Multiple quality assurance activities in the German plastic surgery association are outlined, such as the collection of structural data, inspections of units by expert commissions, tracer diagnosis, continuous evaluation of health outcome by patient questionnaire, training programs for residents and a credit point system for congress activities. Interdisciplinary groups are formed for internal quality management within hospitals. EBOPRAS is responsible for accreditation of training centers and the European (Union) Board certification. EQUAM activities aim for quality improvement of biomaterials. Quality management activities within the international Confederation of Plastic, Reconstructive and Aesthetic Surgery concentrate on the definition of minimal requirements for training units and the establishment of a quality management philosophy.