Are You a Candidate?
Take Our Quiz to Find Out!
What are your main reasons for considering liposuction?
To improve body contour
To remove stubborn fat deposits
To enhance self-esteem
Other
Have you ever previously attempted other surgical methods for fat reduction?
Yes
No
Do you have any medical conditions, take any medications that might affect surgery or recovery, or have any allergies, particularly to medications or anesthesia?
Yes
No
What areas of your body are you interested in targeting with liposuction?
Abdomen
Thighs
Hips
Arms
Back
Other
Have you consulted with a healthcare provider or plastic surgeon about liposuction before?
Yes
No
What are your expectations and goals for the outcome of the liposuction procedure?
Minor body contouring
Significant body reshaping
Weight loss
Other
What is your current level of physical activity?
Very active (exercise regularly, high physical activity job)
Moderately active (exercise occasionally, moderate physical activity job)
Slightly active (light exercise, sedentary job)
Not active (rarely exercise, sedentary lifestyle)
What is your age?
18 -24
25 - 34
35 - 50
51 - 65
65+
Full Name
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Phone
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Email
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