Microsurgical derivative procedures to treat chronic lymphedemas of the limbs are reported here. Techniques used consisted of lymphatic capsule‐venous anastomoses (in pediatric patients) and end‐to‐side lymphatic‐venous anastomoses. Results after more than 5 years showed improvement in about 70% of the cases. The importance of an accurate preoperative diagnostic evaluation and the precise indications for these microsurgical procedures are discussed. Some personal modifications of derivative microsurgical techniques and their advantages are also pointed out.