The authorities believe that the size of the fraud may be as much as €10 million in 2006/7.

It does seem it is not very difficult to get around the regulations, for the operations are simply declared as restorative work required as a result of a medical condition, accident, or deformity.

Thus, a breast enhancement operation may be declared as reconstructive breast surgery; eyelids lifted done under the pretext of remedying an eye condition; liposuction done under the guise of restorative work on the abdomen; or chemical peels carried out to remove wrinkles, declared as an acne problem.

Authorities report that the abuses are particularly concentrated in Paris and the Marseilles region. One plastic surgeon in the Paris region alone is believed last year to have undertaken irregular operations costing around €65,000 to the public health service.

Whilst the 500 or so registered plastic surgeons in France are first in the firing line, the authorities are also investigating operations undertaken by general surgeons, ophthalmologists, and gynaecologists.

Indeed, last year a general practitioner was struck off the medical register for undertaking breast implant surgery in his consulting room. Not only was he not qualified to do so, but the conditions under which the operation took place manifestly failed to comply with regulations.

As authorities seek to clamp down on the abuses, and as the costs of plastic surgery in France rise, many French are deciding to make the trip to Morocco or Tunisia, where over the past few years there has been a substantial growth in plastic surgeons setting up in practice.