Hello! Thanks for the feedback and interest in Love's Apathy. A few changes have been made to the prologue and as a result of some of these changes, Rena (MC) no longer gets the surgery to begin with. I've excluded that due to it no longer affecting the actual story since the true ending has changed.
Your other concerns such as Rena's parents, Ryuu, and other things are discussed in the full game. Once Ciro's route is finished for the strong personality type, It may be released. There will be two paths that are possible to go through for each guy's route. Ciro's route is no exception to this. It depends on how much he likes Rena, depending on the player's choices.
Again, thank you for the feedback and interest in the game.