Liposuction Post-Op QPROM

Thank you for having your liposuction 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 liposuction and it will only take a few minutes.

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Name
Date of birth
What part of your body did you have liposuction on? (check all that apply)

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

1. How your body looks when dressed?
2. How your clothes fits your body?
3. The size of your body (i.e. weight)?
4. The shape of the body?
5. How your body looks in photos?
6. How your body looks from behind?
7. How your body looks from the side (ie side profile)?
8. How your body looks in summer clothes (e.g., shorts, t-shirts)?
9. How your body looks in a swimsuit?
10. How your body looks in the mirror unclothed?