Date of Surgery
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Other Date
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PREOP Dx
• • •
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PreOp Dx Free text
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Post Op Dx
• • •
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Post Op Dx Free Text
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Procedure
• • •
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Operation Free Text
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Tissue Removed Left
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Tissue Removed Right
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Lipo?
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Infiltration volume
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Lipo Cannulas
• • •
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Aspirate volume
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Anesthesia
• • •
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Blood Loss
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Implants
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Indications for procedure
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Set up
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Liposuction
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BodyTite
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Panniculectomy
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Platysmaplasty
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Breast Surgery
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Abdominoplasty
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Breast Augmentation
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Remove and Replace Intact
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R&R Bilat implants - Left Deflation
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R&R Bilat implants - Right Deflation
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Breast Reduction
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Mastopexy
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Simple Rhinoplasty
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Eyes
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Facelift
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FaceTite
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FaceTite Areas Treated
• • •
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Facetite Settings: Internal
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FaceTite External
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FaceTite Total Energy
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Bleph U/L Sub-c
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Bleph U/L Open
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Earlobe Repair
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Bleph Upper
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Earlobe Single
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Earlobes Bilateral
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Fat Transfer?
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Fat Transfer Face - CC's
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Fat Transfer Hands - CC
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Fat Transfer - BBL CC's
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Details of the procedure
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Complications Free Text
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Brachioplasty Level III
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Gynecomastia
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Fat Transfer Face
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Closing
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Findings/Indications for Procedure
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BBL Fat Transferred CC's
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Brazilian
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Aspiration Volume
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Aspirate volume
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Injection Volume
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Infiltration volume
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Aspiration Volume
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Fill Volume
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Injection Volume
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Reference number
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Aspiration Volume
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Fill volume
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Injection Volume
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Injection Volume
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Aspiration Volume
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Injection Volume
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Aspiration Volume
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Injection Volume
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Aspiration Volume
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Injection Volume
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Aspiration Volume
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Injection Volume
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Aspiration Volume
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Injection Volume
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Aspiration Volume
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Total Aspirate
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