Free consultation

If you wish to benefit from a free consultation, please :
* Fill out the form below
* Send us photos of your body areas to be treated (face, right and left profiles )

N.B : All information provided will be treated on a strictly confidential basis.


Name & Forename * :

Sex * :

Date of birth * :

E-mail * :

Phone * :

Address * :

City :

Have you already consulted an aesthetic surgeon ?
Previous surgeries :

Procedures set by surgeon :

Desired surgery * :