Facelift Pre-Op QPROM

Thank you for choosing Kinvara Private Hospital for your facelift. Please complete this short questionnaire (known as a Quality Patient-Reported Outcome Measure – QPROM).

The questionnaire should only be completed by patients who are due to have facelift and will only take a few minutes.

Please enable JavaScript in your browser to complete this form.
Name
Date of birth

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

1. How symmetric your face looks?
2. How balanced your face looks?
3. How well-proportioned your face looks?
4. How fresh your face looks?
5. How your face looks at the end of the day?
6. How rested your face looks?
7. How your profile/ side view looks?
8. How your face looks when you first wake up?
9. How your face looks under bright light?