Online Consultation

Name*

Email*

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Telephone*

Age*

Please tell us in your own words what bothers you about your appearance:*

Please tell us what, in an idea world, you would like us to achieve for you:*

Would you prefer to explore surgical or non-surgical treatment options?

SurgicalNon-surgicalBoth

Please tell us which specific concerns you have using the following boxes:

Forehead wrinklesFrown linesCrow’s feetHeavy upper eyelidsBaggy lower eyelidsUnder eye hollowsSagging cheeksCheek wrinklesNose-to-mouth wrinklesUpper lip lines (“smokers” lines)Lip volumeMarionette linesChin areaJowlsJawlineLoose skin on neckWrinkles on neckPigmentation spotsThread veins

Budget:

Please tell us - if you wish - the budget you would like to invest in your treatment. Please note that you do not have to tell us how much you wish to spend however doing so allows us to better tailor our advice to you and guide you to make the best use of your investment to get the most out of your treatment.

Upload an image:

Please attach at least one clear recent photograph of yourself. Please do not pose in the picture - please keep your head in a neutral position and have someone else take the photograph in natural lighting conditions. Ideally you should also provide a photograph from each side, as well as each oblique view. Finally, please feel free to additionally attach a further close up photograph of any specific feature you wish to highlight. You may upload up to 6 images.

Please give the form up to a minute to receive your photos after pressing "send".

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