Dr. Claudio N. Saladino

+54 11 4811-1575 / +54 11 4813-5814
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Basic Information

Last Name
Name
Age
City
State

Country

Email
Telephone
Medical Specialties:
Type of consultation:
 Breast Augmentation
 Breast Reduction
 Breast Lift ( Mastopexy)
 Peeling
 Face Lift
 Eyelid Surgery
 Rhinoplasty
 Chin Surgery
 Ear Surgery
 Liposuction
 Abdominal Surgery
 Botulinum Toxin
 Arm and Thigh Lift
 Aesthetic Surgery of the Facial Skeleton
 Gynecomastiabr>  Hair Transplant
 Feather Lift
 Viginal Rejuvenation
 Penis Enlargement

Personal information

Your height
Your current weight
What is the maximum weight you had?
Do you smoke?
If yes, how many cigarettes a day?
When did you start smoking?
Have you stopped smoking?
How often do you drink alcohol?

Medical history

Are you currently taking any medications?
Are you taking aspirin?
Are you currently under any treatment?
If yes, since when?
Do you have any allergies?
Are you allergic to any medicines?
If yes, which one?
Do you have diabetes?
Do you suffer from cholesterol?
Do you suffer from high blood pressure?
Do you suffer from anaemia?
Do you suffer from blood?
Other comment

Surgical Record

Have you had surgical procedure before?
Have you had cosmetic surgery?
If yes, on which part of your body?
Other comment

Gynecological and obstetrical record (ladies only)

Number of pregnancies if any?
Number of children if any ?
Number of caesareans if any ?
Do you intend to be pregnant ?
If yes, in how long ?
In case of breast surgery,
What is your cup size?
Have you had mammography?
When?
Have you had breast cancer before?
Is there a history of breast cancer in your family?
If yes, which member of the family?
Other aditional comment
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