Breast Augmentation Post-Op QPROM

Thank you for having your breast enlargement surgery at Kinvara Private Hospital. Please complete this short questionnaire (known as a Quality Patient-Reported Outcome Measure – QPROM).

The questionnaire should only be completed by patients that have had breast enlargement surgery and will only take a few minutes.

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Name
Date of birth
Which breasts did you have surgery on?

With your Breasts in mind, in the past week, how dissatisfied or satisfied have you been with:

1. How your bra fits?
2. How you look in the mirror clothed?
3. How natural your breasts look?
4. How your breast size matches your body?
5. The firmness of your breasts?
6. The position of your implants on your chest (too high or too low)?
7. How naturally your breasts sit/hang?
8. How evenly your implants are positioned in relation to each other?
9. How your breasts feel to the touch?
10. The shape of your breasts when you are not wearing a bra?
11. The size of your breasts?
12. How you look in the mirror unclothed?
13. How much cleavage you have when you wear a bra?
14. How close together your breasts are when you are not wearing a bra?
15. How closely matched (similar) your breasts are to each other?