetic surgery clinic in Tartu.

Pree knows the Finnish-owned clinics in Tallinn well. His clinic used to market heavily in Finland. Now Pree operates mostly on Estonians, operating on approximately 500 patients a year.

"Finland is twice as expensive as Estonia. It is possible to find the same price in Finland, however, patients that have been to these places tell me they'll never go back," he said.

He equates the inexpensive clinics to working in a factory. "They want to (operate on) as many people as possible," he said.

Another problem Pree has with foreigners coming to Estonia for surgery is that he rarely can follow up on the patients. He requires a checkup seven to 10 days following the procedure and a second one two months later.

"If I have a Finnish woman that flies down from Rovaniemi for the surgery, it is unlikely that she will return for any follow-ups," Pree said.

He also says that the "factory-like" conditions of many clinics lead to well publicized stories in tabloids about operations gone awry.

"If you work like a factory worker, you lose your doctors' way of thinking," Pree said.

Still, Pree's practice offers prices similar to the foreign-owned clinics, and he has operated on patients from Latvia and Lithuania, often television personalities or other notables who come to Tartu to avoid the stigma of having plastic surgery.

Pree also said that while many foreigners sought inexpensive surgery in Estonia, Estonians also shop elsewhere for surgery.

"I know of people from Tallinn who have had surgery in France, Finland, even the United States," he said.

Pree, like the other doctors, handles mostly breast augmentation and liposuction.

"Breast surgery is my love," he said.