The diagnosis of lymphedema requires careful attention to patient risk factors and specific findings on physical examination. Noninvasive diagnostic tools and lymphatic imaging can be helpful to confirm the diagnosis of lymphedema or to address a challenging clinical presentation. Initial treatment with decongestive lymphatic therapy can provide significant improvement in patient symptoms and volume reduction of edematous extremities. Selected patients who are unresponsive to conservative therapy can achieve similar outcomes with surgical intervention, most promisingly suction-assisted lipectomy.
Alloplastic implants in rhinoplastic surgery have acceptable complication rates and can be used when autogenous materials are unavailable or insufficient. Outcomes with Medpor or Gore-Tex implants may be slightly better than those with silicone. Improved reporting of implant failures and follow-up times in future studies are needed to better define specific guidelines for the use of these materials.
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