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Patient's Inquiry
Please tick appropriate boxes to indicate your problem
Liposuction
(removal of excess fat from body)
Abdomen Thighs Double chin
Flanks Hip
Arms Male breast
Rhinoplasty
(beautification of nose)
Broad and blunt tip of nose Hump nose/angular elevation
Small nose/lack of height Depressed deformity/saddle nose
Mammoplasty
(beautification of breast)
Too small breast Pendulous/sagging breast
Too big breast
Face
Thick lips Wrinkled skin Dark skin patch
Thin lips Mole
Pimples Baggy eye lids
Scar Mark
Location : Cheek Chin Nose Forehead
Color : Same color as skin Dark
Level : Elavated Depressed Same level of skin
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Patient's Information
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Cosmetic Surgery Centre Ltd.