Recent advancements in microsurgery have transformed the field of plastic and reconstructive surgery, especially in the treatment of lymphoedema. This article explores these innovations, highlighting their significant impact on clinical practices for lymphoedema patients. The evolution of microsurgical instruments and techniques has brought about exceptional precision in lymphoedema surgeries, such as lympho-venous anastomosis and vascularized lymph node transfer. This progress is characterized by the utilization of finer surgical tools, advanced lymphatic imaging diagnostics, and high-magnification microscopes. These advancements have facilitated the reliable execution of procedures on extremely small vessels, under 0.8mm in diameter, a practice increasingly referred to as 'supermicrosurgery'.1 In the last three years, the integration of specialized robotic systems into microsurgery has been a notable development.2, 3 Despite its promise, challenges such as increased anastomosis time, a steep learning curve, and the absence of tactile feedback persist with this technology.2-4 Moreover, the innovation in training methodologies for these sophisticated tools marks a significant step forward. Nonetheless, mastering these techniques, particularly robotic systems, remains a challenge, emphasizing the need for continued investment in training and simulation-based learning.4 In summary, plastic and reconstructive surgery is undergoing a significant transformation thanks to microsurgical innovations, heralding not only enhanced surgical outcomes but also broadening the scope for treating complex medical cases.