Please complete the form below.
Send three photos of yourself (selfie, both profiles) to our office text line at 913-608-8223.
Our team will be in touch within 72 hours following your submission.

Review current surgical pricing here.

(subject to change)

Name *

First Name

Last Name

Gender *

Phone *

(###)

###

####

Email *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How did you hear about FACE Leawood? *

Procedure(s) of interest *

Deep Plane Facelift

Deep Neck Lift

Brow Lift

Upper Blepharoplasty

Lower Blepharoplasty

Chin Implant

Lip Lift

Forehead Reduction

Neck Liposuction

Buccal Fat Reduction

Otoplasty

Mole Removal

Dysport

Botox

Daxxify

Filler

Microneedling

Chemical Peel

Dermaplaning

CO2 Laser

Date of Birth *

YYYY

Height *

Weight *

Are you in the process of losing weight? *

Yes

If so, how many pounds are you from your goal weight?

Are you taking anything for weight loss? If so, which medication? *

List all medical conditions *

List all medications and supplements you are currently taking *

List all prior surgeries *

List all prior facial procedures (Botox, filler, laser, threads, energy-based treatments, etc) *

Do you smoke or vape? *

Next step (required): send three photos of yourself to our office text line at 913-608-8223. One selfie/face on. One of each profile. Hair back. Makeup is okay.

I understand photo review is complimentary. Should I decide to schedule a 1-hour surgical consultation, I understand the $200 fee is non-refundable and will be charged at the time of scheduling.

I understand I am required to send 3 photos of myself to 913-608-8223.

Thank you.

Call or Text: (913) 608-8223

4950 W. 135th St. Leawood, KS 66224

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It’s about you. Asking, knowing, understanding.

Consultation Request for Dr. Lauren Umstattd

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