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Otome dissection is a portrait of an empty person entering a relationship not because it makes them happy or it makes them better, but to have someone be the dump of their problems with no intention of actually solving it. The person is empty, and she is desperate to feel something, hence the first lines,
Let's play maiden dissection!
Don't we all want some excitement to get our hearts pumping?
She (the pov person) calls their partner, trying to connect to them without actually wanting to say something.
Good evening, is now a good time?
I didn't really have anything specific to say, but
Now there's this and that and an "it's alright" comes to mind
Without you, none of that matters
But the last line is offputting. If one is in the company of a person they cherish, the conventional phrase is "with you, none of that matters." Almost as if the purpose of connecting with their partner is merely to dump problems to them.
She is asking to be "dissected" because she would never open her issues herself. The first prechorus establishes it clearly.
This disease, the whole package
I'll send it to you as an attachment
I don't wanna go so far as to share all the things that cause me pain
I just wanna run away from this love
The lyric 「いきたくない」 in the chorus is already unclear in itself, being written in hiragana. It is left to us if she's saying she does not want to live (生きたくない), does not want to die (逝きたくない) or does not want to climax (イきたくない). On its own, いきたくない could also mean "I don't want to go." I think it was purposely ambiguous because she wants us to dissect what she wants to say.
The music video shows us the girl dancing with a skeleton. Some interpret it as her dancing with death, but I think it represents the partner who she dumps her problems to.
Only the skeleton remains of the partner because they've given everything to the "singer." Not only does the partner's bones remain, the bones are even fragmented.
They've opened themselves up while she remains fully human because she would not risk being vulnerable. She keeps the skin, the mask, not even a layer coming off.
At some point, the partner eventually distances themself from her and she takes it badly. The music video shows a progression from her making a phone call,
To holding a stringed cup (where it is unsure if the partner even receives the message),
To a mere hand acting as a telephone.
She is desperate on maintaining the relationship even if it does no good.
Returning to the skeleton representing the partner's state, a blink-and-you-miss-it moment happens near the end that shows the skeleton as a whole figure and witnesses all her self-destructive behavior.
However, being with her broke the skeleton (the partner) apart.
Now without a person that could make her feel - pain, shame, or anything, she succumbs to emptiness and decides to end herself. Lyrically, nothing changes and she goes back to the shell of void that she is. Visually, the music video ends with her in a body bag with a peaceful expression.