摘要Surgical treatment for lymphedema has undergone tremendous advancements over the years, with the earliest techniques focusing on ablative procedures such as liposuction and direct excision. With modern advancements in technology, equipment, imaging, and microscope optics, physiologic procedures have emerged as the standard of care for lymphedema at high-volume institutions and centers of excellence. The lymphovenous bypass and the vascularized lymph node transfer operations have both proven to be effective means for treatment and improving the quality of life of patients suffering from lymphedema. However, with the established foundation of knowledge and experience, innovative approaches to optimize outcomes in patients undergoing supermicrosurgical treatment are constantly evolving. The present review presents a historical review of the lymphovenous bypass and vascularized lymph node transfer procedures and introduces some novel expansions of both techniques in the field of lymphedema surgery.