Witch's chin: a progressive, three-step technique.

Witch's chin is an unpleasant aesthetic defect characterized by ptosis of premental tissue and a deep submental fold, which may be exaggerated by hyperprojection of the mandible. These three elements determine the different degrees of deformity; therefore, the ideal treatment should be directed to one, two, or all three of them. Despite unanimity on the surgical approach of the defect, a large variety of techniques have been proposed by various authors. The need to use a technique suitable for different clinical pictures, characterized by a progressive surgical aggression, as usually performed in this practice, has led to standardize a technique to correct witch's chin, by means of three progressive steps, depending on the degree of deformity. The advantage of this procedure is that once a good result has been achieved, the subsequent steps may be omitted. The technique has been successfully performed in five patients, and the mean follow-up is 12 months. Figures from two representative cases are presented.

Treatment of orbicularis oculi muscle hypertrophy in lower lid blepharoplasty.

Treatment of orbicularis oculi muscle hypertrophy during conventional lower eyelid blepharoplasty is presented. Horizontal resection of a strip of the hypertrophic muscle is carried out, which allows flattening of the muscular bulge in an anteroposterior direction. Since no full-thickness vertical reduction is performed, this simple procedure is "free" from the risk of "scleral show" deformity, due to excessive muscle shortening, leaving a pleasant contour in the lower eyelid. The technique has been successfully employed in 27 cases of blepharoplasty, with separate skin and muscle flaps.

[Plastic surgery in the treatment of the outcome of intestinal bypass for obesity: a clinical case report]. / La chirurgia plastica nel trattamento degli esiti di by-pass intestinale per obesità: presentazione di un caso clinico.

The authors report the case of a 39-year old woman who had a fast and dramatic weight loss after an intestinal bypass performed elsewhere. The result was a generalized skin flakiness which caused dissatisfaction and psychological unbalance of the patient. Three plastic surgeries were therefore programmed and performed at different moments: mastopexy, abdominoplasty and upper thigh dermolipectomy. No immediate or late complications were observed, even after 2 years. The authors stress the importance of a correct planning of a plastic surgery as a solution to the generalized tissue flakiness in the formerly obese patient.