The fundamental principle of aesthetic medicine

In almost all aesthetic procedures, there is one universal rule:

Always evaluate and treat from the superficial layers first.

The anatomical order is:

Skin → Subcutaneous fat → Muscle → Bone

(I treat skin and fat differently, as they require distinct strategies.)

Why skipping superficial layers limits results

For example, bulky calves.

If significant subcutaneous fat is present,

injecting Botox into the calf muscles alone produces limited visible improvement.

✔ Correct order:

Liposuction first → Muscle Botox if needed

This logic applies to the entire body.

Rib remodeling is NOT an exception

Rib remodeling techniques such as RIBXCAR directly modify the skeletal structure.

However, when:

• Skin laxity is significant
• Subcutaneous fat remains excessive

Rib remodeling alone often fails to create a noticeable contour change.

❌ Bone-only approach

⭕ Fat reduction and skin tightening first (or simultaneously),

→ Rib remodeling only if rib flaring still remains

This is the medically correct indication.

Clinical example

A patient previously underwent abdominal and flank liposuction in Korea.

At AVAN TOKYO, we performed:

• 2,000 cc of pure fat removal
• Rib remodeling surgery

Without adequate fat reduction, rib remodeling rarely delivers visible results.

True body contouring starts with fat.

Why AVAN TOKYO

• Specialized liposuction-focused clinic
• Structural design considering fat, skin, muscle, and bone
• Strict patient selection for rib remodeling procedures

We aim for results you can clearly see, not just procedures you undergo.