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Avéli Questionnaire

First Name* This field is required.

Last Name* This field is required.

Email* This field is required.

Birthdate (MM-DD-YYYY)

Please enter a valid phone number.

Please submit your photos for review.

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By submitting this form, you agree to be contacted by phone, email or text and that any associated call may be recorded for quality and training purposes.

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Breast Revision Questionnaire

First Name* This field is required.

Last Name* This field is required.

Email* This field is required.

Birthdate (MM-DD-YYYY)

What is your current height and weight?

Do you smoke/ use tobacco, marijuana, or vape?

Please list all past breast surgeries.

Where are your incisions placed?

What type of breast implants do you have?

What size is your current implant?

Where is your current implant placed?

Please upload a copy of your implant card here.

What did you really like about your first procedure?

What are your current concerns about your breasts?

Have you noticed any changes in breast shape, size, or firmness?

Do you have children?

What are you looking for in breast results?

Use our secure upload tool to submit your photos for review, please see guidelines below for instructions.

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By submitting this form, you agree to be contacted by phone, email or text and that any associated call may be recorded for quality and training purposes.

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*Use our secure upload tool to submit your photos for review.

If you have any questions or concerns, please don't hesitate to contact our office at (737) 787-7338.

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A Patient for Life

When you get plastic surgery at The Piazza Center, we make a long-term commitment to your recovery, your beauty, and your well-being.

Learn More about Patient Resources

Skincare Products

Enhance your daily skin care regimen with professional grade products. We can help personalize your routine based on your skin’s unique features.

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Non-Surgical Team

Our experienced providers are trained in a wide range of aesthetic treatments, ranging from lasers and injectables to the fine details of skin care. They are your specialized team at The Piazza Center.

Meet Your Providers

Real Patients. Real Stories.Helping Our Patients to Live Confidently

Find out what it’s like to be a patient of The Piazza Center. Review the stories and “after” photos of some of the plastic surgery patients who’ve shared their experiences with us.

View all Testimonials

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Before & After

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Words from our patients. We are committed to forming lifelong bonds.

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Lorem Ipsum

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“I am beyond grateful for Dr. Piazza and his team for making me feel beautiful and happy with myself.”

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