Dr. Makoto Mihara, Lymphatic Surgeon
Message from Dr. Makoto Mihara
Lymphedema Clinic Tokyo is one of the world’s few clinics specialized in lymphatic surgery. Although lymphedema used to be regarded as incurable, it is now possible to alleviate the symptoms in the majority of patients because of improvements in examinations, testing, and therapeutic techniques. Alleviation of cellulitis has been observed in 93% of patients, and pain alleviation has been seen in 96%. In particular, based on medical and scientific evidence, we choose treatment options while discussing them with patients and their family members, taking into account the patient's circumstances, medical history, thoughts, and future goals as much as possible. Patients will be able to work, engage in their hobbies, go on a trip, run a marathon, and so on, as well as lead a normal daily life, if they properly undergo examinations and choose a treatment appropriate for their condition. Furthermore, our clinic performs a variety of diagnoses and treatments related to the lymph system, and even patients who have been told by other health care facilities that diagnosis or treatment of their condition would be difficult should be able to reconsider their treatment options.
Our clinic proactively accepts not only patients in Japan, but also those traveling from abroad. We are affiliated with Emergency Assistance Japan Co., Ltd., which has a strong record of accepting a large number of international patients. People who visit Japan for the first time or do not speak Japanese can also receive treatment in a comfortable and relaxing environment.
We hope to provide support for each patient's life and daily activities.
Diseases we treat
Our clinic practices team-based health care with experienced surgeons in lymphatic surgery (a male doctor and a female doctor) and highly trained lymphatic therapists (who hold national medical qualifications, such as nurses, physical therapists, and so on) and we provide treatment with a combination of minimally invasive surgical procedures and conservative treatment of lymphedema (complex decongestive physical therapy).
Brief biographical information
- March 2002 Graduated from the Faculty of Medicine, Fukuoka University
- From April 2002 Resident at the Department of Surgery, Toranomon Hospital Rotated departments: General Surgery, Cardiovascular Surgery, Anesthesia, Breast Surgery, etc.
- From April 2004 Cosmetic Surgery, Department of Plastic Surgery, Teikyo University
- From April 2005 Cosmetic Surgery, Department of Plastic Surgery, Tokyo University
- October 2008 Transplantation Surgery, Harvard Medical School, Research Fellow at Massachusetts General Hospital (MGH)
- June 2010 Transplantation Surgery, Columbia University Medical Center, Clinical Observership at New York-Presbyterian Hospital (NYPH)
- April 2014 Certified as a specialist in plastic surgery
- From April 2014 Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital
- From January 2016 Department of Lymphatic and Reconstructive Surgery opened at Saiseikai Kawaguchi General Hospital
- From January 2018 Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital.
- From November 2018 Started to perform LVA day surgeries at Mukumi Clinic (ongoing)
[ History of surgeries performed and guidance provided on business trips abroad (Selected) ]
- University of Siena, Italy: Lectures and lymphatic surgery, and guidance (March 2014)
- University of Oxford, UK: Lectures and lymphatic surgery, and guidance (February 2014)
- The China-Japan Friendship Hospital, Beijing, China: Lectures and lymphatic surgery, and guidance (November 2013)
- Right Hospital, Chennai, India: Lymphatic surgery, and guidance (2012)
- University of Rome, Italy: Lectures and lymphatic surgery, and guidance (January 2013)
- National University of Singapore: Lectures and lymphatic surgery, and guidance (May 2007)
- Chiang Mai University, Thailand: Lectures and supermicrosurgery, and guidance (November 2006)
- Sant Pau Hospital, Barcelona, Spain: Support for lymphatic surgery (November 2011)
[ Accepted and treated international patients (Selected) ]
- Female patient in her 50s from Spain: Lymphatic venous anastomosis for lymphedema of the lower limb
- Female patient in her 30s from Singapore: Lymphatic venous anastomosis for idiopathic lymphedema of the lower limb
- Male patient in his 60s from New Zealand: Lymphatic venous anastomosis for idiopathic lymphedema of the lower limb
- Female patient in her 60s from Taiwan: Diagnosis of lymphedema of the face and consultation on treatment
- Female patient in her 50s from Italy: Lymphatic venous anastomosis for lymphedema of the lower limb
- Male patient in his 40s from Papua New Guinea: Lymphatic venous anastomosis for lymphedema of the lower limb
Academic activities
I have presented the latest data, new operative procedures, and examination methods at international academic conferences, and received a number of academic awards. I also have experience in performing liposuction and lymph node transplantation in addition to lymphatic venous anastomosis, and select treatment methods appropriate for the patient's condition.
References (Selected)
- Mihara M, Hara H, Furniss D, et al. Lymphaticovenular anastomosis to prevent cellulitis associated with lymphoedema. Br J Surg. 2014 Oct;101(11):1391-6.
- Mihara M, Hara H, Zhou HP, Tange S, Kikuchi K. Lymphaticovenous Anastomosis Releases the Lower Extremity Lymphedema-associated Pain. Plast Reconstr Surg Glob Open. 2017 Jan 26;5(1):e1205.
- Mihara M, Hara H, Kawakami Y. Ultrasonography for classifying lymphatic sclerosis types and deciding optimal sites for lymphatic-venous anastomosis in patients with lymphoedema. J Plast Reconstr Aesthet Surg. 2018 Sep;71(9):1274-1281.
- Hara H, Mihara M. Lymphaticovenous anastomosis and resection for genital acquired lymphangiectasia (GAL). J Plast Reconstr Aesthet Surg. 2018 Nov;71(11):1625-1630.
High-precision surgical instruments made in Japan
The world's highest-power surgical microscope
At Lymphedema Clinic Tokyo, we use the world's highest-power surgical microscope, which is made in Japan. We can reliably anastomose lymphatic vessels or veins of 1 mm or less with this microscope. Patients are able to observe the surgical procedure on a large screen in real time.
The latest lymphedema diagnostic techniques
Indocyanine Green Fluorescence Lymphography
The condition of the lymphatic vessels can be observed using indocyanine green fluorescence lymphography.
Ultrasound for LVA
We can now check the condition of lymphatic vessels and veins with an ultrasound device prior to LVA surgery. In 2018, we reported in an international medical journal that observing the condition of lymphosclerosis could improve the outcome of LVA. It has been shown that anastomoses of ten sites performed with the conventional surgical procedure have about the same outcome or efficacy as anastomoses of three sites with the current surgery.
