【Dr. Makoto Mihara】

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【Welcome to "Lymphedema Clinic Tokyo"】

Thank you for taking the time to visit our website.

We know that deciding to travel abroad for medical care is a major step, and you may be feeling a mixture of hope and anxiety. Our aim is to provide you with clear, evidence-based information so that you can make confident, well-informed decisions about your lymphedema treatment.

At Lymphedema Clinic Tokyo, we focus on lymphaticovenular anastomosis (LVA) surgery and advanced conservative therapies, guided by the latest international medical evidence. Over the past two decades, our team has contributed extensively to the scientific literature on lymphedema, and we apply this knowledge directly to daily clinical practice.

You will notice that this website contains a large amount of detailed content. This is because we want to share not only general explanations, but also the current scientific data, treatment outcomes, and the reasoning behind our recommendations. Wherever possible, we explain complex medical concepts in simple language, so that patients and families without a medical background can understand them.

If you are considering treatment with us, please feel free to explore the sections on:

・LVA surgery and its proven benefits

・Modern, optimized conservative therapy

・Prevention of cellulitis based on clinical research

・Treatment flow for international patients

・Real experiences from patients who have undergone surgery here

【Our promise is simple】

We will combine the strongest available evidence with kind, patient-centered care to support you before, during, and after your treatment in Japan.

You are not alone in this journey.

We are here to walk with you, step by step.

For Appointments

Lymphedema Clinic Tokyo, Japan

【Welcome to Lymphedema Clinic Tokyo — A Message for Our International Patients】

At Lymphedema Clinic Tokyo, we are fully committed to creating an environment where patients from around the world can feel safe, supported, and confident while receiving LVA surgery or conservative therapy.

We understand that traveling to another country for medical treatment can be overwhelming, and our goal is to make every step of your journey as smooth and reassuring as possible.

【Safe LVA Surgery for All Ages】

Our LVA procedures are performed safely under local anesthesia, and have been successfully offered to patients ranging from newborns to 93 years old.

Before you travel to Japan, we ask that you undergo simple tests—such as blood work and an ECG—in your home country. This ensures that it is safe for you to receive local anesthesia during your surgery.

【A Pain-Free Experience With Local Anesthesia】

We prepare our local anesthetic carefully to make sure your surgery is completely comfortable.

・During the operation: patients feel no pain.

・After surgery: most patients need only a mild pain reliever and remain comfortable through the next day.

・The following day: you may return to your normal activities and even enjoy sightseeing in Japan.

【Watching Your Own LVA Surgery in Real Time (Optional)】

Because the procedure is done under local anesthesia, you remain awake.

If you wish, you can watch your surgery live on a monitor connected to the operating microscope.

During the procedure, Dr. Makoto Mihara explains what you see—your lymphatic vessels, surrounding fat, and the surgical process itself.

Patients who choose to watch often find that:

・They understand their condition much more deeply

・Their postoperative care becomes smoother

・Their long-term outcomes are better

This benefit is supported by medical evidence.

(If you prefer not to watch, that is completely fine—there is absolutely no pressure.)

【Family Participation — A Unique Feature of Our Clinic】

Your family is welcome to enter the operating room and observe a portion of the surgery.

This typically happens 90–120 minutes after the start of the procedure, and lasts about 30 minutes.

Family members who watch the surgery often gain a clearer understanding of:

・Your condition

・What the lymphatic system looks like

・How LVA surgery helps

・How they can best support you emotionally and physically

Around the world, it is extremely rare for family members to observe microsurgery.

We offer this opportunity because we believe no patient should feel isolated, and that healing becomes easier when loved ones understand the condition and can walk alongside you.

【Your Stay in Japan — Recovery and Enjoyment】

A typical treatment stay in Japan lasts about 14 days.

On the day of surgery, walking time is limited.

But from the next day onward, you can return to normal daily life and enjoy sightseeing in Japan as you recover.

We hope your visit not only improves your lymphedema, but also becomes a positive, memorable experience.

【We Are Here for You】

This video explains our approach in more detail.

We hope it brings you reassurance and a clearer picture of what to expect.

You are not alone.

We will walk with you throughout your lymphedema journey.

(For International Patients – LVA Surgery & Prevention of Cellulitis)

【Our Commitment to Preventing Cellulitis in Patients with Lymphedema】

For nearly 20 years, our team has dedicated itself to advancing lymphaticovenular anastomosis (LVA) surgery.

By integrating lymphoscintigraphy, ICG lymphography, and high-resolution lymphatic ultrasound, we have continuously refined our surgical approach—achieving high success rates and exceptionally low complication rates.

We have published over 100 peer-reviewed English-language papers in international medical journals and have played a leading role in global LVA research.

【International Collaborative Research: LVA Reduces Cellulitis to One-Eighth】

In our international collaborative studies conducted with

Sapienza University of Rome, University of Siena, and the University of Oxford,

we demonstrated that LVA surgery can reduce episodes of cellulitis (fever ≥ 38.5°C) to one-eighth of their previous frequency.

・After a single LVA procedure, about 90% of patients no longer experience cellulitis.

・For the remaining 10%, performing additional, carefully targeted LVA procedures allows nearly 100% of patients to regain a life free from recurrent cellulitis.

These findings represent a major advancement in lymphedema care worldwide.

【The World’s First Randomized Controlled Trial for Cellulitis Prevention】

Our team later conducted a randomized controlled trial, becoming the first in the world to scientifically prove that:

LVA surgery combined with optimized conservative therapy

is significantly more effective than conservative therapy alone

in preventing cellulitis.

This study has helped reshape global standards for lymphedema management.

【A Deep Understanding of the Burden of Cellulitis】

We know how devastating cellulitis can be.

Repeated infections can lead to:

・Interrupted work and daily life

・Progressive worsening of lymphedema

・Emotional stress, anxiety, and reduced quality of life

Our goal is to help patients break this cycle, restore confidence, and return to an active, fulfilling life.

LVA surgery is not only a microsurgical procedure—it is a way to give patients back the freedom that cellulitis has taken from them.

【Safety First: A Core Principle in Our Treatment Planning】

Every international patient who undergoes surgery at our clinic has returned home safely, without any severe complications.

Our surgical complication rate remains below 0.2%, and even the rare complications that occur (such as minor wound separation) heal naturally within about a week.

We design each treatment plan with safety as our top priority—so patients can travel to Japan, receive treatment, and return home with peace of mind.

【Learn More — We Have Prepared a Detailed YouTube Explanation】

We have created a YouTube video summarizing the scientific evidence behind LVA surgery and its effectiveness in preventing cellulitis.

We encourage you to watch it to better understand how this surgery can change the course of your condition.

【Continuing to Lead the World in LVA Surgery】

We aspire to remain a global leader in LVA surgery—

a clinic that continues to define the future of lymphedema treatment.

To achieve this, we are committed to:

・Pursuing even greater treatment effectiveness

・Striving for a zero-complication standard

・Refining our techniques every day

・Providing world-class care to every patient who visits Japan for treatment

We will never give up on your lymphedema treatment.

And we will continue pushing the boundaries of what LVA surgery can accomplish for patients worldwide.

【Why International Patients Trust Us — Rated 4.9 on Google】

At Lymphedema Clinic Tokyo, we are deeply grateful that many patients from around the world have shared their experiences with us.

As of December 2025, our clinic has received 61 Google reviews with an exceptional average rating of 4.9 out of 5.0.

This high rating reflects the trust our patients place in our team, the quality of our LVA surgery and conservative therapy, and the compassionate support we provide throughout each patient’s treatment journey.

＜Many reviews highlight＞

・The safety and comfort of our LVA procedures

・The kindness and professionalism of our medical staff

・The clarity of our explanations

・The reassurance patients felt while traveling to Japan for treatment

・The meaningful improvements in swelling, pain, and cellulitis frequency

For international patients who may feel anxious about seeking medical care abroad, these reviews offer real voices from people who once stood in the same place—and who now share their stories to help others make informed, confident decisions.

We will continue striving to provide world-class care and to be a clinic where every patient feels safe, understood, and supported.

About Doctors

Office Hours/Access

LVA Day surgerySurgery 

【A Gentle, Effective, and Evidence-Based Approach to Lymphedema Treatment】

At Lymphedema Clinic Tokyo, our first priority is to offer a safe, minimally invasive, and scientifically grounded treatment plan for every patient.

For this reason, LVA (lymphaticovenular anastomosis) surgery under local anesthesia has become the cornerstone of our approach. With the aid of high-resolution lymphatic ultrasound, more than 99% of our patients are able to choose LVA as their primary treatment, and additional therapies are considered only when necessary.

【Why LVA Surgery Is Often the Best First Step】

LVA is performed under local anesthesia, which makes it a gentle and low-risk procedure.

Because the surgery reconnects functioning lymphatic vessels to small veins, it directly improves lymphatic drainage without removing tissue or damaging existing structures.

This precision and safety are major reasons why LVA is widely preferred among our international patients.

【Comparing LVA with Lymph Node Transfer】

Lymph node transfer is a respected treatment option, and many patients benefit from it.

However, the procedure requires harvesting lymph nodes from another area of the body, which creates a risk of developing lymphedema at the donor site.

For this reason, many patients feel hesitant about lymph node transfer and prefer LVA as a safer first-line option.

【Comparing LVA with Liposuction】

Liposuction removes excess fatty tissue and can provide rapid cosmetic improvement, especially in advanced stages where fat deposition is prominent.

However, if functioning lymphatic vessels remain, liposuction may damage these vessels, potentially worsening lymphatic flow.

For this reason, our clinic recommends:

１．Perform LVA first, to eliminate excess lymphatic fluid and restore physiological lymph flow.

２．Wait at least 6 months to observe how much the swelling improves.

３．If residual fat remains, consider secondary liposuction safely.

Liposuction is a widely available procedure globally; however, high-precision LVA surgery is technically demanding, and only a small number of institutions worldwide can perform it with consistent success.

This makes our clinic’s expertise a significant advantage for international patients seeking optimal outcomes.

【What to Expect After LVA Surgery】

After LVA, symptoms typically improve gradually over 6 to 12 months.

It is normal to experience fluctuations—some days better, some days worse.

Long-term success depends strongly on:

・Daily exercise

・Maintaining a healthy lifestyle

・Careful weight control

・Wearing compression garments with the correct, medically measured pressure

Our 20 years of clinical research show that patients who continue gaining weight or wear inappropriate compression garments tend to have poorer results.

For this reason, we carefully assess and prescribe the optimal compression stockings or sleeves when you visit our clinic.

We also ask patients to manage their weight carefully before undergoing LVA, as this improves both surgical safety and long-term outcomes.

【Our Commitment】

Our goal is not only to perform a technically excellent surgery, but to help you regain control of your life, reduce cellulitis risk, and move toward a healthier, more active future.

You are never alone in this process—we walk with you every step of the way.

【Why Patients from Around the World Choose "Lymphedema Clinic Tokyo"】

At Lymphedema Clinic Tokyo, we understand that seeking medical care abroad—especially for a chronic condition like lymphedema—can feel overwhelming.

Our mission is to provide world-class treatment, genuine emotional support, and a safe,安心, and comfortable experience at every step of your journey.

Below, we share the key reasons why patients from more than 20 countries have chosen our clinic with confidence.

【1. One of the World's Highest Volumes of LVA Surgery】

For nearly 20 years, we have specialized in lymphaticovenular anastomosis (LVA) and have performed:

・Over 4,000 LVA procedures

・More than 1,600 anastomoses per year

This experience allows us to deliver highly precise, consistent, and safe surgical outcomes that very few centers worldwide can offer.

Our extensive research—including over 100 peer-reviewed English publications—has contributed to the global advancement of lymphedema treatment.

【2. Advanced Imaging for Accurate and Personalized Treatment】

We are one of the few clinics worldwide that routinely use three complementary imaging tools:

・Lymphatic ultrasound

・ICG lymphography

・Lymphoscintigraphy

These technologies allow us to visualize lymphatic flow in great detail and select the exact vessels suitable for LVA.

As a result, over 99% of patients are able to receive LVA under local anesthesia, minimizing the need for more invasive procedures.

【3. Minimally Invasive Surgery Under Local Anesthesia】

Our LVA surgery is performed under carefully prepared local anesthesia, which allows patients to:

・Feel no pain during the operation

・Be awake and able to communicate

・Walk and resume normal activities the next day

・Recover safely without general anesthesia

Patients who wish to learn more about their anatomy can even watch the surgery in real time on a monitor—an educational and empowering experience unique to our clinic.

【4. A Family-Inclusive Approach Rarely Seen Worldwide】

We believe that no patient should face lymphedema alone.

During the procedure, family members are welcomed into the operating room for a short observational session.

This rare opportunity helps families:

・Understand the condition more deeply

・Learn how to support the patient after surgery

・Feel connected and emotionally reassured

This family-centered approach is one of our most appreciated features, especially among international patients.

【5. Scientifically Proven Ability to Reduce Cellulitis】

Through international collaboration with the University of Oxford, Sapienza University of Rome, and the University of Siena, we demonstrated that LVA surgery can:

・Reduce cellulitis episodes to one-eighth

・Prevent cellulitis in 90% of patients after one surgery

・Achieve nearly 100% prevention with carefully performed additional procedures

We also conducted the world’s first randomized controlled trial showing that LVA + optimized conservative therapy is significantly superior to conservative therapy alone.

For patients who struggle with repeated infections, these results provide real hope for reclaiming their lives.

【6. Safe for Patients of All Ages — From Infants to Age 93】

LVA is a gentle, low-risk surgery.

We have safely treated patients ranging from 0 years old to 93 years old, with excellent postoperative safety profiles.

Complications are rare (<0.2%) and minor when they occur.

【7. A Smooth and Supportive Medical Journey for International Patients】

We partner with Emergency Assistance Japan (EAJ) to assist with:

・Interpreter arrangements experienced in LVA surgery

・Online consultations

・Visa documentation

・Scheduling and travel coordination

Our goal is to make your entire experience in Japan seamless and stress-free.

【8. Transparent, Ongoing Support — Before and After Surgery】

Once you decide to receive treatment at our clinic, we offer:

・Unlimited email support, before and after surgery

・Detailed postoperative guidance

・Compression garment assessment using objective tools (PicoPress)

・Long-term care planning for the best outcomes

You are never alone.

We stay connected with you even after you return home.

【9. Evidence-Based, Comprehensive Treatment Plans】

LVA surgery is not the end—it is the beginning of recovery.

We help patients achieve the best outcomes by ensuring:

・Proper weight management

・Correct compression pressure

・Exercise guidance

・Lifestyle adjustments

Our research over 20 years shows that these factors strongly influence long-term success.

【10. A Clinic Built on Compassion, Science, and Hope】

Every patient’s story matters to us.

We take time to listen, to understand your goals, and to support you as you work toward a healthier, more active, and more confident life.

We will never give up on your lymphedema treatment.

And we will continue to advance LVA surgery so that patients worldwide can receive the safest and most effective care.

Lymphedema Clinic Tokyo has commissioned a survey by Sogo Medical and posted a patient satisfaction survey. Our staff will offer patients a relaxing and comfortable experience. The following are excerpts from the patient feedback.

About Lymphedema

Please enjoy Japan Trip

We perform LVA under local anesthesia. And you can enjoy Japan trip 2-3 days after LVA surgery. You can do sports and hot spa 'Onsen' 7days after LVA. We recommend Tokyo and Kyoto, Nikko etc... Please check video before your trip!