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Plastic, Reconstractive and Aesthetic Surgery

Plastic, Reconstractive and Aesthetic Surgery

While conventional plastic surgery only includes correction of congenital malformation and acquired deformity of face and body, progress has been seen in recent years in reconstructive surgery to reconstruct lost body parts aesthetically and recover movement and sensation as well as for aesthetic surgery and medicine.

Medical services

A team of specialists not only in plastic surgery but also in a variety of other therapeutic areas provide comprehensive medical care for a wide range of medical conditions.

Diagnosis and treatment policy

A group of professors and lecturers with different specialties discuss surgical methods suitable for individual patients and the final decision on treatment plans is made based on a comprehensive review by all doctors of the department at a case review meeting.


Reconstructive surgery

Reconstruction of the head and neck, face, extremities, and breast not only after cancer resection but also for congenital deformities; replantation of severed fingers; functional reconstruction of paralyzed facial nerves and limb nerves; auricular reconstruction of microtia; congenital anomaly of the cranium, face and limbs (cleft lip and palate, craniofacial bone anomaly, facial fat atrophy); sclerosing and embolization therapy, extensive resection, and reconstructive free flap surgery for hemangioma (arteriovenous malformation) painless treatment for acronyx, surgical procedure for gender identity disorder, urethroplasty and phalloplasty

Aesthetic surgery

Double eyelid formation, face lift surgery, liposuction, and other aesthetic surgeries; and aesthetic dermatologic procedures such as laser therapy for freckles, wrinkles and nevus, and external application of tretinoin

Target diseases

Deformation/neurologic dysfunction after malignant tumor resection, congenital anomaly of the cranium, face and limbs (cleft lip and palate, craniofacial bone anomaly, microtia, etc.), various freckles, nevus, and hem-angioma (arteriovenous malformation), severed fingers, fingertip (nail) loss, lymphatic edema, decubitus, varix, acronyx, ulcer/ refractory ulcer/ osteomyelitis/ diabetic ulcer, various tumors (parotid gland tumor, skin cancer, soft tissue sarcoma)

Advanced treatments/ Specialized treatments

Lymphatico-venular anastomosis for lymphedema and also for its prophylaxis

Bypasses from lymphatic vessels to venules

Minimally invasive reconstruction surgery using microsurgerical technique (vascular anastomosis of 0.7 mm or smaller)

Vascularized adiposal flap transfer for the deformities of face, breast etc.

Vascularized nerve transplant/free muscle transplant for facial palsy

Facial subcutaneous implant of vascularized nerve and muscle
Reconstruction of a “smiling” facial expression

Sclerosing and embolization therapy, aesthetic and reconstructive free flap surgery for hemangioma/ arteriovenous malformation

Frequently performed tests

  • Function test for lymphatic edema using fluorescence lymphography (infrared ray camera and indocyanine green injection)
  • Facial expression analysis based on moving video pictures
  • Vascular examination by color Doppler echography
Isao Koshima

Isao Koshima


Plastic, Reconstructive and Aesthetic Surgery


Professor and Chief


General Plastic Surgery and Aesthetic Surgery, Supermicrosurgery (flap transfer with vascular anastomosis around 0.5mm), Perforator flaps, Head and Neck Reconstruction (muscle transfer &vascul nerve flaps for facial palsy, vascularized fat flap for lipodystrophy and sclerodermia, irradiated severe facial deformity, mandibular loss etc.), Aesthetic Facial Reconstruction, Hand Surgery, Functional Muscle and Bone Transfer, Free flap transfer for arteriovenous alformation, Aesthetic finger reconstruction, Congenital deformity, Vascularized toenail transfer, floating thmb etc), Breast Reconstruction (DIEP flap, vascularized fat flap etc.), Gender Identity Disorder, Penile& Urethral Reconstruction (SCIP flap), Vascular Malformation, Arteriovenous Malformation (wide resect and free flap repair), Lymphedema (surgical treatments LVA, node transfer,l iposuction), Leg Reconstruction (AVM, Osteomyelitis, DM ulcer etc.), Plantar repair

Research Interests

supermicrosurgery, vascularized nerve graft, nerve regeneration, Patinian corpuscle, vascularized muscle flap, muscle regenaration, lymphatic regenaration, microneurovascular anatomy



See More

Major diseases and numbers of inpatients treated
(Number of inpatient surgeries only. Outpatient surgeries and treatments are not included)

Disease name Number of inpatients
1 Trauma (including fractures) 106
2 Congenital anomalies 59
3 Tumor 178
4 Cicatrices and keloids 54
5 Refractory ulcers 17
6 Inflammation, degenerative disease (mainly lymphoma) 251
7 Cosmetic surgery 152
8 Other ambulatory surgery 124


Areas of expertise, treatment and examination methods

  1. Reconstruction after malignant tumor resection
  2. Facial nerve paralysis
  3. Microtia
  4. Cosmetic surgery
  5. Lymphedema
  6. Hemangioma (arteriovenous malformation)
Treatment methods
  1. Tissue transplantation with bone muscle flaps using microvascular anastomotic techniques
  2. Functional reconstruction for facial expressions with nerve and muscle transplants
  3. Otoplasty using the costal cartilage and the improvement of the hearing function in cooperation with the Department of Otolaryngology
  4. General cosmetic surgical treatments, such as eyelid surgery, face lifting, removal of wrinkles around the eyes, ptosis, liposuction, and fat injection, and cosmetic dermatological procedures, such as laser treatment of wrinkles, dermal stains, and nevi and topical tretinoin administration
  5. Microscopic surgery for swollen limbs (lymphedema)
  6. Sclerotherapy combined with surgical procedures for treatment-refractory hemangioma

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