my surgeon was local and he had great reviews and I stand by him dr Marc Zare in San Jose Ca. the whole approval process took 3 months and they handled the insurance for me and were very thorough. I had the vertical sleeve and so far no regrets. i agree with some of the reviews about just doing your research and join a local support group. read reviews on drs and talk to people about their experiances. wether you get in un US or France doesn't matter complications can happen nothing is 100 percent gurantee. good luck with your journey.