Lymphedema Surgery has continued to evolve and become more established with the advent of Supermicrosurgery techniques internationally. Proponents of lymphovascular microsurgery have shown some promising results in managing chronic lymphedema disease through the use of lymphovascular anastomosis and lymph node transfers. Most countries have began establishing their supermicrosurgical centres to provide this highly niche service to patients suffering from lymphedema following trauma or surgery. Moreover, its applications may extend beyond lympheadema surgery as boldly suggested by Xie et al. (2023) in their study to improve incurable neurological diseases such as Alzheimer’s disease which was described by them as a disease of the brain lymphatic system (1). This study sought to review the current evidence in lymphovascular microsurgery as well as the potential challenges of establishing a highly specialised lymphovascular microsurgery centre in our institution. 1. Xie, Q. , Louveau, A. , Pandey, S. , Zeng, W. & Chen, W. (2023). Rewiring the Brain – the Next Frontier in Supermicrosurgery. Plastic and Reconstructive Surgery, Publish Ahead of Print , doi: 10.1097/PRS.0000000000010933