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First Name

Last Name

Date of Birth

Gender

Email

Phone Number

Height in feet and inches

Weight in pounds

Appointment request with

Body Surgery:
(Please check the procedures you are interested in)

Abdominoplasty (Tummy Tuck)

Brachioplasty (Arm Lift)

Body After Baby

Body After Weight Loss

Buttock Lift

Labiaplasty

Liposuction

Scar Revision

Thigh Lift

Face Surgery:
(Please check the procedures you are interested in)

Brow Lift

Blepharoplasty (Eyelids)

Face and/or Neck Lift

Fat Grafting

Otoplasty

Rhinoplasty

Breast Surgery:
(Please check the procedures you are interested in)

Breast Augmentation

Breast Reduction

Breast Lift (Mastopexy)

Breast Asymmetry Correction

Male Breast Reduction

Medical Aesthetics:
(Please check the procedures you are interested in)

BelaMD Advanced Hydrafacial

Botox/Nuceiva

Facial/Peel

Cosmetic Fillers

Microneedling

Skin Analysis/Care

Other

Timeframe:

Additional Information

Preferred method of contact

How did you hear about us?

Our office is designed to feel warm and welcoming

The Landings Surgical Centre

Our surgeons have the training and expertise to provide the beautiful results you deserve. Drs. Bendor-Samuel and Boileau are members of several esteemed organizations, such as:

Royal College of Physicians and Surgeons of Canada
Canadian Society of Plastic Surgeons
Canadian Medical Association

Schedule a consultation online or call us at (902) 492-2007 to learn more. Our Halifax practice provides convenient care for patients from Prince Edward Island and nearby areas.

Halifax Office

1477 Lower Water St
#145
Halifax, NS B3J 3Z4

Open Today 7:00am - 4:30pm

About Our Office Directions (902) 492-2007

Google map image of our location in 1477 Lower Water St Halifax, NS

*Disclaimer: results are not guaranteed, may not be permanent, and can vary per individual. Some images are of models, not actual patients.

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