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What is QWO® Cellulite Treatment?

Cellulite is the bane of many patients and causes so much anxiety. Cellulite is the rippling, “cottage cheese” like skin condition that occurs in over 90% of women in the country. Cellulite usually starts to develop during puberty and can feel like a cosmetic nuisance from then on. These dimples that appear on the thighs, buttocks, arms, and stomach can keep you from feeling comfortable in those new shorts or prevent you from buying that cute bikini. There is a common misconception that cellulite is fat and that it is caused by eating too much or not exercising enough. But in reality, the development of cellulite is complex and multifaceted and often hormonally based. There is not a lot that you can really to do prevent it but you can take steps to get rid of it. In fact, an exciting new dermatological development has just been approved with incredible results.

In July of 2020, the United States Food and Drug Administration (US FDA), approved the first ever injectable to treat cellulite: QWO. QWO works in several ways to combat cellulite at its sources. Cellulite is caused by a combination of collagen-heavy fibrous bands, which connect the skin to the muscle, fat cells, and the looseness (or laxity) of your skin. When collagen builds up in these bands, there is a lot of tension and the fat cells are pushed up to the surface. The result is the “orange peel” look and feel of the skin, which can look more severe the looser your skin. When QWO is injected, it breaks down those fibrous bands, which then releases the tension and smooths out the skin. The fat cells in the area get more evenly distributed and QWO also helps to stimulate the production of more collagen, which keeps your skin looking smooth, firm, and youthful.

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QWO treatment is the first FDA approved injectable to treat cellulite. Dr. Michele Green was one of the first dermatologists on the Upper East Side of New York City to incorporate QWO into her discreet, private, NYC dermatology office. Dr. Green is at the forefront of cellulite treatment and has combined Thermage FLX with Velashape with this unique injection to restore normal skin and reduce the appearance of cellulite. This novel cellulite treatment has revolutionized the treatment of cellulite and replaces the affected skin with new, beautiful, smoother skin.

What is cellulite?

Cellulite is an extremely common condition that is characterized by dimpling on the surface of the skin that is sometimes referred to as “orange-peel” like or “cottage cheese” like. Cellulite can happen to anyone – male or female – but most commonly affects adult women. In fact, over 90% of women experience cellulite at some point in their lives. Cellulite occurs when the fibrous bands, called fibrous septae, that connect the dermis (you skin) to your muscle increase in thickness. As we age, collagen production in these bands can increase, which is what causes the increase in thickness. This thickening of the tether creates tension between the muscle and the dermis and pushes fat cells up towards the surface of the skin, causing the rippling cellulite dimples across the surface of the skin. Higher skin laxity (or looser skin) can make the cellulite look more severe, as there is more room for fat cells to gather under looser skin.

What causes cellulite?

Part of the reason why so many people feel embarrassed about having cellulite is the common misconception that cellulite is caused by fat. While enlarged fat cells under the skin can be part of the reason why cellulite appears, it is, in fact, a multifaceted condition that is caused by a variety of factors. There are many biological and genetic factors that contribute to the development of cellulite that are beyond an individual’s control but often this is not acknowledged. Beauty magazines and public figures will often promote their healthy diet and exercise regime as the way of preventing the development of cellulite through weight loss but that is not always realistic. Cellulite is caused by a variety of biological and environmental factors – not just whether or not you exercise or watch what you eat.

One such biological risk factor for developing cellulite is the presence of certain hormones. Folks assigned female at birth have a higher prevalence of estrogen than those assigned male. This higher amount of estrogen causes women to develop larger fat cells in the body, which can be one aspect of the development of cellulite. Another biological risk factor in developing cellulite is aging. For women, when you go through menopause, there is a shift in hormones, which can cause an increase in the prevalence of cellulite. Also, as a result of the natural aging process, the fibrous bands that connect our skin to the muscle increase in thickness, which causes a higher amount of tension. This tension in the connective tissue is part of what causes depressions on the skin surface. As we age, our skin also becomes looser (increases in laxity). This can increase the visibility of these dimples in the skin, as the more laxity your skin has, the more space there is for fat cells to fill underneath.

So while an increase in fat cells can contribute to the appearance of cellulite on the skin, there are many other factors as well. The prevalence of estrogen or other hormones and the effects of the natural aging process cannot be prevented by putting yourself through crazy diets or strenuous exercise routines. If you still would like to reduce the appearance of cellulite on your body, that is where dermatological treatments like QWO come in.

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Can cellulite be prevented?

Unfortunately, because there are so many potential risk factors for developing cellulite – including being female, genetics, and the natural aging process – there is no true way to prevent the development of cellulite. There are some things that you can do to lower the risk of developing cellulite, like getting regular exercise and reducing the amount of processed sugars that you eat but neither of these things are guaranteed to prevent cellulite. Fortunately, however, there are revolutionary treatment processes such as QWO that are now on the market to eliminate cellulite in different areas of your body like your buttocks and thighs.

Can cellulite be treated?

Yes! There are several ways to treat cellulite at Dr. Green’s office but the newest, most innovative method its called QWO injectables. QWO is the first FDA approved injectable treatment for cellulite. QWO was FDA approved in 2021 and Dr. Green’s office was among the first offices in NYC to use this revolutionary new cellulite treatment. Dr. Green combines QWO with Velashape and Thermage treatment to restore the affected skin and result in beautiful, smoother skin.

What is QWO treatment?

QWO treatment is a very exciting innovation in dermatology to treat cellulite – it is the first ever injectable treatment for moderate to severe cellulite on the buttocks and thighs. After clinical trials that included over 1,800 women, QWO treatment, sometimes referred to as collagenase clostridium histolyticum-aaes, has proven extremely effective as a long term way to eliminate cellulite. The treatment has been manufactured by Endo Aesthetics, a company based out of Malvern, PA, which specializes in medical therapeutic treatments. The whole procedure is easy, painless, and quick, with no downtime necessary following the procedure and a low risk of any side effects.

How does QWO treatment work?

QWO treatment has a leg up on other cellulite treatments currently on the market in that it works to address several of the main causes of cellulite development. The QWO injection has the triple benefit of breaking down excess collagen in the fibrous septae (or bands), redistributing fat cells, and stimulating the production of new collagen, which rejuvenates the skin. For a variety of reasons, collagen in the fibrous septae can increase, which leads to more tension between the muscle and the skin. This tension also causes fat cells to rise to the surface, generating the “cottage cheese” like texture of cellulite. The QWO injectable fluid contains to enzymes that occur naturally in the body, called AUX-I and AUX-II enzymes. These enzymes are collagenase enzymes, which target the type 1 and type 3 collagen that are found in the fibrous bands. The enzymes break down the excess collagen in the bands, causing the septae to snap. This then releases the tension in the bands, which has caused the dimpling on the skin. Also as a result of the release of tension, the fat cells that had previously accumulated near the surface of the skin are redistributed. The QWO treatment also encourages the body to produce new collagen, which leads to firmer, smoother skin.

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What is the procedure for QWO?

When you make the decision that QWO is the right procedure for you to address your cellulite, Dr. Green is ready to help you reach your physical and aesthetic goals. You will start the process with a consultation appointment with Dr. Green. The two of you will talk about your goals and she will take your unique needs and perspective into account when developing your treatment plan. At this initial consultation, it is important to disclose your medical history, any medications you may take, and whether you are or planning to become pregnant.

Then, you are ready for the procedure! Dr. Green will start by marking the treatment areas on your buttocks or thighs. Most patients do not feel any discomfort or pain during the injection process. QWO is so painless that topical numbing cream is not even required. Dr. Green will mark (circle) the treating areas of cellulite, and photograph these areas to follow and assess treatment. Then, you will receive the injections of QWO in the areas of the body, of the buttock, that you want treated.

There is no downtime needed after the treatment, which means you can go back to your regularly scheduled activities right away. You may experience some minimal side effects like slight swelling or bruising around the injection site. For the best results, Dr. Green recommends that patients come in for three treatment visits, spaced 21 days apart. After that, the effects of the treatment should be permanent and you can say goodbye to cellulite in the buttocks and thighs.

How soon do you see results?

The QWO treatment works by injecting a solution with two enzymes (AUX-1 and AUX-II) that work to break down the fibrous connective tissue that tethers the muscle to the skin. In order for this process to be most effective, you will come in for the injection treatment three times spaced 21 days apart. You should start to see the permanent, last effects of cellulite reduction within the first 10 weeks after you begin treatment. The process of breaking down the collagen in the fibrous tissue happens gradually over the weeks so you may start to see results within the first couple of weeks as well.

How long will results last?

One of the other major benefits of this new treatment for cellulite is that the effects of the procedure are permanent. After three treatment sessions, you should not need to come in again – you will be saying goodbye to your cellulite in the treatment areas. Clinical studies have demonstrated the long lasting success of the QWO treatment at reducing the appearance of cellulite in the injection areas.

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What are the side effects of QWO?

QWO cellulite injectable treatment is a non-invasive procedure, so the risk of any side effects is low. This also means that there is no recovery period following the treatment – making it truly a “lunch hour” procedure. Some common side effects of QWO, which are usually mild and go away after a couple of days, include injection site bruising, discoloration around the treatment area, soreness, itching, or other redness. You should avoid QWO treatment if you have an infection in the treatment area or are allergic to collagenase. Also, women who are pregnant or nursing or considering becoming pregnant or starting to nurse should disclose this information to Dr. Green as a part of your initial consultation.

What is the QWO cost?

When patients as how much does QWO treatment cost, the answer is: it depends. There are a lot of factors that go into determining the price of QWO including the size and severity of the condition on the treatment area, the type of institution where you are receiving treatment, and your geographic location. If you are dealing with moderate to severe cellulite, which can mean deep rippling of the skin with more than 10 depressions in the skin, this would require more injectable solution to be used across a greater surface area. That can increase the cost of QWO treatment. Receiving treatment from an experienced, board-certified dermatologist such as Dr. Green may be more costly than receiving treatment elsewhere. However, the price is based on the high level of expertise that Dr. Green has in administering injectables and helping her patients reach their unique aesthetic goals. When you have your initial consultation with Dr. Green, her office will be able to disclose more information about the price of QWO treatment based on your specific needs.

How soon can I get the treatment?

QWO is now available at Dr. Michele Green’s private NYC dermatology office! QWO is a revolutionary, new treatment option which was FDA approved in May of 2020 and was released to selected offices, like Dr. Green’s Upper East Side office, in May of 2021. With over 25 years of experience expertly administering a variety of injectables, including Botox®Juvederm®, Restylane®, Sculptra®, and Kybella®, Dr. Green is ready to bring you this safe, effective cutting edge treatment for cellulite!

What are other cellulite treatment options?

There are several other options that have been on the market for a while when it comes to eliminate cellulite. While QWO is the first injectable treatment, there are other non-invasive treatments such as Thermage®, CoolSculpting®, or Velashape® or invasive procedures such as liposuction or plastic surgery.

Cellulaze vs. QWO treatment

Cellulaze is a treatment for cellulite that uses lasers to break apart the collagen-rich fibrous septae (fibrous bands that connect the skin to the muscle). A fiber of the laser is inserted under the skin and uses heat and laser energy to weaken the fibrous bands. As a result the tension is released and the skin takes on a smoother appearance. While Cellulaze is another option for cellulite treatment, it is invasive. QWO breaks a part the fibrous bands that cause cellulite without being invasive. Further, while Cellulaze has results that remain effective for up to a year, QWO is a permanent treatment.

Cellfina vs. QWO treatment

Another cellulite treatment that has been available for a while is Cellfina treatment. Cellfina treatment uses a needle to break up the fibrous bands that cause cellulite. When the fibrous bands are broken, the tension on the skin goes away, removing the dimpled appearance of the skin. QWO treatment is also able to break up the fibrous bands with the enzyme injection and while Cellfina is effective for up to a year at eliminating cellulite, QWO results are permanent.

Liposuction vs. QWO treatment for cellulite

Liposuction is an invasive procedure performed by a plastic surgeon to remove excess fat cells from under the skin. While liposuction is effective in reducing the number of fat cells, it actually doesn’t address the root causes of cellulite, which is the tension of fibrous septae on the skin. Liposuction can be used in conjunction with other treatments, including radiofrequency treatments like Thermage (which is designed to tighten the skin). Liposuction also requires a great deal of recovery time because it is invasive. QWO treatment, on the other hand, is non-invasive and treats the root causes of cellulite including breaking up the fibrous bands and redistributing fat cells.

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Skin care for Cellulite

When it comes to treating cellulite with skincare products, there are some key ingredients that you should be keep an eye out for. For her patients who are looking to smooth out their cellulite, Dr. Green often recommends a unique combination of in-office treatments, like QWO, and the best specially formulated skincare products. The following ingredients and products are some of Dr. Green’s favorites for combatting the characteristic dimples associated with cellulite.

Caffeine is a skincare ingredient that boosts circulation, improving blood flow in the area which it is applied and dilating blood vessels in the skin, ultimately helping to smooth out the appearance of cellulite dimples. Using creams and lotions that contain caffeine is a great way to take advantage of the skin benefits that the ingredient offers. You can also opt to use a simple coffee scrub, either by finding one that is ready to use or by making your own at home (be sure not to use decaf coffee beans if you choose to make your own scrub).

Vitamin C is a powerful antioxidant ingredient that has been found to play a role in collagen synthesis in the skin. Collagen is a component of the skin that gives it a firm foundation and a youthful, supple appearance. Using vitamin C serum on a daily basis is a great way to help brighten and even out skin tone as well as produce a smoother, healthier complexion. Dr. Green has carefully developed the high concentration Vitamin C serum from her MGSkinLabs, Inc. line of skincare products that can be used twice daily to promote skin cell renewal, revitalizing and moisturizing skin while improving texture and radiance.

Hyaluronic acid is a natural and essential component of the skin that helps to retain moisture, enhance the natural protective barrier of skin, and increase hydration. This skincare ingredient is vital for anti-aging skincare and can be used as an anti-cellulite treatment, too. The appearance of cellulite can be exacerbated by dehydration, and hyaluronic acid is one of the most important factors involved in skin hydration. Skincare products containing HA are helpful for reducing the visibility of cellulite due to the humectant properties of hyaluronic acid, bringing moisture to the surface of the skin and providing a healthy, supple look and feel.

Retinol can help to improve the appearance of hyperpigmentation and uneven skin tone as well as textural irregularities of the skin including fine lines and wrinkles, enlarged pores, and even cellulite. Retinol products are derived from Vitamin A and work by increasing the rate of skin cell turnover. Dead skin cells are sloughed off more quickly to reveal new, healthy, and even-toned skin cells that are smoother in texture, with increased elasticity and a softer feel.

Laser treatment for cellulite:  Thermage and Velashape

Combining your QWO treatments with other cutting-edge in-office procedures for body contouring is a great way to enhance the overall effects of QWO and achieve smooth, firm, supple skin that lasts.

The Thermage treatment is a non-invasive radiofrequency therapy that can smooth, tighten and contour skin for an overall refreshed appearance in just a single session. There is little to no downtime associated with the procedure, meaning that you are free to resume your daily activities right after the treatment is complete. There are multiple areas of the body that can be treated with Thermage to address several skin concerns, such as wrinkles and loose skin on the face, around the eyes, as well as on the body. As we age, the body naturally starts to breakdown the collagen in the skin that keeps it firm and tight, resulting in the appearance of fine lines and wrinkles (among other textural irregularities). The Thermage treatment uses radiofrequency technology to heat the deeper, collagen-rich layers of the skin. The applied heat is what stimulates new collagen production in the skin, helping to create a smoother, tighter, firmer appearance after just a single treatment. By combining Thermage with QWO treatments, one can achieve a firm, tight, smooth appearance.

Velashape is a body contouring procedure that utilizes two technologies to achieve a smooth skin texture. This innovative treatment works by combining Infrared light (IR) and bi-polar radiofrequency energy with vacuum suction and a deep-tissue massage. During the treatment, the fat cells and the connective tissue in the targeted area are deeply heated. By heating the underlying dermal collagen fibers and surrounding connective tissue, new collagen and elastin production is induced, resulting in a skin texture which is firmer, stronger, smoother, and more elastic. Additionally, the deep tissue massage during the VelaShape procedure helps to improve lymphatic drainage, further improving the appearance of the cellulite dimples. The VelaShape provides a general smoothing effect in the area that is treated, helping to significantly improve the appearance of cellulite. Pairing QWO treatments with VelaShape is one of the greatest strategies for improving the look of cellulite.

Who is a good candidate for QWO treatment for cellulite?

If you are like the 90% of women who experience cellulite throughout their lifetime, QWO injection treatment may be the solution you’ve been looking for. Dr. Michele Green was one of the first dermatologists to treat cellulite with QWO in her NYC private dermatology practice. Dr. Green is an expert in cosmetic injections and consistently voted as one of the best dermatologists in New York and the best Botox injections. With over 25 years of experience in Thermage, Juvederm injections, Fraxel, Kybella, CoolSculpting and other non-invasive cosmetic treatments, Dr. Green will help revitalize your skin. Please contact the NYC office of Dr. Michele Green online today or call 212 535 3088 for a long lasting solution to eliminate cellulite.

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