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If you are an adult woman, you likely have seen cellulite develop on your body. Cellulite, or those tiny bumps under the surface of the skin that create a dimple-like texture on the skin, affects 90% of all women. The cause of cellulite for most people of all genders, ages and ethnicities is generally due to the same three biological factors and, previously, these factors have been difficult to disrupt. However, a brand new cellulite treatment this year, QWO™, is now able to treat and reduce the appearance of cellulite on the skin.

QWO™, formally known as collagenase clostridium histolyticum-aaes, was recently granted approval by the U.S. Food and Drug Administration (FDA). This means that QWO™, made by Endo Aesthetics in Malvern, PA, is the first FDA-approved injectable treatment for cellulite in the buttocks of adult women. When it comes to dealing with cellulite in this treatment area, QWO™ can be used to effectively and permanently remove moderate to severe cellulite. QWO™ is an injectable that’s designed to target one of the primary causes of cellulite, fibrous septae, reducing the thickness of these fibrous bands in order to reduce the tension on the skin above it. In this way, QWO™ is able to reduce cellulite on the surface of the skin without any invasive procedures or downtime needed.

If you’re frustrated by the appearance of cellulite along the buttocks and upper thigh, board-certified dermatologist Dr. Michele Green is here to help. Dr. Green is a world renown expert in non-invasive body contouring, including CoolSculpting, Kybella injections, Botox, Juvederm, Thermage, and Velashape treatment. Dr. Green is excited to offer QWO™ treatment, a “game changer” in the world of cellulite reduction, to her patients in her New York City office.

butt lift photo

What is Cellulite?

Cellulite is a common skin condition that presents as dimpling on the skin.  In mild cases, it can appear as a subtle dimpled area, and in moderate to severe cases, it can cause an unwanted “cottage cheese” texture on the skin surface. Cellulite tends to appear on the upper thighs, abdomen, and buttocks. Cellulite is a condition that can affect both men and women, but it is much more commonly found amongst women.

The root cause of cellulite is currently unknown, but there are three key biological factors that are currently linked to the development of cellulite. For most patients, the primary contributing factor of cellulite is an interaction between fibrous connective tissue and fat layers within the skin. Fibrous bands, or the bands that tether the skin to muscle, are in fact a key player in the development of cellulite. Over time, these fibrous septae can become thicker, which then leads to tension on the surface of the skin that creates the appearance of dimples. Fibrous bands contain type 1 and type 3 collagen, common forms of collagen in the body that also are behind the development of scar tissue, ligaments, bone and skin. This collagen unfortunately can build up within the fibrous septae, which can lead to the thickened bands that create unwanted cellulite. In order to rejuvenate fibrous band, the bands themselves typically need to be disrupted in some way, whether by cutting, interrupting, or altering the band itself.

Skin laxity, or loose skin, can also have a large effect on the appearance of collagen in the body. The more elasticity your skin has, the more youthful and firm it will appear…and, unfortunately, the more laxity your skin has, the more space is left for fat cells to fill underneath the skin’s surface. The increase in concentration of fat cells under the skin can lead to an increase in the appearance of cellulite, particularly for patients who are dealing with a loss of collagen and elastin in the skin. Skin tightening treatments such as Thermage FLX can help to firm the layers of the dermis using radiofrequency energy, which in turn can improve the look of sagging skin and even temporarily reduce the appearance of cellulite.

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The third contributing factor to the development of cellulite is that of fat cells. This factor seems to explain why more women deal with cellulite than men, as increased estrogen leads women to have larger fat cells in the body than men. When these larger fat cells press into thickened fibrous bands in the skin, it can lead to the uneven skin surface that is the trademark appearance of cellulite. For most women, puberty leads to the development of initial cellulite, as an increase of estrogen can increase the size of fat cells and, in turn, create dimples on the skin. However, cellulite can develop at a variety of ages. Regardless of your size, dietary habits, or exercise routines, cellulite is a frustrating, near-universal skin issue among adult women.

Previously, cellulite was addressed through unsuccessful topical treatments or  invasive surgical procedures that a plastic surgeon might offer. Topical treatments often led to the use of sugar scrubs or coffee grounds with little to no improvement. More invasive surgical procedures, such as fat grafting (liposuction), were once considered an option for reducing cellulite, but unfortunately this treatment option removes fat cells, and does not alter the fibrous bands that are the primary instigators of cellulite development. However, recent innovations in the world of dermatology have led to much more effective treatments for reducing the appearance of cellulite along the surface of the skin. QWO™ injectable treatment is one of the most exciting advancements yet when it comes to restoring smooth skin in a treatment area where cellulite most commonly affects women.

FDA Approval for QWO™

QWO™ injectable treatment was FDA approved in July 2020 to treat cellulite in the buttocks of women. Endo Aesthetics, the makers of QWO™, embarked on the largest clinical trial phase in the history of cellulite treatment options in order to gain FDA approval. As Matthew Davis, Senior Vice President and Chief Medical Officer of Endo Aesthetics, stated. “Supported by rigorous research, testing and development processes, we are proud to have received FDA approval of the first injectable treatment for cellulite in the buttocks and we look forward to delivering QWO to the aesthetics community and their adult female patients.” Detailed information from QWO™’s recent FDA-approval can be found here.

QWO™ is designed to me injected in to the treatment area in order to break down collagen build-up within the fibrous septae under the surface of the skin. This in turn can rejuvenate the fibrous bands, reducing the appearance of dimpling on the skin. QWO™ has two different active enzymes (AUX-I and AUX-II) that help to breakdown collagen without any need for downtime. Additionally,  QWO™ injectable treatment provides permanent cellulite reduction with as little as three treatment sessions. This injectable treatment will be available to healthcare providers in spring of 2021, and Dr. Green is ready to help patients get rid of unwanted cellulite with this exciting advancement.

How does QWO™ injectable treatment work?

QWO™ injectable treatment is simple, fast, and painless. First, you’ll meet with Dr. Green to talk about your individual needs, medical history, and aesthetic goals. Through this initial consultation, Dr. Green will be able to assess if QWO™ is right for you and develop a customized treatment plan to best fit all of your needs.

The QWO™ treatment session is very straightforward. Initially, the targeted treatment area will be marked. Then, Dr. Green will artfully inject QWO™ into the injection site. The majority of patients require no anesthesia, though a topical numbing cream can be applied to avoid any potential discomfort. The majority of patients find the treatment completely painless, experiencing even less discomfort than other injectable treatments such as Botox or dermal fillers. After the treatment session is over, patients can resume normal daily activity. Patients may experience mild swelling or discomfort at or near the injection site, so it’s recommended that treatment occur well before any trips to the beach to show off revitalized, smooth skin.

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52 year old patient before and after: source qwo-hcp.com

QWO™ has shown success in reducing the appearance of cellulite over the course of three treatment sessions, spaced three weeks apart, for patients of all skin types. Over the course of three treatments, patients can expect to see visible smoothness and reduced dimpling on the skin with results that last. It’s a unique option that greatly improves upon previous cellulite treatments such as Cellfina and Cellulaze. QWO™ is revolutionary within the treatment of cellulite, and is an excellent treatment option for patients looking to create smooth skin and reduce dimpling along the surface of the skin.

Are there any side effects?

As with any treatment, QWO™ may not be an ideal procedure for every patient. As QWO™ is an injectable treatment, common side effects include some temporary injection site bruising and discoloration, as well as injection site pain or soreness, the development of nodules, redness, or itching.  In rare cases, side effects of QWO™ may include allergic reactions and anaphylaxis. Before engaging with treatment such as QWO™, it’s best to meet with Dr. Green so that you can discuss your medical history and determine if QWO™ is the right treatment option for you. Additional prescribing information for moderate to severe cellulite in the buttocks of adult women can be found on qwo.com

Are there other effective cellulite treatments?

There are currently a number of successful treatments when it comes to cellulite. Dr. Green often recommends treating cellulite by targeting different biological factors that often lead to cellulite. For example, when it comes to treating excess pockets of fat, CoolSculpting or Kybella can be used to eliminate fat cells and rejuvenate the treatment area. Additionally, Thermage FLX treatment is an excellent option in particularly for patients who are dealing with skin laxity. By firming up the skin and boosting collagen and elastin within the layers of the dermis, cellulite can temporarily disappear. Some patients find that the use of dermal fillers such as Sculptra can be an effective way to shape the surface of the skin and in turn create a smoother skin texture along the treatment area. Dr. Green offers the Sculptra butt lift as a way to provide artful contouring and cellulite reduction along the buttocks and upper thigh.

There are a couple of other cellulite treatments that have developed in recent years, but few have offered the consistent results that patients long for. Cellulaze is a laser device that targets the fibrous bands within the skin. The treatment uses laser fiber that is threaded through a cannula. The cannula is inserted into the skin and allows for a white-hot beam to target the fibrous septae within the skin, cutting the bands. Cellulaze is also designed to heat the skin to encourage new collagen growth to rejuvenate the treatment area. Cellfina is a minimally invasive treatment that requires the use of a tiny blade in order to create small cuts within the fibrous septae as well, and it is able to reduce the appearance of cellulite for up to three years in some patients. Both rely on altering the structure of fibrous septae in order to reduce cellulite but, unfortunately, they require recovery time and can lead to inconsistent results. Additionally, Cellulaze and Cellfina both require local anesthesia in order to prevent discomfort during treatment. QWO™ is the first non-invasive cellulite treatment that permanently rids patients of unwanted cellulite without any need for downtime, and the treatment is entirely painless. When it comes to ease of treatment, process, and effective results, QWO™ truly lies within a class of its own.

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Patients may also consider reducing the appearance of cellulite via diet and exercise. As body weight can sometimes increase a patient’s likelihood or severity of cellulite development, many patients think that the solution is to prioritize clean eating and exercise. However, cellulite is also common amongst women who are at a perfectly healthy weight, and losing weight does not guarantee that cellulite will be gone forever. Cellulite is truly a one-size-fits-all skin feature for women, and lifestyle shifts alone are unlikely to remove the appearance of cellulite from the surface of the skin. Part of what makes QWO™ treatment so exciting is that it can effectively rejuvenate fibrous septae by reducing collagen build-up that thickens these bands, in turn reducing tension against the surface of the skin for ideal smoothness. It’s a treatment that works for almost all patients, and can lead to full cellulite removal as little as three treatment sessions.

If you’re frustrated by the appearance of cellulite on the upper thigh and buttocks, QWO™ injectable treatment may be the solution that you’ve been searching for. With over 25 years of experience in cosmetic dermatology, lasers, injectables, Thermage, and collagen stimulating procedures, Dr. Green is a world class expert. If issues with skin laxity and cellulite are bothering you, don’t hesitate to contact us online today or call 212-535-3088 to learn more about the best treatments for cellulite and to create a tailored treatment plan with Dr. Green.

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