www.aristocratps.com Open in urlscan Pro
141.193.213.21  Public Scan

Submitted URL: https://www.chinimplantnewyorkcity.com/
Effective URL: https://www.aristocratps.com/
Submission: On July 12 via api from US — Scanned from DE

Form analysis 5 forms found in the DOM

POST /#gf_26

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_26" id="gform_26" action="/#gf_26" data-formid="26" novalidate="">
  <div class="gform-body gform_body">
    <div id="gform_fields_26" class="gform_fields top_label form_sublabel_below description_below validation_below">
      <div id="field_26_8"
        class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_8">
        <center><i>Do not include any medical information on this form submission. <br>Free consultations apply to virtual consultations only. In-person consultations do require a consultation fee.</i></center>
      </div>
      <fieldset id="field_26_1" class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_1">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_26_1">
          <span id="input_26_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.3" id="input_26_1_3" value="" tabindex="2" aria-required="true">
            <label for="input_26_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
          </span>
          <span id="input_26_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.6" id="input_26_1_6" value="" tabindex="4" aria-required="true">
            <label for="input_26_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
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      <div id="field_26_3" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_3"><label class="gfield_label gform-field-label" for="input_26_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_3" id="input_26_3" type="email" value="" class="large" tabindex="6" aria-required="true" aria-invalid="false">
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      </div>
      <div id="field_26_4" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_4"><label class="gfield_label gform-field-label" for="input_26_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_4" id="input_26_4" type="tel" value="" class="large" tabindex="7" aria-required="true" aria-invalid="false"></div>
      </div>
      <div id="field_26_5" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_5"><label class="gfield_label gform-field-label" for="input_26_5">Location<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_5" id="input_26_5" class="large gfield_select" tabindex="8" aria-required="true" aria-invalid="false">
            <option value="Manhattan">Manhattan</option>
            <option value="Great Neck">Great Neck</option>
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      </div>
      <div id="field_26_6" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_6"><label class="gfield_label gform-field-label" for="input_26_6">Procedure of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_6" id="input_26_6" class="large gfield_select" tabindex="9" aria-required="true" aria-invalid="false">
            <option value="MedSpa">MedSpa</option>
            <option value="Breast">Breast</option>
            <option value="Body">Body</option>
            <option value="Face">Face</option>
            <option value="Male">Male</option>
          </select></div>
      </div>
      <div id="field_26_7" class="gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_7"><label class="gfield_label gform-field-label" for="input_26_7">Decision Stage</label>
        <div class="ginput_container ginput_container_select"><select name="input_7" id="input_26_7" class="large gfield_select" tabindex="10" aria-invalid="false">
            <option value="Just started researching">Just started researching</option>
            <option value="Evaluating procedures">Evaluating procedures</option>
            <option value="Ready to schedule">Ready to schedule</option>
          </select></div>
      </div>
      <fieldset id="field_26_11"
        class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_11">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">I consent to receive text messages from Aristocrat Plastic Surgery &amp; MedAesthetics<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_26_11">
            <div class="gchoice gchoice_26_11_1">
              <input class="gfield-choice-input" name="input_11.1" type="checkbox" value="Yes" id="choice_26_11_1" tabindex="11">
              <label for="choice_26_11_1" id="label_26_11_1" class="gform-field-label gform-field-label--type-inline">Yes</label>
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        data-js-reload="field_26_10"><label class="gfield_label gform-field-label" for="input_26_10">CAPTCHA</label>
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          <div style="width: 304px; height: 78px;">
            <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-fj98xmtk1l39" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
                src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LcWiK0lAAAAAE9Z8q1immNBKzc7NKqtjHnQ793D&amp;co=aHR0cHM6Ly93d3cuYXJpc3RvY3JhdHBzLmNvbTo0NDM.&amp;hl=en&amp;v=rKbTvxTxwcw5VqzrtN-ICwWt&amp;theme=light&amp;size=normal&amp;cb=9c5c944fj7hh"
                tabindex="12"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <button class="button gform_button" id="gform_submit_button_26">
      <div class="x-anchor-content">
        <span class="x-graphic" aria-hidden="true"><i class="x-icon x-graphic-child x-graphic-icon x-graphic-primary" aria-hidden="true" data-x-icon-o=""></i></span>
        <div class="x-anchor-text">
          <span class="x-anchor-text-primary">Submit</span>
        </div>
      </div>
    </button> <input type="hidden" name="gform_ajax" value="form_id=26&amp;title=&amp;description=&amp;tabindex=1&amp;theme=gravity-theme">
    <input type="hidden" class="gform_hidden" name="is_submit_26" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="26">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_26" value="WyJ7XCIxMS4xXCI6XCIxMjgwZGQ1ZDdlMzgyZDFkMTBjYWVkMTIxZDM2NTI2YlwifSIsImUxZmZiNzNmNmFkZjkyMzIxMjFhZmE1Njc1MzBjMmRlIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_26" id="gform_target_page_number_26" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_26" id="gform_source_page_number_26" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

POST /#gf_26

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_26" id="gform_26" action="/#gf_26" data-formid="26" novalidate="">
  <div class="gform-body gform_body">
    <div id="gform_fields_26" class="gform_fields top_label form_sublabel_below description_below validation_below">
      <div id="field_26_8"
        class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_8">
        <center><i>Do not include any medical information on this form submission. <br>Free consultations apply to virtual consultations only. In-person consultations do require a consultation fee.</i></center>
      </div>
      <fieldset id="field_26_1" class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_1">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_26_1">
          <span id="input_26_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.3" id="input_26_1_3" value="" tabindex="2" aria-required="true">
            <label for="input_26_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
          </span>
          <span id="input_26_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.6" id="input_26_1_6" value="" tabindex="4" aria-required="true">
            <label for="input_26_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
          </span>
        </div>
      </fieldset>
      <div id="field_26_3" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_3"><label class="gfield_label gform-field-label" for="input_26_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_3" id="input_26_3" type="email" value="" class="large" tabindex="6" aria-required="true" aria-invalid="false">
        </div>
      </div>
      <div id="field_26_4" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_4"><label class="gfield_label gform-field-label" for="input_26_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_4" id="input_26_4" type="tel" value="" class="large" tabindex="7" aria-required="true" aria-invalid="false"></div>
      </div>
      <div id="field_26_5" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_5"><label class="gfield_label gform-field-label" for="input_26_5">Location<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_5" id="input_26_5" class="large gfield_select" tabindex="8" aria-required="true" aria-invalid="false">
            <option value="Manhattan">Manhattan</option>
            <option value="Great Neck">Great Neck</option>
          </select></div>
      </div>
      <div id="field_26_6" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_6"><label class="gfield_label gform-field-label" for="input_26_6">Procedure of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_6" id="input_26_6" class="large gfield_select" tabindex="9" aria-required="true" aria-invalid="false">
            <option value="MedSpa">MedSpa</option>
            <option value="Breast">Breast</option>
            <option value="Body">Body</option>
            <option value="Face">Face</option>
            <option value="Male">Male</option>
          </select></div>
      </div>
      <div id="field_26_7" class="gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_7"><label class="gfield_label gform-field-label" for="input_26_7">Decision Stage</label>
        <div class="ginput_container ginput_container_select"><select name="input_7" id="input_26_7" class="large gfield_select" tabindex="10" aria-invalid="false">
            <option value="Just started researching">Just started researching</option>
            <option value="Evaluating procedures">Evaluating procedures</option>
            <option value="Ready to schedule">Ready to schedule</option>
          </select></div>
      </div>
      <fieldset id="field_26_11"
        class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_11">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">I consent to receive text messages from Aristocrat Plastic Surgery &amp; MedAesthetics<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_26_11">
            <div class="gchoice gchoice_26_11_1">
              <input class="gfield-choice-input" name="input_11.1" type="checkbox" value="Yes" id="choice_26_11_1" tabindex="11">
              <label for="choice_26_11_1" id="label_26_11_1" class="gform-field-label gform-field-label--type-inline">Yes</label>
            </div>
          </div>
        </div>
      </fieldset>
      <div id="field_26_10" class="gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_10"><label class="gfield_label gform-field-label" for="input_26_10">CAPTCHA</label>
        <div id="input_26_10_1" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LcWiK0lAAAAAE9Z8q1immNBKzc7NKqtjHnQ793D" data-theme="light" data-tabindex="12" data-badge="">
          <div style="width: 304px; height: 78px;">
            <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-m3yk511e5vfk" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
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                tabindex="12"></iframe></div><textarea id="g-recaptcha-response-1" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <button class="button gform_button" id="gform_submit_button_26">
      <div class="x-anchor-content">
        <span class="x-graphic" aria-hidden="true"><i class="x-icon x-graphic-child x-graphic-icon x-graphic-primary" aria-hidden="true" data-x-icon-o=""></i></span>
        <div class="x-anchor-text">
          <span class="x-anchor-text-primary">Submit</span>
        </div>
      </div>
    </button> <input type="hidden" name="gform_ajax" value="form_id=26&amp;title=&amp;description=&amp;tabindex=1&amp;theme=gravity-theme">
    <input type="hidden" class="gform_hidden" name="is_submit_26" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="26">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_26" value="WyJ7XCIxMS4xXCI6XCIxMjgwZGQ1ZDdlMzgyZDFkMTBjYWVkMTIxZDM2NTI2YlwifSIsImUxZmZiNzNmNmFkZjkyMzIxMjFhZmE1Njc1MzBjMmRlIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_26" id="gform_target_page_number_26" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_26" id="gform_source_page_number_26" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

POST /#gf_26

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_26" id="gform_26" action="/#gf_26" data-formid="26" novalidate="">
  <div class="gform-body gform_body">
    <div id="gform_fields_26" class="gform_fields top_label form_sublabel_below description_below validation_below">
      <div id="field_26_8"
        class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_8">
        <center><i>Do not include any medical information on this form submission. <br>Free consultations apply to virtual consultations only. In-person consultations do require a consultation fee.</i></center>
      </div>
      <fieldset id="field_26_1" class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_1">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_26_1">
          <span id="input_26_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.3" id="input_26_1_3" value="" tabindex="2" aria-required="true">
            <label for="input_26_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
          </span>
          <span id="input_26_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.6" id="input_26_1_6" value="" tabindex="4" aria-required="true">
            <label for="input_26_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
          </span>
        </div>
      </fieldset>
      <div id="field_26_3" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_3"><label class="gfield_label gform-field-label" for="input_26_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_3" id="input_26_3" type="email" value="" class="large" tabindex="6" aria-required="true" aria-invalid="false">
        </div>
      </div>
      <div id="field_26_4" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_4"><label class="gfield_label gform-field-label" for="input_26_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_4" id="input_26_4" type="tel" value="" class="large" tabindex="7" aria-required="true" aria-invalid="false"></div>
      </div>
      <div id="field_26_5" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_5"><label class="gfield_label gform-field-label" for="input_26_5">Location<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_5" id="input_26_5" class="large gfield_select" tabindex="8" aria-required="true" aria-invalid="false">
            <option value="Manhattan">Manhattan</option>
            <option value="Great Neck">Great Neck</option>
          </select></div>
      </div>
      <div id="field_26_6" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_6"><label class="gfield_label gform-field-label" for="input_26_6">Procedure of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_6" id="input_26_6" class="large gfield_select" tabindex="9" aria-required="true" aria-invalid="false">
            <option value="MedSpa">MedSpa</option>
            <option value="Breast">Breast</option>
            <option value="Body">Body</option>
            <option value="Face">Face</option>
            <option value="Male">Male</option>
          </select></div>
      </div>
      <div id="field_26_7" class="gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_7"><label class="gfield_label gform-field-label" for="input_26_7">Decision Stage</label>
        <div class="ginput_container ginput_container_select"><select name="input_7" id="input_26_7" class="large gfield_select" tabindex="10" aria-invalid="false">
            <option value="Just started researching">Just started researching</option>
            <option value="Evaluating procedures">Evaluating procedures</option>
            <option value="Ready to schedule">Ready to schedule</option>
          </select></div>
      </div>
      <fieldset id="field_26_11"
        class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_11">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">I consent to receive text messages from Aristocrat Plastic Surgery &amp; MedAesthetics<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_26_11">
            <div class="gchoice gchoice_26_11_1">
              <input class="gfield-choice-input" name="input_11.1" type="checkbox" value="Yes" id="choice_26_11_1" tabindex="11">
              <label for="choice_26_11_1" id="label_26_11_1" class="gform-field-label gform-field-label--type-inline">Yes</label>
            </div>
          </div>
        </div>
      </fieldset>
      <div id="field_26_10" class="gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_10"><label class="gfield_label gform-field-label" for="input_26_10">CAPTCHA</label>
        <div id="input_26_10_2" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LcWiK0lAAAAAE9Z8q1immNBKzc7NKqtjHnQ793D" data-theme="light" data-tabindex="12" data-badge="">
          <div style="width: 304px; height: 78px;">
            <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-c12o8b7x5x06" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
                src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LcWiK0lAAAAAE9Z8q1immNBKzc7NKqtjHnQ793D&amp;co=aHR0cHM6Ly93d3cuYXJpc3RvY3JhdHBzLmNvbTo0NDM.&amp;hl=en&amp;v=rKbTvxTxwcw5VqzrtN-ICwWt&amp;theme=light&amp;size=normal&amp;cb=j6s8r8pv8un4"
                tabindex="12"></iframe></div><textarea id="g-recaptcha-response-2" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <button class="button gform_button" id="gform_submit_button_26">
      <div class="x-anchor-content">
        <span class="x-graphic" aria-hidden="true"><i class="x-icon x-graphic-child x-graphic-icon x-graphic-primary" aria-hidden="true" data-x-icon-o=""></i></span>
        <div class="x-anchor-text">
          <span class="x-anchor-text-primary">Submit</span>
        </div>
      </div>
    </button> <input type="hidden" name="gform_ajax" value="form_id=26&amp;title=&amp;description=&amp;tabindex=1&amp;theme=gravity-theme">
    <input type="hidden" class="gform_hidden" name="is_submit_26" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="26">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_26" value="WyJ7XCIxMS4xXCI6XCIxMjgwZGQ1ZDdlMzgyZDFkMTBjYWVkMTIxZDM2NTI2YlwifSIsImUxZmZiNzNmNmFkZjkyMzIxMjFhZmE1Njc1MzBjMmRlIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_26" id="gform_target_page_number_26" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_26" id="gform_source_page_number_26" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

POST /#gf_26

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_26" id="gform_26" action="/#gf_26" data-formid="26" novalidate="">
  <div class="gform-body gform_body">
    <div id="gform_fields_26" class="gform_fields top_label form_sublabel_below description_below validation_below">
      <div id="field_26_8"
        class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_8">
        <center><i>Do not include any medical information on this form submission. <br>Free consultations apply to virtual consultations only. In-person consultations do require a consultation fee.</i></center>
      </div>
      <fieldset id="field_26_1" class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_1">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_26_1">
          <span id="input_26_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.3" id="input_26_1_3" value="" tabindex="2" aria-required="true">
            <label for="input_26_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
          </span>
          <span id="input_26_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.6" id="input_26_1_6" value="" tabindex="4" aria-required="true">
            <label for="input_26_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
          </span>
        </div>
      </fieldset>
      <div id="field_26_3" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_3"><label class="gfield_label gform-field-label" for="input_26_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_3" id="input_26_3" type="email" value="" class="large" tabindex="6" aria-required="true" aria-invalid="false">
        </div>
      </div>
      <div id="field_26_4" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_4"><label class="gfield_label gform-field-label" for="input_26_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_4" id="input_26_4" type="tel" value="" class="large" tabindex="7" aria-required="true" aria-invalid="false"></div>
      </div>
      <div id="field_26_5" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_5"><label class="gfield_label gform-field-label" for="input_26_5">Location<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_5" id="input_26_5" class="large gfield_select" tabindex="8" aria-required="true" aria-invalid="false">
            <option value="Manhattan">Manhattan</option>
            <option value="Great Neck">Great Neck</option>
          </select></div>
      </div>
      <div id="field_26_6" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_6"><label class="gfield_label gform-field-label" for="input_26_6">Procedure of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_6" id="input_26_6" class="large gfield_select" tabindex="9" aria-required="true" aria-invalid="false">
            <option value="MedSpa">MedSpa</option>
            <option value="Breast">Breast</option>
            <option value="Body">Body</option>
            <option value="Face">Face</option>
            <option value="Male">Male</option>
          </select></div>
      </div>
      <div id="field_26_7" class="gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_7"><label class="gfield_label gform-field-label" for="input_26_7">Decision Stage</label>
        <div class="ginput_container ginput_container_select"><select name="input_7" id="input_26_7" class="large gfield_select" tabindex="10" aria-invalid="false">
            <option value="Just started researching">Just started researching</option>
            <option value="Evaluating procedures">Evaluating procedures</option>
            <option value="Ready to schedule">Ready to schedule</option>
          </select></div>
      </div>
      <fieldset id="field_26_11"
        class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_11">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">I consent to receive text messages from Aristocrat Plastic Surgery &amp; MedAesthetics<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_26_11">
            <div class="gchoice gchoice_26_11_1">
              <input class="gfield-choice-input" name="input_11.1" type="checkbox" value="Yes" id="choice_26_11_1" tabindex="11">
              <label for="choice_26_11_1" id="label_26_11_1" class="gform-field-label gform-field-label--type-inline">Yes</label>
            </div>
          </div>
        </div>
      </fieldset>
      <div id="field_26_10" class="gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_10"><label class="gfield_label gform-field-label" for="input_26_10">CAPTCHA</label>
        <div id="input_26_10_3" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LcWiK0lAAAAAE9Z8q1immNBKzc7NKqtjHnQ793D" data-theme="light" data-tabindex="12" data-badge="">
          <div style="width: 304px; height: 78px;">
            <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-lu2vgm117rq3" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
                src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LcWiK0lAAAAAE9Z8q1immNBKzc7NKqtjHnQ793D&amp;co=aHR0cHM6Ly93d3cuYXJpc3RvY3JhdHBzLmNvbTo0NDM.&amp;hl=en&amp;v=rKbTvxTxwcw5VqzrtN-ICwWt&amp;theme=light&amp;size=normal&amp;cb=y7yeotkdc4fn"
                tabindex="12"></iframe></div><textarea id="g-recaptcha-response-3" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <button class="button gform_button" id="gform_submit_button_26">
      <div class="x-anchor-content">
        <span class="x-graphic" aria-hidden="true"><i class="x-icon x-graphic-child x-graphic-icon x-graphic-primary" aria-hidden="true" data-x-icon-o=""></i></span>
        <div class="x-anchor-text">
          <span class="x-anchor-text-primary">Submit</span>
        </div>
      </div>
    </button> <input type="hidden" name="gform_ajax" value="form_id=26&amp;title=&amp;description=&amp;tabindex=1&amp;theme=gravity-theme">
    <input type="hidden" class="gform_hidden" name="is_submit_26" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="26">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_26" value="WyJ7XCIxMS4xXCI6XCIxMjgwZGQ1ZDdlMzgyZDFkMTBjYWVkMTIxZDM2NTI2YlwifSIsImUxZmZiNzNmNmFkZjkyMzIxMjFhZmE1Njc1MzBjMmRlIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_26" id="gform_target_page_number_26" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_26" id="gform_source_page_number_26" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

POST /#gf_26

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_26" id="gform_26" action="/#gf_26" data-formid="26" novalidate="">
  <div class="gform-body gform_body">
    <div id="gform_fields_26" class="gform_fields top_label form_sublabel_below description_below validation_below">
      <div id="field_26_8"
        class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_8">
        <center><i>Do not include any medical information on this form submission. <br>Free consultations apply to virtual consultations only. In-person consultations do require a consultation fee.</i></center>
      </div>
      <fieldset id="field_26_1" class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_1">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_26_1">
          <span id="input_26_1_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.3" id="input_26_1_3" value="" tabindex="2" aria-required="true">
            <label for="input_26_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
          </span>
          <span id="input_26_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
            <input type="text" name="input_1.6" id="input_26_1_6" value="" tabindex="4" aria-required="true">
            <label for="input_26_1_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
          </span>
        </div>
      </fieldset>
      <div id="field_26_3" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_3"><label class="gfield_label gform-field-label" for="input_26_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_3" id="input_26_3" type="email" value="" class="large" tabindex="6" aria-required="true" aria-invalid="false">
        </div>
      </div>
      <div id="field_26_4" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_4"><label class="gfield_label gform-field-label" for="input_26_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_4" id="input_26_4" type="tel" value="" class="large" tabindex="7" aria-required="true" aria-invalid="false"></div>
      </div>
      <div id="field_26_5" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_5"><label class="gfield_label gform-field-label" for="input_26_5">Location<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_5" id="input_26_5" class="large gfield_select" tabindex="8" aria-required="true" aria-invalid="false">
            <option value="Manhattan">Manhattan</option>
            <option value="Great Neck">Great Neck</option>
          </select></div>
      </div>
      <div id="field_26_6" class="gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_6"><label class="gfield_label gform-field-label" for="input_26_6">Procedure of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_6" id="input_26_6" class="large gfield_select" tabindex="9" aria-required="true" aria-invalid="false">
            <option value="MedSpa">MedSpa</option>
            <option value="Breast">Breast</option>
            <option value="Body">Body</option>
            <option value="Face">Face</option>
            <option value="Male">Male</option>
          </select></div>
      </div>
      <div id="field_26_7" class="gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_7"><label class="gfield_label gform-field-label" for="input_26_7">Decision Stage</label>
        <div class="ginput_container ginput_container_select"><select name="input_7" id="input_26_7" class="large gfield_select" tabindex="10" aria-invalid="false">
            <option value="Just started researching">Just started researching</option>
            <option value="Evaluating procedures">Evaluating procedures</option>
            <option value="Ready to schedule">Ready to schedule</option>
          </select></div>
      </div>
      <fieldset id="field_26_11"
        class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_11">
        <legend class="gfield_label gform-field-label gfield_label_before_complex">I consent to receive text messages from Aristocrat Plastic Surgery &amp; MedAesthetics<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_26_11">
            <div class="gchoice gchoice_26_11_1">
              <input class="gfield-choice-input" name="input_11.1" type="checkbox" value="Yes" id="choice_26_11_1" tabindex="11">
              <label for="choice_26_11_1" id="label_26_11_1" class="gform-field-label gform-field-label--type-inline">Yes</label>
            </div>
          </div>
        </div>
      </fieldset>
      <div id="field_26_10" class="gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible"
        data-js-reload="field_26_10"><label class="gfield_label gform-field-label" for="input_26_10">CAPTCHA</label>
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WELCOME TO ARISTOCRAT.

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NEW YORK'S LEADING PLASTIC SURGERY PRACTICE


At Aristocrat Plastic Surgery & MedAesthetics, we believe that plastic surgery
should be more than a procedure—it should also foster a sense of artistry and
expression. Located in Manhattan, New York City, and Great Neck, Long Island,
Aristocrat Plastic Surgery & MedAesthetics and top New York plastic surgeon Dr.
Kevin Tehrani offers the best in reconstructive and plastic surgery and
non-surgical treatments. Dr. Tehrani founded his practice on the foundation of
patient satisfaction and top-notch care. During your consultation, he will make
sure that every decision will be made as a collaborative effort with your
well-being in mind. As you work together, Dr. Tehrani will treat your journey
through cosmetic and plastic surgery with absolute respect.
Begin Here

--------------------------------------------------------------------------------


OUR PROCEDURES

We offer a broad spectrum of surgical and non-invasive medical aesthetic
procedures to make you look and feel great. Actual Aristocrat Plastic Surgery
patients are featured below.






--------------------------------------------------------------------------------


FACE PROCEDURES

Do you looking tired? Do you hesitate before looking in the mirror, not wanting
to see what looks back? Are you looking older than normal? Consider a face
procedure from Dr. Kevin Tehrani.

LEARN MORE


BREAST PROCEDURES

Our breast procedures extend well beyond the breast lift and breast
augmentation, and all are performed in Dr. Tehrani’s fully equipped and
certified Long Island office.

LEARN MORE


BODY PROCEDURES

There are several different types of surgical body procedures that alleviate a
wide variety of problems. Liposuction, tummy tucks, and body lifts can
rejuvenate the way you look.

LEARN MORE


MEDSPA

Aristocrat Plastic Surgery doesn't just offer surgery - we have a wide variety
of non-surgical procedures that are quick, painless, and affordable!

LEARN MORE


MEN'S PROCEDURES

Cosmetic procedures aren’t just for women. With increasing demands on men to
look great in many circumstances, more men have turned to procedures to combat
the signs of aging.  

LEARN MORE


FACE PROCEDURES

Do you looking tired? Do you hesitate before looking in the mirror, not wanting
to see what looks back? Are you looking older than normal? Consider a face
procedure from Dr. Kevin Tehrani.

LEARN MORE


BREAST PROCEDURES

Our breast procedures extend well beyond the breast lift and breast
augmentation, and all are performed in Dr. Tehrani’s fully equipped and
certified Long Island office.

LEARN MORE


BODY PROCEDURES

There are several different types of surgical body procedures that alleviate a
wide variety of problems. Liposuction, tummy tucks, and body lifts can
rejuvenate the way you look.

LEARN MORE


MEDSPA

Aristocrat Plastic Surgery doesn't just offer surgery - we have a wide variety
of non-surgical procedures that are quick, painless, and affordable!

LEARN MORE


MEN'S PROCEDURES

Cosmetic procedures aren’t just for women. With increasing demands on men to
look great in many circumstances, more men have turned to procedures to combat
the signs of aging.  

LEARN MORE


FACE PROCEDURES

Do you looking tired? Do you hesitate before looking in the mirror, not wanting
to see what looks back? Are you looking older than normal? Consider a face
procedure from Dr. Kevin Tehrani.

LEARN MORE


BREAST PROCEDURES

Our breast procedures extend well beyond the breast lift and breast
augmentation, and all are performed in Dr. Tehrani’s fully equipped and
certified Long Island office.

LEARN MORE


BODY PROCEDURES

There are several different types of surgical body procedures that alleviate a
wide variety of problems. Liposuction, tummy tucks, and body lifts can
rejuvenate the way you look.

LEARN MORE


MEDSPA

Aristocrat Plastic Surgery doesn't just offer surgery - we have a wide variety
of non-surgical procedures that are quick, painless, and affordable!

LEARN MORE


MEN'S PROCEDURES

Cosmetic procedures aren’t just for women. With increasing demands on men to
look great in many circumstances, more men have turned to procedures to combat
the signs of aging.  

LEARN MORE


MEET DR. KEVIN TEHRANI, MD FACS

Top plastic surgeon Dr. Kevin Tehrani is the founder and director of Aristocrat
Plastic Surgery. He values reaching the highest levels of achievement in
reconstructive and plastic surgical training, continuing education and clinical
experience. Your comprehensive consultation will be exceedingly informative,
clear, balanced and there will be plenty of opportunity to discuss all your
concerns.

Meet Dr. Tehrani


MEET DR. KEVIN TEHRANI, MD FACS

Top plastic surgeon Dr. Kevin Tehrani is the founder and director of Aristocrat
Plastic Surgery. He values reaching the highest levels of achievement in
reconstructive and plastic surgical training, continuing education and clinical
experience. Your comprehensive consultation will be exceedingly informative,
clear, balanced and there will be plenty of opportunity to discuss all your
concerns.

Meet Dr. Tehrani



BEGIN YOUR JOURNEY WITH DR. TEHRANI TODAY.




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 * Great Neck: 516-498-9790

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Do not include any medical information on this form submission.
Free consultations apply to virtual consultations only. In-person consultations
do require a consultation fee.
Name*
First Last
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Phone*

Location*
ManhattanGreat Neck
Procedure of Interest*
MedSpaBreastBodyFaceMale
Decision Stage
Just started researchingEvaluating proceduresReady to schedule
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MedAesthetics*
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SCHEDULE YOUR CONSULTATION

"*" indicates required fields

Do not include any medical information on this form submission.
Free consultations apply to virtual consultations only. In-person consultations
do require a consultation fee.
Name*
First Last
Email*

Phone*

Location*
ManhattanGreat Neck
Procedure of Interest*
MedSpaBreastBodyFaceMale
Decision Stage
Just started researchingEvaluating proceduresReady to schedule
I consent to receive text messages from Aristocrat Plastic Surgery &
MedAesthetics*
Yes
CAPTCHA

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SCHEDULE YOUR CONSULTATION

"*" indicates required fields

Do not include any medical information on this form submission.
Free consultations apply to virtual consultations only. In-person consultations
do require a consultation fee.
Name*
First Last
Email*

Phone*

Location*
ManhattanGreat Neck
Procedure of Interest*
MedSpaBreastBodyFaceMale
Decision Stage
Just started researchingEvaluating proceduresReady to schedule
I consent to receive text messages from Aristocrat Plastic Surgery &
MedAesthetics*
Yes
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