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Michael J. YAREMCHUK, M.D. Craniofacial Plastic Surgeon

Bespoke Plastic Surgery



	Patient Resources post operative guidelines

		Abdominoplasty Blepharoplasty Breast Augmentation Breast Reduction Browlift and Browlift Reversal Chin Implants Dermabrasion Facelift (Rhytidectomy) Infraorbital rim implants Liposuction Malar and paranasal implants Mandible implants Midface Lift Click here to download Post Operative Instructions

		Abdominoplasty Rest Rest is important for the first 48 hours. Rest in bed or on the couch, getting up only to go to the bathroom. Minimal activity. Sleep with your head elevated and with a pillow under your knees. Medications You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. Diet It is best to stay on clear liquids in the first night following surgery. You may resume a regular diet the following day. Activity You will need to walk bent over for the first seven days after surgery to minimize tension on the closure. Garments Keep the support garments on continuously until your first postoperative visit with your surgeon. Supportive girdles may be removed to go to the bathroom. Please replace them immediately. Drains and Dressings Prior to discharge from the recovery room, the nurses will instruct you how to manage drainage tubes. You will be asked to record the drainage output every 24 hours. These drains may be necessary for several days. All dressings will be removed in the office between four and seven days post-op. Work Most patients return to work within 2-3 weeks of their surgery. Vigorous sports or activities are prohibited for several weeks. Your surgeon will advise you when it is safe to resume vigorous activities. Hygiene You may shower and wash your hair after the initial dressing change. Hot baths should be avoided for at least four weeks to prevent swelling. Questions If there are any questions, contact the staff @ 617-267-0710. Follow-Up Call your surgeon’s office to make your follow-up appointment. Blepharoplasty 1. Cold compresses should be used continuously to reduce swelling for the first 48 hours. They may be used for comfort for as long as you wish 2. An ointment or drops will be prescribed for you. They should be used as directed. An ointment will be prescribed for you which is to be used at bedtime to prevent drying of the surface of your eyes. 3. Do not remove steri-strips or small tapes which may be used to provide early support for your lids. 4. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 5. Sleep with your head elevated. 6. You may eat whatever you wish. 7. You may wash your face and hair as usual starting the day after surgery. 8. Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. You may then gradually increase your activity back to normal. 9. You may be swollen and bruised for up to two weeks. (Everyone is different.) 10. Avoid contact lenses for two weeks. Check with your doctor after that before wearing them. 11. Temporary (for three to six weeks) small lumps or pulling down of the lower eyelids are quite common and generally of no concern. 12. Make-up may be used 48 hours after the sutures are removed. Start with a new tube of mascara after surgery. 13. Your eyes may feel dry or scratchy after surgery. This is common and can be helped with the use of Theratears an over the counter eye lubricant. Eye lubricants may temporarily blur your vision. 14. Call the surgeon’s office if you experience sudden severe pain or blurred vision. 15. Avoid sun directly on the operated area for six months. You may, however, be out in the sun using a 30 SPF sun block and a hat. 16. If there are any problems, contact the staff @617-267-0710 17. Call your surgeon’s office to make your follow-up appointment. Breast Augmentation 1. Breast augmentation can be quite painful. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 2. A marked increase in pain and swelling on one side may indicate late bleeding on that side. Notify your surgeon immediately if this should occur. 3. Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, vacuuming, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. Do not drive for one week. Limit the use of your arms. 4. Change the dressing as often as necessary. You may shower beginning the day after surgery. If you find the dressing is sticking to the incision, standing under a warm shower will help to loosen it without causing discomfort, or damage, that pulling them might. 5. Ice packs applied to the breast for 48-72 hours will help diminish pain and discomfort. 6. The breast tissue may feel tight for several weeks postoperatively. You may also be black and blue. This is normal during the postoperative recovery phase. 7. You may wear a soft bra continuously for comfort until the sutures are out. 8. If there are any problems, contact the staff @ 617-267-0710. 9. Call your surgeon’s office to make your follow-up appointment. Breast Reduction 1. Breast augmentation can be quite painful. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 2. A marked increase in pain and swelling on one side may indicate late bleeding on that side. Notify your surgeon immediately if this should occur. 3. Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, vacuuming, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. Do not drive for one week. Limit the use of your arms. 4. Change the dressing as often as necessary. You may shower beginning the day after surgery. If you find the dressing is sticking to the incision, standing under a warm shower will help to loosen it without causing discomfort, or damage, that pulling them might. 5. Ice packs applied to the breast for 48-72 hours will help diminish pain and discomfort. 6. The breast tissue may feel tight for several weeks postoperatively. You may also be black and blue. This is normal during the postoperative recovery phase. 7. You may wear a soft bra continuously for comfort until the sutures are out. 8. If there are any problems, contact the staff @ 617-267-0710. 9. Call your surgeon’s office to make your follow-up appointment. Browlift and Browlift Reversal Cold Compresses Apply cold compresses to your eyes for the first 72 hours after surgery. This will help minimize the swelling and bruising which will include not only your scalp and forehead but will also extend down to your eyes. This will subside within one to two weeks. Physical Activity Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. Hair Wash Our staff will was your hair 2 or 3 days after surgery. You should then shower and wash your hair each day. Any mild type of shampoo will do, and use a cream rinse or conditioner to help soften hair. Medications You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. Normal Scalp and Hair Issues Sensation on the scalp may be decreased for a few weeks or months. For that reason, be careful when using a blow dryer, curling iron, or hot rollers for three weeks, since you unknowingly may burn your scalp. There may be a loss of hair along the suture line. This is usually temporary, and within four to six months the hair will grow back. Do not use any hair coloring or tinting for four weeks following surgery. Color your hair a few days before surgery. It is normal for you to feel a pulling or tightness in your forehead and scalp. As the skin relaxes slightly in the months following surgery, these feelings diminish. Questions If there are any questions, contact the staff @ 617-267-0710. Follow-Up Call your surgeon’s office to make your follow-up appointment. Chin Implants Ice Apply ice compresses to the area for the first 48 to 72 hours after surgery. Activity Get plenty of rest. Do not do anything which requires other than minimal exertion for two weeks following surgery. Bathing You may shower and wash your face and hair the day after surgery. Pain Medication You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. Diet You may resume a regular diet the day after surgery if your surgery was done through a skin incision beneath your chin. If other implants were placed (eg, jaw or malar) through intraoral incisions, you should take fluids for the first day after surgery, then soft foods for the next day or so. You may begin to gradually increase your diet to regular food as the discomfort of chewing diminishes. Be careful not to disrupt the suture line with hard pieces of food. Swelling and Bruising You may be quite swollen and have some bruising. These are temporary and will subside over several days to weeks. Numbness and Tightness There will be areas of numbness and tightness. You may find you feel stiff and have some difficulty moving your chin and lips as you normally would. These may take several months to resolve. Resuming Activity You may begin to gradually return to preop activities such as jogging, bicycling, and aerobics two and one-half weeks after surgery. Remember, if it hurts, you are over doing it! Make-up Make-up and moisturizers may be worn on all skin areas where there are no stitches. Aesthetician There is an aesthetician available by appointment to consult with you. Please speak with your surgeon or the nurses about arrangements to see her if you are interested. Sun Avoid sun directly on the operated area for two weeks to three months. You may however, be out in the sun using a 30 SPF sun block and a hat. Problems If there are any problems, contact the nursing staff @ 617-267-0710. Call if your temperature goes above 101°. Follow-Up Call your surgeon’s office to make your follow-up appointment. Dermabrasion 1. Keep the dermabriaded areas dry for two days. You may then get them wet in the shower. 2. The Xeroform (yellow) sheeting will be taken off at your follow-up appointment. 3. The day after your procedure apply ointment to affected areas. 4. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Areas will appear to be red and you may experience some swelling. This in normal. 5. If there are any problems, contact the staff @ 617-267-0710. 6. Call your surgeon’s office to make your follow-up appointment. Facelift (Rhytidectomy) Activity Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. Do not drive for one week. Be careful not to strain your neck. Hygiene Do not shower or take a hot bath until the initial bandages have been removed -at which time we will wash your hair. You should wash your face and hair the day after your bandages have been removed. Any mild type of shampoo or soap will do, and use cream rinse to help soften hair. Shower at least once a day until the sutures are removed. Cold Compresses Cold compresses may be applied for comfort around the eyes. Suture Line Care Use a Q-tip to clean crusts around sutures with antibiotic ointment. Sleeping It is advisable to sleep at a 45° angle for the first five to seven days after surgery. This helps with the natural drainage of fluids in the facial area and helps decrease the swelling. If you can, sleep on your back rather than your side. Hair You should not use any type of hair coloring or tinting until at least four weeks after surgery. Color your hair a few days before surgery. Avoid the use of hair dryers, hot curlers, or curling irons since sensation on the scalp is decreased and/ or absent temporarily, and usage may result in scalp burns. It takes about six months to feel “normal” again in the scalp area. Medications You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. Swelling and Bruising You may be quite swollen, black and blue, with lumps and bumps for several days or weeks after surgery. This swelling and discoloration always is different on the two sides of the face and neck. This is normal. Remember that each side of the face heals somewhat independently of the other side. Numbness and Tightness There will be areas of numbness and tightness. Because the neck muscles are tightened with a facelift, you may also feel what patients describe as a “tight band” under the chin and upper neck area. This diminishes over the course of several weeks. Resuming Activity You may begin to gradually return to preop activities such as jogging, bicycling, and aerobics two and one-half weeks after surgery. Remember, if it hurts, you are over doing it! Make-up Make-up and moisturizers may be worn on all skin areas where there are no stitches. Aesthetician There is an aesthetician available by appointment to consult with you. Please speak with your surgeon or the nurses about arrangements to see her if you are interested. Sun Avoid sun directly on the operated area for two weeks to three months. You may however, be out in the sun using a 30 SPF sun block and a hat. Questions If there are any questions, contact the staff @ 617-267-0710. Follow-Up Call your surgeon’s office to make your follow-up appointment. Infraorbital Rim Implants 1. Apply ice compresses to the area for to 72 hours after surgery. They may be used for comfort for as long as you wish. 2. An eye ointment or drops will be prescribed for you. They should be used as directed. An ointment will be prescribed which is to be used at bedtime to prevent drying of the surface of your eyes. Eye lubricants may temporarily blur your vision. 3. Do not remove steri-strips or small tapes which may be used to provide early support for your lids. 4. Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. Do not drive for one week. 5. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 6. Do not shower or take a hot bath until the initial bandages have been removed -at which time we will wash your hair. You should wash your face and hair the day after your bandages have been removed. Any mild type of shampoo or soap will do, and use cream rinse to help soften hair. Shower at least once a day until the sutures are removed. 7. Take fluids for the first day after surgery, then soft foods for the next day or so. You may begin to gradually increase your diet to regular food as the discomfort of chewing diminishes. Be careful not to disrupt the suture line in your mouth with hard pieces of food. 8. Rinse your mouth with an ½ peroxide and ½ water solution or standard mouthwash three or four times a day and after each meal to keep the area clean. Continue to do this for one week following surgery. 9. Because of the incision and sutures, it may be too uncomfortable to use a toothbrush for the first few days postop. You may purchase large glycerin swabs at your drug store which will make it less uncomfortable to clean your teeth. 10. If you are discharged with drains, record the amount of drainage every eight hours. 11. You will be quite swollen and have some bruising. This is temporary and will subside over several days to weeks. 12. There will be areas of numbness and tightness. You may find you feel stiff and have some difficulty moving your lips as you normally would. This may take several weeks to resolve. 13. Often, a stitch is placed in the corner of the eyelids (temporary tarsorrhaphy) to help control the swelling (chemosis) of the tissues around the eye. This stitch will be removed in 3 to 7 days, depending on the amount of swelling. 14. Sleep with your head elevated. 15. Avoid contact lenses for two weeks. Check with your doctor after that before wearing them. 16. Make-up may be used 48 hours after the sutures are removed 17. Please notify your surgeon if your temperature goes above 101°. 18. If there are any problems, contact the staff @ 617-267-0710. 19. Call your surgeon’s office to make your follow-up appointment. Liposuction 1. Rest is important for the first 48 hours. Rest in bed or on the couch, getting up only to go to the bathroom. Minimal activity. 2. It is best to stay on clear liquids the first night following surgery. You may resume a regular diet the following day. 3. For the first 24 hours, expect to have some watery fluid and blood staining on the dressings. (This is from the tumescent infiltration.) 4. Take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 5. Keep the support garments on continuously until your first postoperative visit with your surgeon. Supportive girdles may be removed to go to the bathroom. Please replace them immediately. Chin straps may be loosened to comb your hair. Reapply them. 6. All dressings will be removed in the office between four and seven days after surgery. 7. Most patients return to work within a week of their surgery. Vigorous sports or activities are prohibited for three weeks. You may take long walks after five days, with your support garment in place. 8. You may shower and wash your hair after the initial dressing change. Please replace the garment immediately. The best results are obtained if you wear the garment continuously for two to three weeks. Thereafter, the longer you wear the garment during the day, the faster the swelling will decrease. 9. For the first week after your liposuction, areas will be swollen and will not show reduction in contour. Your clothes may fit more tightly, and you may even weigh more. By the end of the first week, the swelling begins to subside. Final improvement may not be apparent until three months or more after surgery. 10. Hot baths should be avoided for at least four weeks to prevent swelling. 11. If there are any problems, contact the staff @ 617-267-0710. 12. Call your surgeon’s office to make your follow-up appointment. Malar and Paranasal Implants 1. Apply ice compresses to the area for 48 hours after surgery. 2. Get plenty of rest. Do not do anything which requires other than minimal exertion for two weeks following surgery. 3. You may shower and wash your face and hair the day after surgery. 4. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 5. Take fluids for the first day after surgery, then soft foods for the next day or so. You may begin to gradually increase your diet to regular food as the discomfort of chewing diminishes. Be careful not to disrupt the suture line with hard pieces of food. Protein shakes are a good source of nutrition during this early post-operative period. 6. Rinse your mouth with an ½ peroxide and ½ water solution or standard mouthwash three or four times a day and after each meal to keep area clean. Continue to do this for one week following surgery. 7. If you are discharged with drains, record the amount of drainage every eight hours. 8. The intraoral incisions incision and sutures may make the use a toothbrush uncomfortable for the first few days after surgery. You may purchase large glycerin swabs at your drug store which will make it less uncomfortable to clean your teeth. 9. You will be quite swollen and have some bruising after surgery. This is temporary and will subside over several weeks. 10. There will be areas of numbness and tightness. You may find you feel stiff and have some difficulty moving your lips as you normally would. These may take several months to resolve. 11. You may begin to gradually return to preop activities such as jogging, bicycling, and aerobics two and one-half weeks after surgery. Remember, if it hurts, you are over doing it! 12. Please notify your surgeon if your temperature goes above 101°. 13. If there are any problems, contact the staff @ 617-267-0710. 14. Call your surgeon’s office to make your follow-up appointment. Mandible Implants 1. Apply ice compresses to the area for 48 hours after surgery. 2. Get plenty of rest. Do not do anything which requires other than minimal exertion for two weeks following surgery. 3. You may shower and wash your face and hair the day after surgery. 4. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 5. Take fluids for the first day after surgery, then soft foods for the next day or so. You may begin to gradually increase your diet to regular food as the discomfort of chewing diminishes. Be careful not to disrupt the suture line with hard pieces of food. Protein shakes are a good source of nutrition during this early post-operative period. 6. Rinse your mouth with an ½ peroxide and ½ water solution or standard mouthwash three or four times a day and after each meal to keep area clean. Continue to do this for one week following surgery. 7. If you are discharged with drains, record the amount of drainage every eight hours. 8. The intraoral incisions incision and sutures may make the use a toothbrush uncomfortable for the first few days after surgery. You may purchase large glycerin swabs at your drug store which will make it less uncomfortable to clean your teeth. 9. You will be quite swollen and have some bruising after surgery. These are temporary and will subside over several weeks. 10. There will be areas of numbness and tightness. You may find you feel stiff and have some difficulty moving your lips as you normally would. These may take several months to resolve. 11. You may begin to gradually return to preoperative activities such as jogging, bicycling, and aerobics two and one-half weeks after surgery. Remember, if it hurts, you are over doing it! 12. Please notify your surgeon if your temperature goes above 101°. 13. If there are any problems, contact the staff @ 617-267-0710. 14. Call your surgeon’s office to make your follow-up appointment. Midface Lift 1. Apply ice compresses to the area for 72 hours after surgery. They may be used for comfort for as long as you wish. 2. An eye ointment or drops will be prescribed for you. They should be used as directed. An ointment will be prescribed for you which is to be used at bedtime to prevent drying of the surface of your eyes. Eye lubricants may temporarily blur your vision. 3. Do not remove steri-strips or small tapes which may be used to provide early support for your lids. 4. Get plenty of rest and don’t do anything requiring other that minimal exertion for two weeks following surgery. Avoid jogging, calisthenics, aerobics, weightlifting, sit-ups or other similar vigorous activities. Avoid bending over and avoid lifting. Do not drive for one week. 5. You may take Extra-Strength Tylenol or your prescribed pain medication every four hours, if needed. Avoid any activity immediately after taking the medication as you may experience some drowsiness. Avoid use of tranquilizers or sleeping pills while taking narcotics as this combination may be too strong for you. Avoid alcohol if taking narcotic pain medications. Colace (an over the counter stool softener medication) is effective to treat constipation which often occurs with the use of narcotic pain medications. 6. Do not shower or take a hot bath until the initial bandages have been removed -at which time we will wash your hair. You should wash your face and hair the day after your bandages have been removed. Any mild type of shampoo or soap will do, and use cream rinse to help soften hair. Shower at least once a day until the sutures are removed. 7. Take fluids for the first day after surgery, then soft foods for the next day or so. You may begin to gradually increase your diet to regular food as the discomfort of chewing diminishes. Be careful not to disrupt the suture line in your mouth with hard pieces of food. 8. Rinse your mouth with a ½ peroxide and ½ water solution or standard mouthwash three or four times a day and after each meal to keep the area clean. Continue to do this for one week following surgery. 9. Because of the incision and sutures, it may be too uncomfortable to use a toothbrush for the first few days postop. You may purchase large glycerin swabs at your drug store which will make it less uncomfortable to clean your teeth. 10. If you are discharged with drains, record the amount of drainage every eight hours. 11. You will be quite swollen and have some bruising. This is temporary and will subside over several days to weeks. 12. There will be areas of numbness and tightness. You may find you feel stiff and have some difficulty moving your lips as you normally would. This may take several weeks to resolve. 13. Often, a stitch is placed in the corner of the eyelids (temporary tarsorrhaphy) to help control the swelling (chemosis) of the tissues around the eye. This stitch will be removed in 3 to 7 days, depending on the amount of swelling. 14. Sleep with your head elevated. 15. Avoid contact lenses for two weeks. Check with your doctor after that before wearing them. 16. Make-up may be used 48 hours after the sutures are removed 17. Please notify your surgeon if your temperature goes above 101°. 18. If there are any problems, contact the staff @ 617-267-0710. 19. Call your surgeon’s office to make your follow-up appointment.

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