Facelift

Author: Dr. Richard Chaffoo

Your whole outlook can be influenced by your reflection in the mirror. A refreshed, sculpted, youthful-looking face can increase your confidence and make life more rewarding. Unfortunately, stress, gravity, heredity, and exposure to the elements can take their toll on your face, making you look perpetually tired and aged. Facelift surgery at our San Diego area practice can help turn back the years from your appearance, so you look like you, only better.

Facelift
 Before & After Photos

Keep in mind that each patient is unique and your results may vary.

Case: 1 of 41
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Case: 1 of 41
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Brow Lift Case 25 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 1 of 40

Case #25

This 45 year old San Diego woman disliked the signs of facial aging. She felt that her eyebrows were drooping with excess upper eyelid skin as well as loose skin along her jaw and neck line. She underwent an endoscopic brow lift, bilateral upper blepharoplasty, and facelift. She was thrilled with the natural rejuvenation of her facial features following... Read More
Facelift Case 113 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 2 of 40

Case #113

This 61-year-old patient was unhappy with the appearance of the skin on her face and neck. Gravity, aging and sun damage can take a toll on a person's face, leading to a "tired" look. She scheduled a consultation with Dr. Richard Chaffoo, to discuss face lift in San Diego, and to learn about her options for facial rejuvenation.Dr.... Read More
Laser Resurfacing Case 46 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 3 of 40

Case #46

This mid 40's year old San Diego woman was unhappy with the signs of facial aging. She disliked the loose skin along her lower face and neck line and excess upper eyelid skin with facial lines and wrinkles. She underwent an uncomplicated upper blepharoplasty, face/neck lift with laser resurfacing to the facial lines. She was thrilled with the... Read More
Facelift Case 104 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 4 of 40

Case #104

This 63-year-old woman wanted to rejuvenate the look of her face, jaw line, and neck. Dissatisfied with the sagging skin on her jaw and under her chin as well as with the wrinkles on her cheeks, she decided to explore her options for facial plastic surgery in San Diego. She chose to meet with Dr. Chaffoo for a consultation to discuss face lift surgery... Read More
Laser Resurfacing Case 48 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 5 of 40

Case #48

This late 50's San Diego woman disliked the signs of facial aging and desired facial rejuvenation including improvement in the facial lines and sagging skin of the face and neck. She underwent an uncomplicated facelift with laser resurfacing of the facial rhytids as a secondary procedure. She was thrilled with the marked improvement in the appearance... Read More
Rhinoplasty Case 141 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 6 of 40

Case #141

This is a 59-year-old who desired a "fresher" face. She had complained of a drooping nose, extra skin on her upper eyelids, and skin laxity of her neck and jawline. After meeting with plastic surgeon Dr. Richard Chaffoo, she was educated on the different options available for facial sculpting procedures such as rhinoplasty at... Read More
Facelift Case 57 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 7 of 40

Case #57

This 44 year old San Diego patient was unhappy with the signs of facial aging of her upper eyelids, face, and neck. She underwent a face and neck lift, upper blepharoplasty, laser to lower lids, and peri-oral (around mouth). She returned to work within 10 days following surgery and was delighted with the aesthetic outcome. Read More
Facelift Case 378 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 8 of 40

Case #378

This 63 year old San Diego gentleman desired a more well defined frontal hairline and improved definition and contour to the face and neck. He underwent FUE using the Neograft system to the frontal hairline and facial rejuvenation including a neck lift. He is shown approximately one year following these procedures. His frontal hairline is more defined... Read More
Facelift Case 22 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 9 of 40

Case #22

When the obvious signs of aging become evident on the face, both women and men want a way to make sure their outer appearance still reflects how young and energetic they feel inside. This woman in her late 50s felt that the deep lines and wrinkles throughout her face, forehead, and neck did not reflect her bright character. Like many women and men... Read More
Facelift Case 543 Before & After View 1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 10 of 40

Case #543

This delightful 60 year old professional San Diego woman desired facial rejuvenation surgery to improve the appearance of her lower face and neckline. She underwent an uneventful lower face and neck lift and was thrilled with the improved appearance which was natural. There were no perceptible scars and no alteration to her hairline. Read More
Facelift Case 472 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 11 of 40

Case #472

53 year old Southern California professional woman had previously undergone rhinoplasty by another surgeon years previously. She was unhappy with the appearance of her nose and bilateral nasal obstruction. She felt that her nose was flat with visible ridges along the bridge and a drooping nasal tip. In addition, she disliked the loss of volume to... Read More
Facelift Case 287 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 12 of 40

Case #287

Patient is a 55 year old retired US Navy Seal who desired improved appearance to his upper eyelids, face, and neck. He disliked the hooded appearance to his upper eyelids, loose skin along his jaw and neck line and double chin when seen in Dr. Chaffoo's La Jolla office. He underwent an upper eyelid lift, face and neck lift with liposuction to... Read More
Facelift Case 20 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 13 of 40

Case #20

44 year old San Diego woman desired facial rejuvenation to improve the signs of facial aging of her upper eyes, lower jaw and neckline. She underwent an upper blepharoplasty with a "short scar" facelift which rejuvenated her face and neck with no visible scars and no distortion of her hairline. She returned to work within a week of surgery... Read More
Facelift Case 526 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 14 of 40

Case #526

This lovely 77 year old woman consulted us to improve the aging of her lower face and neck as well as to improve the loss of hair to her frontal and temporal regions from a severe burn which occurred many years previously. She underwent a facelift and hair restoration to her right temporal and frontal area with the Neograft device. Her recovery was... Read More
Facelift Case 286 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 15 of 40

Case #286

This patient is a 65 year old San Diego Hispanic female who has noted signs of aging in her face and neck, specifically she felt that she had hooding and excess skin on her upper eyelids. Dr Chaffoo performed a full facelift/necklift with liposuction of the jowls and neck and upper blepharoplasty. Read More
Rhinoplasty Case 229 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 16 of 40

Case #229

66 year old delightful San Diegop lady was unhappy with the results of previous cosmetic surgery. She underwent a rhinoplasty and facelift elsewhere. She desired a more defined and refined nasal shape and more youthful contour to her jaw and neckline. She underwent revision facelift and rhinoplasty and was thrilled with the aesthetic outcome.  Her... Read More
Facelift Case 291 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 17 of 40

Case #291

This 55 year old San Diego physician desired facial rejuvenation surgery to reverse signs of facial aging. She disliked the heavy upper eyelids and puffy lower eyelids as well as the loose skin of her lower face and neck. She underwent a bilateral upper and lower eyelid blepharoplasty, liposuction of the neck, and facelift. She also underwent Fraxel... Read More
Brow Lift Case 27 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 18 of 40

Case #27

This 55 year old San Diego lady was displeased with the signs of facial aging to her forehead, eyebrows, upper eyelids, face, and neck. She underwent an endoscopic brow lift, bilateral upper eyelid blepharoplasty, face and neck lift. She healed uneventfully and was delighted with the more youthful appearance and natural look. Read More
Facelift Case 427 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 19 of 40

Case #427

This 74 year old San Diego woman desired an improvement in the appearance of her lower face and neck. She disliked the loose skin along her jawline and upper neck. In addition, she disliked the excess skin of her upper eyelids. She underwent an uneventful bilateral upper blepharoplasty and facelift. Her aesthetic results are shown approximately one... Read More
Eyelid Surgery Case 296 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 20 of 40

Case #296

55 year old San Diego woman disliked the signs of facial aging including heavy eyelids and loose skin and fat along her neck and jawline. After surgery, she was very pleased with the youthful look of her face and neck.
Facelift Case 398 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 21 of 40

Case #398

45 year old health care professional desired a more youthful looking face. She felt that her face appeared tired with sagging skin along her jawline and upper neck. She underwent an uneventful facelift and recovered fully within 2 weeks. She was delighted with the more youthful appearance of her face and neck. Read More
Facelift Case 380 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 22 of 40

Case #380

This delightful 55 year old professional San Diego woman desired a subtle improvement in the definition of her jaw and neck line. She wanted a more sculpted neck and lower face and underwent an uneventful face and neck lift with liposuction of the neck. Her recovery was uneventful, and she returned to her usual activities within two weeks following... Read More
Facelift Case 289 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 23 of 40

Case #289

73 year old San Diego lady desired improvement in the heavy appearance of her upper eyelids and a more youthful look to her jaw and neck line. She underwent an uneventful upper eyelid lift, face & neck lift and is shown 3 months after surgery. Her eyes are more open and rested appearing. Her neck and jawline look more youthful with no noticeable... Read More
Facelift Case 288 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 24 of 40

Case #288

This San Diego lady in her mid-50's who wanted to appear more youthful. She was concerned with her sagging face and neck, and wanted her eyes to be more visible. Dr. Chaffoo performed an upper blepharoplasty procedure as well as a face/neck lift. The patient is extremely happy with the results and the procedures have taken years off of her appearance! Read More
Rhinoplasty Case 247 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 25 of 40

Case #247

45 year old woman who disliked the signs of facial aging including heavy eyelids and loose skin along her neck and jawline. She had previously undergone a rhinoplasty elsewhere and was unhappy with the outcome. After surgery she was delighted with the more youthful appearance of her face and neck as well as a more natural and refined nasal appearance. Read More
Facelift Case 292 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 26 of 40

Case #292

This delightful 71 year old San Diego lady desired an improvement in her facial appearance. She was unhappy with the heavy upper eyelids and loose skin along her jawline and neck. On examination she demonstrated excess upper eyelid skin, jowls, loose skin along her jawline, and a double chin with laxity of the muscles of her neck. She underwent an... Read More
Eyelid Surgery Case 381 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 27 of 40

Case #381

50 year old San Diego male felt his upper and lower eyelids were puffy and had loose skin along his jaw and neckline. He underwent bilateral upper and lower eyelid surgery and a face/neck lift. He was delighted with the natural and more youthful appearance to his eyelids, face, and neck.  Read More
Facelift Case 24 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 28 of 40

Case #24

Combination procedures are extremely common as Dr. Chaffoo's San Diego plastic surgery patients want the best possible results to enhance their appearance. This woman in her mid-50s has a consultation with Dr. Chaffoo because she felt that the areas of loose, sagging skin along her jaw line and deposits of excess fat near her chin detracted from... Read More
Facelift Case 290 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 29 of 40

Case #290

This delightful 50 year old San Diego lady disliked the signs of facial aging with her upper eyelids and loose skin along her jaw and neck line. She underwent an uneventful upper blepharoplasty in addition to a face and neck lift. She was thrilled with the rejuvenated appearance to her eyes, face, and neck with no detectable scars nor alteration... Read More
Facelift Case 379 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 30 of 40

Case #379

This delightful 69 year old San Diego woman desired improvement in the appearance of her jaw and neckline. She had previously undergone a facelift elsewhere and was unhappy with the lack of definition to her jaw and neckline. She underwent an uneventful revision rhytidectomy (facelift) to correct the laxity and poor definition to her jaw and neckline.... Read More
Facelift Case 97 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 31 of 40

Case #97

As we age our skin loses its elasticity and firmness, causing it to droop or sag. This 66-year-old woman was unhappy with the loose skin along her jaw and neck line and decided to research plastic surgery in San Diego. She came across Dr. Richard Chaffoo and was impressed with his triple board certification so she decided to make an appointment.At... Read More
Neck Lift Case 285 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 32 of 40

Case #285

This delightful 56 year old San Diego woman consulted Dr. Chaffoo to correct a difficult neck deformity from previous aggressive liposuction and laser treatment to her neck by a "cosmetic" dermatologist. She was bothered by the unsightly thick neck bands and irregular contour of her lower face and neck. She underwent a face and neck lift... Read More
Facelift Case 21 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 33 of 40

Case #21

This 66 year old San Diego grandmother was unhappy with the appearance of her face and neck. She led a very active life and was disappointed with her facial appearance including her facial lines and wrinkles. She underwent an uneventful upper blepharoplasty, facelift, and secondary full face laser resurfacing. She healed without any complications... Read More
Facelift Case 115 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 34 of 40

Case #115

This 67-year-old female disliked the puffiness under her eyes as well as the loose skin along her jaw and neck. She was interested in facial rejuvenation but wasn't sure which procedure would best address her concerns. She had heard many positive things about Dr. Chaffoo's La Jolla cosmetic surgery practice and decided to call and schedule a consultation.At... Read More
Facelift Case 29 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 35 of 40

Case #29

Age: early 60'sProcedure(s): Bilateral Upper Blepharoplasty, Rhytidectomy (Eyelid Surgery)Remove excess upper eyelid skin, rejuvenate aging face and neck.
Facelift Case 23 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 36 of 40

Case #23

Age: mid 50'sProcedure(s): Rhytidectomy (Face Lift), Liposuction of NeckRejuvenation of the face and neck.
Facelift Case 19 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 37 of 40

Case #19

66 year old San Diego woman disliked the aging signs of her lower face and neck. She was very active and wanted to face to be more reflective of how she viewed herself. She underwent an uneventful upper eyelid lift with a face and neck lift to create a natural yet more youthful appearance to her eyes, face and neck. She returned to her usual activities... Read More
Facelift Case 443 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 38 of 40

Case #443

This 64 year old San Diego woman was concerned with signs of facial aging. She had previously undergone upper eyelid surgery, and she felt there was residual excess upper eyelid skin that was asymmetrical, more on the right side. In addition, she disliked the fact that her face had lost volume over the years with hollowing of the cheeks, temples,... Read More
Rhinoplasty Case 223 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 39 of 40

Case #223

This delightful 61 year old San Diego interior designer desired a very natural improvement in her facial appearance. Specifically, she disliked the extra upper eyelid skin and loose skin along her neckline and double chin. She underwent an uneventful bilateral upper blepharoplasty (eyelid surgery) along with neck liposuction and facelift. In addition,... Read More
Facelift Case 80 Before & After View #1 | La Jolla, CA | La Jolla Plastic Surgery & Dermatology
Before & After
Case: 40 of 40

Case #80

This early 60's San Diego woman was unhappy with facial aging. She disliked the extra skin of her lower face and neck and desired facial rejuvenation. She underwent a face and neck lift with a marked improvement in her jaw and neck line with no detectable scars after surgery and no distortion of her hairline. She was thrilled with the natural... Read More

Keep in mind that each patient is unique and your results may vary.

Am I a Candidate for a Facelift?

Many people who visit us because they’re interested in facial rejuvenation make good candidates for Dr. Chaffoo’s customized facelift approach. There is no optimal age for a facelift. Instead, it’s the skin’s condition and tone that determine whether an individual would benefit from a surgical facelift, a short scar or “mini” facelift, or even a nonsurgical facelift. The best candidates for a full facelift have loose, sagging skin and underlying muscles on the lower two-thirds of their faces, as well as:

  • Some skin elasticity: In addition to repositioning the underlying tissue and muscle, a face lift still stretches the skin somewhat, and successful results and recovery require the skin to still be fairly supple.
  • Strong bone structure: Well-defined facial features provide support for good facelift results.
  • Realistic expectations: The goal of facelift surgery is to refresh your appearance so that you look like a younger version of yourself, not like someone else.

Younger patients whose skin retains much of its elasticity and shows only limited sagging may get excellent results from an endoscopic short-scar or mini facelift. At your complimentary consultation, Dr. Chaffoo will discuss, based on the laxity of your skin and your underlying bone structure, whether you would benefit most from the traditional facelift or the short- scar mini version (as well as explain the differences between the procedures).

Dr. Chaffoo

Dr. Richard Chaffoo

Triple board-certified plastic surgeon Dr. Richard Chaffoo provides exceptional care and results. He has been recognized time and again as a Top Doc by patients and peers.

Meet Dr. Chaffoo

A Unique Combination

A facelift restores a youthful facial appearance, but you might want to combine it with other facial rejuvenation procedures to achieve all the improvements you desire. Dr. Chaffoo asks about overall cosmetic goals during your complimentary consultation and may recommend a customized treatment plan to meet those goals. He can use liposuction to remove unwanted fat from the cheeks, under the chin, and the neck for firmer, more sculpted facial contours. Other procedures that may be appropriate include:

Dr. Chaffoo will consider your cosmetic goals and design a combination of procedures customized to you.

About the Surgery

Dr. Chaffoo performs facelift surgery as an outpatient procedure that takes several hours to complete. While each procedure is unique, a traditional facelift generally proceeds as follows:

  • Incisions are made at the sides of the face concealed within natural folds and creases.
  • Skin of the face is separated from the fat and muscle underneath without changing your existing hairline.
  • Extra fat from the neck and chin is removed (in some cases fat is suctioned away with liposuction).
  • The muscles of the neck and cheeks are tightened.
  • Excess skin is trimmed away.
  • Remaining skin is draped over the face in its normal position.
  • Thin tubes called drains are inserted (if necessary) just below the skin to prevent fluid from building up.
  • Incisions are closed with stitches.
  • Your head is bandaged.

If Dr. Chaffoo has determined that you are a good candidate for a mini facelift, he will explain in detail the steps of that procedure, which differ slightly from a full facelift. This technique is quicker and less invasive, requiring a shorter recovery than the traditional facelift.

What to Expect During Recovery

You will return home the day of surgery, so arrange for a friend or family member to drive you home from the cosmetic surgery center and then to remain with you, helping you out around the house for the first few days. You will be supplied with detailed post-operative care instructions to take with you.

Patient experiences vary after facelift surgery. To minimize swelling and bruising, keep your head elevated at all times for the first few days.

After about 5 to 7 days—around the same time that the swelling typically subsides—your stitches will be removed. You might experience some temporary numbness and facial movements might feel stiff; this is to be expected following surgery and should diminish within a few weeks.

For the first few weeks, you are advised to abstain from alcohol and any physical activity that might place strain upon your body, including sexual intimacy. Additionally, it is recommended that you avoid steam baths and saunas, and limit your exposure to ultraviolet light. And, be sure to get your beauty rest!

Throughout your recovery, you will periodically meet with Dr. Chaffoo so that he can assess your progress. Of course, in-between appointments, should you have any questions or concerns, you can contact your Patient Coordinator.

The fact is that the majority of men and women experience minimal discomfort following facelift surgery. Most of Dr. Chaffoo’s patients return to work after just 10 to 14 days; however, recovery rates vary.

Potential Complications

When an experienced, triple board-certified plastic surgeon such as Dr. Chaffoo performs your facelift, complications are rare. Those that do occur are usually temporary, can be treated with antibiotics, or can be corrected by Dr. Chaffoo. Possibilities include:

  • Build up of blood under the skin (hematoma)
  • Injury to nerves that control the facial muscles
  • Numbness
  • Infection at the incision site
  • Reaction to anesthesia such as nausea
  • Skin discoloration
  • Incision fails to heal properly
  • Unsatisfactory results

You can have an in-depth discussion with Dr. Chaffoo about the risks, complications and rewards of a facelift, including how a patient’s anatomy and healing abilities play an important role, during your complimentary consultation.

Facelift FAQ

Will a facelift raise my sagging forehead?

No, this is a common misconception. A facelift is designed to improve the appearance of the lower two-thirds of the face. If you have concerns about your brow or eyes, Dr. Chaffoo may recommend combining your facelift with a brow lift or eyelid surgery to complete your rejuvenation.

Can I go out in the sun after a facelift?

You should pamper your skin following any facial rejuvenation procedure, especially after a face lift. Avoid the direct sunlight until your incisions are completely healed, and then be extra vigilant about sun protection. The sun’s rays on fresh scars can cause permanent discoloration. This sun protection habit is a good one to get into for the long term, as well, because sun exposure causes a lot of the damage and discoloration to our skin that spurs us to seek out cosmetic treatments. The better you protect your skin, the better it will look for many years to come.

Can you make my scars from a facelift I had years ago less noticeable?

Patients who have had facelift surgery elsewhere or at a time when less-advanced techniques were being used may be left with visible scars or an elevated hairline. Today, Dr. Chaffoo can use NeoGraft® hair restoration to cover scars at the edge of the hairline or even have their hairlines restored to their pre-surgery locations.

How long do facelift results last?

This is a question most patients ask, and for good reason. It’s important to remember that a face lift results in a younger, refreshed appearance, but it doesn’t stop the aging process. The same factors that influence the way we age — genetics, lifestyle, and the natural passage of time — continue to play a role. That said, a facelift performed by an experienced board-certified plastic surgeon such as Dr. Chaffoo typically results in changes that last for at least 10 years.

Next Steps

When you decide to undergo cosmetic surgery, it’s important to feel comfortable and confident about the plastic surgeon you choose. Patients appreciate triple board-certified plastic surgeon Dr. Richard Chaffoo because he makes their goals a priority and strives to exceed their expectations with natural-looking improvements. To learn more, request your complimentary cosmetic consultation online or call (858) 623-6333 for an appointment.

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