At the final aesthetic surgery meeting of the year in Miami, USA, I focused on the latest global updates in body contouring.

Trends in Europe and the United States are typically 2–3 years ahead of Japan. Below is a summary of the key concepts I will be bringing back and applying at AVAN TOKYO to continue delivering top-level results in Japan.

1. GLP-1 Agonists (Ozempic, Mounjaro) and “Ozempic Face”

With rapid weight loss induced by GLP-1 receptor agonists, we are seeing more cases of:

• Skin laxity
• Facial volume loss

The same can occur after aggressive liposuction or extreme dieting: any sudden, drastic change can trigger deflation and sagging.

This is why downtime management and lifestyle guidance are essential after body contouring.

2. Abdominal Liposuction + Underarm / Under-breast: The Global Standard

In Japan, the abdomen is still often treated “alone,”

but in Miami the standard is to design:

Abdomen + under-breast + lateral chest/underarm area as one aesthetic unit.

This approach helps to:

• Make the décolleté look cleaner
• Create a beautiful shadow under the breast
• Enhance overall waist definition

3. Fat Grafting Around the Pelvis to Enhance the Bikini Line

By injecting fat into the subperiosteal plane over the iliac crest (hip bone),

the contrast between the waist and hip is intensified, creating:

• A sharper curve at the waist
• A more three-dimensional bikini line

This is an area of treatment that will almost certainly gain popularity in Japan as well.

4. Silicone Implant Breast Augmentation: Capsular Contracture Prevention Is Critical

A major theme throughout the meeting was:

“The most important thing is to avoid capsular contracture.”

Key strategies included:

• Re-evaluating mesh-based reinforcement materials (textured mesh)
• Using implants with a slightly textured surface to reduce contracture risk
• Meticulous selection of the dissection plane and implant size

And the conclusion was consistent:

Motiva remains one of the most reliable and stable implant options worldwide.

5. Mild Breast Ptosis Can Be Corrected Without Lifting – With Implants Alone

In the U.S., severe ptosis is frequently treated with mastopexy (breast lift),

but for mild ptosis, position correction can often be achieved with implant augmentation alone.

The prevailing concept is to aim for the “golden triangle”:

• A triangle formed by both nipples and the midpoint of the clavicle,
  with near-equilateral proportions.

6. Why Pure Fat-Graft Breast Augmentation Is Less Favored in the West

There is essentially one main reason:

The degree of change is often limited to around 1.5 cup sizes.

In cultures where patients want a large, definite change in one surgery,

implant-based augmentation is far more popular than fat alone.

However, in Japan many patients prioritize:

• A very natural feel
• Results that are less obviously “done”

So fat-graft breast augmentation remains highly valuable when indications are appropriate.

7. BBL (Buttock Fat Grafting) and Safety: Ultrasound Is Essential

In many Western countries, BBL has become more common than breast fat grafting.

Because of the risk of fat embolism, it is now considered essential to perform:

Ultrasound-guided injection for buttock and body fat grafting.

At AVAN TOKYO, we will be actively integrating these safety standards into our protocols.

8. Risks of Superficial Fat Injection: Fat Migration

When too much fat is injected into very superficial layers, it can migrate within the soft tissue planes.

This is similar to what can occur with hyaluronic acid:

accurate control of the injection depth and layer is crucial to avoid visible irregularities or displacement.

9. “Who Controls the Ribs Controls the Waist” –

Rib Remodeling Is Rapidly Spreading in the West

The beauty of the abdominal area is determined not only by subcutaneous fat, but also by:

The angulation and shape of the rib cage itself.

There was extensive discussion on techniques to correct anterior rib prominence.

The training I will attend in Colombia next week focuses exactly on these anterior rib remodeling techniques.

10. Anatomy, Ultrasound, and Safety Protocols as Global Standards

Complications discussed included:

• Pneumothorax
• Hemothorax
• Infection
• Hemorrhage

The key message was that surgeons must have clear, predefined protocols for rapid response.

Across all sessions, there was a strong consensus:

In body contouring surgery, ultrasound assessment is indispensable.

11. A New Era: Female Patients Also Want Visible Muscle Definition

Procedures such as:

• Abdominal “etching” (highlighting the rectus abdominis lines)
• Fat grafting along the erector spinae and core muscle lines

are now in demand for both men and women, reflecting a global trend toward an “athletic” aesthetic.

12. The Global Trend: Combining Three Key Elements

The combination most highly rated at the meeting was:

1. Abdominal and waist liposuction
2. Buttock fat grafting
3. Rib remodeling surgery

Together, these three elements produce what many surgeons now regard as:

The most powerful strategy for creating a dramatic, yet sculpted waistline.

Summary:

The Most Focused Global Themes – Silicone Implants × Rib Remodeling

Right now in the West, the most intensively discussed combination is:

Silicone implant augmentation × Rib remodeling surgery

These trends almost invariably arrive in Japan with a 2–3 year delay.

At AVAN TOKYO, we have already begun integrating these concepts and techniques,

and we will continue to update our practice so that patients in Japan can receive world-class body contouring without having to travel abroad.

Next week, I will travel to Colombia to fully master anterior rib remodeling techniques.

Going forward, AVAN TOKYO will remain committed to:

• The highest level of surgical technique
• Safety based on anatomy and evidence
• Bringing global standards directly into our daily clinical practice

for every patient who entrusts us with their body.