— A Structural Approach to Upper Body Contouring —

Many patients complain of:

• Bulky shoulders
• Short-looking neck
• Persistent heaviness despite arm liposuction

In many cases, the cause is not fat or trapezius muscle, but

the prominence of the superior angle of the scapula (bone).

Why Shoulders Look Bulky

Common especially in slim individuals with desk work:

• Elevated scapular position
• Poor posture
• Overactivation of the levator scapulae muscle

This creates vertical bulk on the shoulder, making the neck appear shorter and the upper body heavier.

Why Traditional Treatments Fail

Standard shoulder Botox targets the trapezius.

However, vertical shoulder projection is often caused by

the deeper levator scapulae muscle, not the trapezius.

This explains why:

• Botox may not work
• Liposuction alone may not improve the contour

The AVAN TOKYO Approach

We evaluate shoulders in two dimensions:

Lateral fullness

→ Arm liposuction for contour refinement

Vertical elevation

→ Ultrasound-guided levator scapulae Botox

Relaxing this muscle:

• Lowers shoulder height
• Elongates the neck
• Creates a refined, feminine silhouette

Designing Lines, Not Points

At AVAN TOKYO, we design the upper body as a continuous line—

integrating shoulder, arm, and décolletage.

Ideal Candidates

• Prominent shoulder top
• Poor response to shoulder Botox
• Residual bulk after liposuction
• Desire for a longer, slimmer neck

Our Philosophy

Precision anatomy × Technique × Total design