The Beauty Standard with Dr. Roy Kim

Is Rib Remodeling Safe? Lean Lipo, Botox Scandals & What Patients Should Know

• Dr. Roy Kim

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What’s really behind 2025’s boldest body-contouring trends?

In this episode of The Beauty Standard with Dr. Roy Kim, board-certified plastic surgeon Dr. Roy Kim breaks down the week’s most talked-about stories in aesthetics — from the controversial “waist surgery” (rib remodeling) trend to the evolution of Lean Lipo and the alarming rise of illegal Botox sales in the UK.

Learn how rib remodeling actually works, why “fine-tuning” liposuction is replacing fat removal fads, and what every patient must know about product safety, prescriber laws, and the growing influence of celebrity transparency (including Amy Schumer’s candid weight-loss story).

Key topics:

  • What “waist surgery” really means — and why it’s not true rib removal
  • Lean Lipo vs. traditional liposuction: precision sculpting explained
  • BBC’s undercover Botox investigation — and the hidden patient risks
  • Amy Schumer’s honest conversation about surgery, GLP-1 drugs, and body image
  • Facelifts in your 20s: myth, motivation, and long-term results

Listen now for an unfiltered, evidence-based look at how modern plastic surgery trends are shaping the new beauty standard.

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Join us next week as we explore another fascinating topic in the world of beauty, and remember: your body, your choice, your standard!

SPEAKER_00:

Welcome to the Beauty Standard with Dr. Roy Kim. Welcome to the Beauty Standard with Dr. Roy Kim. My name is Dr. Roy Kim, a board certified plastic surgeon in San Francisco and Beverly Hills, here to bring clarity, reality, and compassionate expertise, along with a little dry humor, to today's aesthetic headlines. If you've ever wondered about waist surgery, W-A-I-S-T, lean lipo, illegal injectables, or the whirlwind of trends shaping patient decisions, this episode's for you. I use this to mainly talk about the week's latest articles in plastic surgery. So first off, let's start off with the New York Times article and social feeds article, the so-called waist surgery, specifically rib remodeling. Technically, this is not rib removal, although the internet sometimes blurs that line. There's no removal of bones. Rather, rib remodeling involves carefully controlled microfract or an infracture and reshaping of the lower ribs, often ribs through 12, to create a more narrow waist without excision or removing an actual rib. So far it seems that the average rib remodeling procedure costs around$8,000 and takes about 10 minutes. Of course, we're doing other things in the operating room under generalized anesthesia. Recovery is not a walk in the park. Patients can expect 8 to 12 weeks in a snug corset, with most seeing about 2-4 inches of waste reduction, according to the American Society of Plastic Surgeons. Now, why the fuss? Because this concept really pushes the edge of what's possible in body modification. Techniques so far include puncture-based methods and ultrasonic tools like the wasp, waistline aesthetic, slimming by puncture. But published long-term data is scarce. The real trade-offs are important pain, the risk of misaligned healing or asymmetry, nerve and soft tissue effects, visible scarring, and unknown long-term impact on biomechanics. The fine print, credentials, and surgery, facility, safety matter far more than any fancy marketing term or snappy trend. In my own practice, most of my patients really have not asked about this. After tummy tuck or no tummy tuck, and definitely sliposuction, and assuming that you maintain the weight loss after surgery and you improve your core muscles and posture, most of my patients find that their waist goals are achievable without any rib work at all. I do think that this is the norm for the vast majority of patients. Before surgery, I document exactly what your waist measurements are, weigh the wrists, and typically stick to a traditional or more conservative approach. We could definitely do repeat measurements afterwards, and yes, my patients are pretty satisfied. So if you're considering this procedure, remember informed consent is paramount. Next up, let's talk about lean lipo, precision over debulking. This is an evolution in body contouring, what Marie Claire magazine calls lean lipo. The days of focusing only on fat removal are sort of behind us. Lean Lipo isn't about taking off as much fat as possible, it's more about fine-tuning and getting a beautiful body sculpting contour. Candidates are typically near their goal weight already, with good skin elasticity. The aim is to sculpt, in other words, to reveal underlying lines and shadows, hills and valleys, not to debulk. Modern technologies such as even traditional liposuction, power-assisted liposuction, vasor liposuction, Renewion, and Ion, A Y-O-N. These are all FDA-proof tools that make this selective approach possible. If you're asking yourself, will this make me look like I spent every day in the gin? The honest answer is it sort of highlights what you've already built. It's not going to create muscle from nothing, but it can dramatically enhance your natural physique. Recovery involves compression garments, possible lymphatic massage, and time away from workouts. When you do a consultation with me, the pathway is always goal setting, mapping, conservative sculpting, skin quality, and patient safety. Subtlety always looks best in the long run. Over etching can really age poorly. Next up, a really fascinating story from the BBC. A recent investigation caught UK pharmacists offering Botox vials to non-medical injectors without the required face-to-face assessment. Under UK law, botulinotoxin can only be prescribed by a qualified professional after an in-person clinical evaluation. But undercover journalists easily purchase Botox for unapproved use, putting patient safety at serious risk. If you're a patient or thinking about injectables in the UK, please ask yourself, who examined me? Who prescribed the product? What's the origin of batch number? And what happens if there's a complication? If the answers are vague from your injector, just walk away. Always verify that the prescriber and the injector prioritize product traceability and emergency protocols. Complications from black market toxins, including paralysis, do exist. Now, I'll admit that they're quite rare, but they're a little more common than getting Botox through the normal channels. Remember, patient safety should always be your number one priority. Amy Schumer reveals a lot in her People magazine discussion. So people actually covered Amy Schumer's weight loss in health journey. This included liposuction, some attempts at the injectables like Weigovi and Manjaro, and an honest discussion of the side effects of medical diagnoses. So why does she share this? Well, she wanted to discuss the pros and cons and to empower anyone and everyone to ask smarter questions, sort of the sequence of weight loss, potential surgery, optimal timing for both, skin changes, and what's realistic. If you're considering surgery while using these injectables, the GLP-1 medications, plan around weight stability, skin laxity, and nutrition altogether. Next up is an interesting article, getting a facelift at the age of 28. The BBC put a spotlight on a growing subset of younger patients, some of their late 20s or early 30s, who are opting for facelifts from mini lifts to deep plane and ponytail approaches. The motivation often comes from the desire for definition, fatigue from repeated temporary fillers, or perpetual self-viewing on social media. However, if you're a facelift candidate, it still revolves on the old school clinical factors, skin elasticity, underlying anatomy, fat in your face, muscle layers and other structural things in your face, and realistic expectations for aging. Remember, conservative structure-based plans almost always age better than trendy quick fixes. Now, if you do have early signs of aging and you have tried other non-surgical treatments, facelift honestly may be for you. I often find that my patients may need a smaller procedure now and they definitely need a bigger procedure maybe 10 to 20 years in the future. However, if early signs of aging to you are sort of minimal, there may be a chance that optimal skincare, sun protection, and even healthy living may be more beneficial than a scalpel. If you take one thing for today's episode, let it be this, that in plastic surgery, nuance always wins. There's rarely a silver bullet or a single definitive procedure for any aesthetic problem. Always look for surgeons who take time to understand your unique goals, educate you honestly, and prioritize safety and ethics over hypertrend. For more evidence-based conversations, you can find me all over social media. I'm on YouTube at Dr. Kim MD. You can also subscribe to this podcast. You can also follow me on social media, including Instagram at Dr. Roy Kim, X, also at Dr. Roy Kim, and other social media platforms. If you have any questions about this, please fire below or just communicate with me through social media profiles. Remember, we're trying to maintain the beauty standard. As always, thanks for listening.