Personal Information
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Your Details
  1. Sex (required)
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Choice of Plastic Surgery(s)
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Medical History
FOR WOMEN ONLY
  1. Have you undergone any surgical means of birth control (e.g. Tubal Ligation)?
  3. Are you pregnant now?
  5. Are you planning any more pregnancies?
  9. Have you ever breastfed?
  11. Do your breasts still have milk at this time?
  13. Do you smoke?
  17. Do you drink alcohol?
  20. Note: Lactation may also be induced by other factors such as hormone intake. Please test by squeezing breasts
ADDITIONAL INFORMATION
UPLOAD PICTURES FOR FREE EVALUATION
  1. Please make the pictures as clear as possible and take side view and front view pictures and back if relevant.
 

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Cosmatic Surgery Procedures
Botox Injection
Breast Augmentation
Breast Augmentation – Saline Breast Implants
Breast Lift
Brow Lift
Buttock Implants with high cohesive gel
Chin Augmentation
Chin Reduction Reshaping (Genioplasty)
Dorsal Hump Correction
Double Eyelid Surgery
Endoscopic Brow Lift
Endoscopic Face Lift
Endoscopic Forehead Lift
Eyelid Surgery
Face Lift
Facial Feminization Surgery (FFS)
Facial Surgery
Fat Transfer
Gummy Bear – Cohesive Gel Breast Implants
Hair Transplant
Labia Surgery
Lip Augmentation
Lip Reduction
LipoSelection by Vaser
Liposuction
Liposuction with Body Jet (Water Assisted)
Mandible Angle Resection (Jaw and Chin Shaving) Surgery
Nasal Tip Rhinoplasty
Nose Augmentation – Fat Injection
Nose Augmentation – Rhinoplasty
Nose Surgery – Alarplasty
Otoplasty – Ear Surgery
Penis Enlargement Surgery Phalloplasty
Permanent Hair Removal
Restylane Injection
Rhinoplasty – Nose Surgery
Sex Change, Sex Reassignment Surgery
Silhouette Lift
Tummy Tuck
Vagina Tightening
Vaser High Definition Sculpting
 
 

 


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SP Clinic 1519/69-70 Ladproud 41/1 Samsennog Huaykuang Bangkok 10310, Thailand
Mobile Phone For English please call + 6681 9011 030
Tel. +662 9304450-5 Fax. +662 9399061
 
email: spsansiri@yahoo.com       drsompob@sp-cosmeticsurgery.net
 
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