MyLook Appointments

Doctor Taneja

MyLook Surgery
Your journey starts with an online consultation.
The initial fee is $150 which will be applied to your procedure. After Dr. Taneja reviews your photos we will call you and email you with our recommendations. At this point you can schedule the procedure or an in person consultation.

Thank you so much for your interest, we look forward to working with you.
MyLook Surgery AppointmentForm

Please complete this form and you will receive a confirmation email
Name*

First NameMiddle NameLast Name
Full Name OLD (without middle name)
First and Last Name
Gender*
Phone Number*

Area CodePhone Number
Current Date

MonthDayYear
Date
Date of Birth*

MonthDayYear
Birthday OLD

MonthDayYear
Your Age:
Address*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail Address*
Re-Enter e-mail address*
What procedures are you interested in? *
Did you have previous surgeries? If yes, please let us know which ones*
If you have had breast surgery before, when, what type and size of implant?
Are you taking any medications? If so, please list:
How many children do you have?*
Age of youngest child
Upload a picture of a government issued ID*

Browse Files

Cancelof
Upload Pictures

Please upload pictures of your FRONT, LEFT and RIGHT profile views. Photos should not include your face.
All photos are private.

Your front picture should have both arms to the side. Please remove your top and bra. (Breast consults only)
FRONT*

Browse Files

Cancelof
LEFT*

Browse Files

Cancelof
RIGHT*

Browse Files

Cancelof
BACK

Browse Files
(if breast or tummy consult back picture not necessary) Cancelof
Pre-Qualification

We need to verify that you pass our BMI and health requirements.
Calculate your BMI*
BMI
Please click the Submit Form Button and Dr. Taneja or one his associates will call you regarding if weight loss surgery is right for you
Payment Information

There is a $150 for the consultation payable upon submission below. The fee is not refundable but will be applied towards your surgery should you proceed.

My Products*

Consultation Fee$150.00

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please note, you are waiving your rights for a chargeback. Once form is submitted and card is charged, we do not issue refunds. All information is private and we do not share information. Please allow up to 14 business days to receive a call from the doctor or a consultant.
About Dr. Taneja

Dr . Taneja is not only the top choice of Orange County, Los Angeles, and Inland Empire clients for breast augmentation, but also the premier plastic surgeon for those requiring corrective surgery for breast implants, as well. Dr, Taneja’s meticulous attention to detail has earned him a reputation as a “perfectionist”.
Locations

Find Us!
Newport Beach
400 Newport Center Drive #608 Newport Beach, CA 92660
(949) 644-0555

Pasadena
333 South Arroyo Parkway #201 Pasadena, CA 91105
(626) 844-0555
Follow Us on Social Media
Should be Empty:

Doctor Taneja

MyLook Surgery AppointmentForm

Upload Pictures

Pre-Qualification

Payment Information

About Dr. Taneja

Locations