Redefining Breast Augmentation2026.09.27
The Future of Breast Aesthetic Surgery at AVAN TOKYO
When people hear the term “breast augmentation,” they often think of one thing:
making the breasts larger.
But I believe the future of breast surgery should go far beyond simply increasing breast size.
Breast shape, symmetry, skin quality, the inframammary fold, changes caused by aging, pregnancy and breastfeeding, overall body proportions, and how the breasts will look years after surgery all matter.
At AVAN TOKYO, our goal is to evaluate all of these factors comprehensively and select the most appropriate treatment for each individual patient.
We want to redefine breast augmentation as something broader:
comprehensive, medically driven breast aesthetic surgery.
Moving Beyond Surgery Based on a Single Surgeon’s Perspective
AVAN TOKYO will continue to strengthen our dedicated breast surgery team.
Our breast procedures will be managed by a multidisciplinary team including:
● A female board-certified plastic surgeon who is part of a university hospital breast reconstruction team
● Dr. Fujimoto Avelino from the Department of Plastic Surgery at Kyorin University
● A board-certified anesthesiologist
● Myself, Shin Moriwaki, MD, Director of AVAN TOKYO
Each physician brings a different field of expertise.
Rather than viewing the breast only from the perspective of cosmetic surgery, we want to incorporate expertise from plastic and reconstructive surgery, breast reconstruction, anesthesiology, and body contouring.
I believe this multidisciplinary approach—multiple specialists evaluating and discussing a single case—is exactly what modern aesthetic medicine needs.
Fat Transfer or Implants? Breast Surgery Is More Complex Than That.
Every patient has different goals.
“I want a subtle, natural increase in volume.”
“I am very slim, but I want to increase my breast size by two or three cup sizes.”
“I want more upper-pole fullness.”
“My breasts lost volume after pregnancy and breastfeeding.”
“My breasts have started to sag.”
“I want to improve asymmetry.”
“I am worried that implants may look too visible because I am thin.”
There is no single operation that can appropriately address all of these concerns.
At AVAN TOKYO, our breast surgery options will increasingly include:
Fat transfer breast augmentation
Silicone implant breast augmentation
Hybrid breast augmentation
Breast lift surgery (mastopexy)
Combined procedures when medically appropriate
The important question is not:
“Which procedure is the best?”
The real question is:
“Which procedure is most appropriate for this patient?”
Bone structure, existing breast tissue, subcutaneous fat, skin elasticity, the position of the inframammary fold, the degree of breast ptosis, and the desired breast size can all change the surgical strategy.
That is why accurate assessment and appropriate patient selection are fundamental.
From “It Looks Better” to Measurable Aesthetic Medicine
Another major area we want to develop at AVAN TOKYO is the objective evaluation of aesthetic surgical outcomes.
In cosmetic surgery, outcomes are often described subjectively:
“It looks beautiful.”
“It looks natural.”
Of course, patient satisfaction is one of the most important outcomes in aesthetic medicine.
But if we want aesthetic surgery to continue developing as a medical discipline, subjective evaluation alone is not enough.
We should also ask:
What objectively changed after surgery?
How did breast shape change?
Did symmetry improve?
How did breast position change over time?
How satisfied was the patient?
What happens at six months, one year, or even longer after surgery?
At AVAN TOKYO, we plan to evaluate breast surgery using both quantitative and qualitative outcome measures, accumulate clinical data, analyze our results, and ultimately present our findings through academic conferences and peer-reviewed publications.
I believe aesthetic surgery should be approached with this level of scientific rigor.
Our Goal Is Not Simply to Be “Good at Surgery”
AVAN TOKYO does not aim to become a clinic known only for performing a high number of procedures.
Nor do we want to be defined simply by social media popularity.
Our long-term goal is to create an environment in aesthetic medicine where three elements coexist:
Clinical practice.
Research.
Education.
In university hospitals, medicine is rarely built around a single physician.
Specialists from different disciplines discuss complex cases together.
New treatments are studied.
Clinical outcomes are analyzed.
Findings are presented at academic meetings and published.
And the next generation of physicians is trained.
I want to bring that culture into aesthetic medicine.
Breast surgery will be one of the major fields in which we pursue this vision.
Building a Team Around Genuine Medical Expertise
Going forward, AVAN TOKYO intends to collaborate with physicians who have seriously trained in their respective specialties at university hospitals and major medical institutions.
We are not simply collecting impressive titles.
What matters to us is whether a physician has genuine expertise and shares the same philosophy:
to pursue better medicine based on anatomy, evidence, technical excellence, and long-term outcomes.
We want specialists who are willing to discuss cases, question established practices, evaluate their results, conduct research, and continue improving.
This is the type of medical team we want to build.
Breast Augmentation Should Not End the Day the Breasts Become Larger
The breast changes throughout life.
It changes with age.
It changes after pregnancy and breastfeeding.
It changes with weight gain and weight loss.
And naturally, it continues to change over 10 or 20 years.
For that reason, we do not believe that a result should be considered successful simply because the breasts look beautiful immediately after surgery.
We need to think about:
one month after surgery,
six months after surgery,
one year after surgery,
and the years beyond.
That long-term perspective should influence how we choose a surgical procedure.
Fat transfer has advantages, but it also has limitations.
Silicone implants have advantages and disadvantages.
Hybrid breast augmentation has specific indications.
And when significant skin excess or breast ptosis is present, simply inserting an implant may not provide the optimal result—in some patients, a breast lift may need to be considered.
Our philosophy is simple:
We should not force the patient to fit a particular surgical technique.
We should select the surgical technique that fits the patient.
At AVAN TOKYO, we intend to pursue this principle consistently.
Aesthetic Medicine Should Be More Medical
What I want to build at AVAN TOKYO is not simply a place that offers whatever procedure happens to be popular at the moment.
I want to create an environment where specialists come together, evaluate each case carefully, perform surgery, measure the results, identify areas for improvement, conduct research, and use what we learn to improve future treatment.
That is the direction in which we want to take breast surgery.
We will gradually introduce the physicians joining our breast surgery team and explain their individual areas of expertise.
Our goal is to change the concept of breast augmentation:
from simply “making the breasts larger”
to creating a field of breast aesthetic surgery that considers the patient’s anatomy, body proportions, lifestyle, and long-term future.
Fat transfer.
Silicone implants.
Hybrid breast augmentation.
Breast lift surgery.
Rather than promoting one technique as the answer for everyone, we want to understand the strengths and limitations of every option and combine them when appropriate.
And we want to go beyond clinical practice alone.
We want to connect what we learn in the operating room to research, academic publication, and medical education.
Aesthetic medicine should be more medical.
That is the kind of aesthetic surgery we are building at AVAN TOKYO.