In the past, the only options available for tackling “dimply” skin on the buttocks were ineffective anti-cellulite massagers and creams or more invasive mechanical or laser-based techniques that could be uncomfortable, leave behind scars, and require recovery. There’s now a much easier, more accessible option for cellulite reduction: QWO®. Denver’s AboutSkin Dermatology and DermSurgery provides QWO® (collagenase clostridium histolyticum-aaes) by Endo Aesthetics: the first and only FDA-approved, non-surgical injectable procedure designed for targeting cellulite on the buttocks.
The AboutSkin Dermatology and DermSurgery team was part of the QWO® launch, serving as faculty for the early experience program among key physicians in the country before its official release. Board-certified dermatologist Dr. Joel Cohen, our practice director, participated in the FDA trial over several years and served as lead author for the cellulite “photo-numeric scale” used and published in the study.
As of March 2021, Dr. Cohen was the only Colorado doctor providing QWO® cellulite injections, and he is excited to talk about his experience with the product. To learn more about QWO®, as well as other cellulite treatment options, check out his “Scientifically Speaking” video series. Dr. Cohen has also been a clinical trial participant and author for the Cellfina® device for treating dimple cellulite, and was co-author of a cellulite review article in Seminars of Cutaneous Medicine and Surgery.
The “bumpy, dimpled” hail-damaged-appearing skin that we sometimes get on the buttocks and thighs is called cellulite. More than 90 percent of women have some form of cellulite, and it makes no difference how active they are or how much or little they weigh, because this skin condition isn’t specifically caused by fat. Cellulite develops due to bands of collagen—known as “septae”—that pull the surface of the skin downward, causing dimples to appear. The condition is frequently associated with fat because larger fat cells in an area can create more tension by pushing the skin’s surface outward, leading to more noticeable depressions everywhere the septae are pulling the skin downward—like an old-fashioned “tufted” couch.
The reason why a much larger percentage of women have cellulite compared to men is because their fat cells and connective tissue are arranged vertically. The tight, fibrous, connective bands tie the skin down to the muscle beneath while the fat cells between them push up against the skin and protrude. While the exact causes of the condition aren’t fully understood, it is believed that poor circulation and the way the septae vertically pull the skin down around the compartments of fat cause cellulite to occur in women.
Cellulite often has either a “puckered” or “rippled” appearance with distinct peaks and depressions. The condition, which is sometimes called “cottage cheese skin” or “orange peel skin,” is very common and not dangerous, so many people feel that treatment isn’t necessary—but if you don’t like the way it looks, QWO® can be used to specifically address the dimples directly. QWO® only is used for the dimples.
QWO® is considered more effective than other anti-cellulite options because it’s injected below the surface to improve the structure of the skin itself. QWO® contains two types of purified enzymes called collagenases, which specifically dissolve collagen types 1 and 3, “breaking-up the septae” and releasing the tension, allowing the skin to lie smoother on the surface. At the same time, QWO® encourages redistribution of fat cells and regeneration of collagen for a more even layer below the surface and a thicker, smoother outermost layer.
QWO® is used specifically for dimple cellulite, not laxity or waviness.
QWO® is approved for treating moderate to severe cellulite of the buttocks on adult women. It works best for the rigid, fibrous type of hard cellulite that resembles an orange peel and is associated with the tough bands of collagen fibers tethered deep below the surface of the skin.
Patients who are allergic to collagenase or other ingredients in the treatment, who have a bleeding disorder or an active infection in the treatment site, or who are breastfeeding or pregnant (or may become pregnant soon) won’t be suitable candidates.
Before the QWO® injections begin, patients will have a one-on-one consultation with one of our board-certified dermatologists—so that they can decide whether they’re a good candidate for the procedure and explain what their long-term goals are. Patients can have all of their questions about QWO® answered, and our dermatologist will describe what’s involved in each stage of the treatment.
A tiny needle is used to inject liquid QWO® directly into each individual dimple on the skin during a quick procedure that usually last less than 10 minutes. No anesthesia is necessary, and the injections are really not painful at all for the vast majority of people.
QWO® is a minimally invasive treatment with injections into individual dimples of cellulite. As with any type of injectable treatment, patients can expect some swelling at the injection site. Bruising is very common, so patients should plan their treatment at a suitable time to account for this significant bruising. For example, if you have a vacation or a social or work event coming up where shorts or a bathing suit is planned, you might want to plan to have QWO® several weeks in advance to give the bruises time to fade (sometimes they can persist for longer periods of time).
Three QWO® sessions spaced roughly 21 days apart (in the FDA study) can lead to significant improvements for cellulite dimples on the buttocks. Noticeable results can usually be seen within around 10 weeks.
QWO® is designed for improving the appearance of cellulite, but other concerns relating to the skin—such as sagging and uneven pigmentation or texture—require other types of cosmetic dermatology treatments.
There are several light and laser options offered by AboutSkin Dermatology for addressing surface-level imperfections, such as laser resurfacing, radiofrequency, BBL, BBL Hero, and intense pulsed light (IPL). Loose skin can be addressed with one of several non-invasive options including Genius® RF, a skin-tightening procedure that utilizes a combined radiofrequency with microneedling technique, and Ultherapy, a high-intensity ultrasound-based technique. Both of these procedures stimulate collagen production to enhance the quality of the skin from the inside out.
There are other treatments that can be used for correcting the “ripple- type” cellulite that can’t be addressed with QWO®, including bipolar fractional radiofrequency microneedling (Genius® RF, Morpheus8) used along with high-reconstituted dermal fillers like Radiesse® and Sculptra®.
As director of AboutSkin Dermatology, the nationally renowned Dr. Cohen oversees the practice.READ MORE
Dr. Stoler has provided medical and surgical services at AboutSkin Dermatology since 2011.READ MORE
Dr. Ho joined AboutSkin Dermatology in 2012, and provides medical and surgical services.READ MORE
Dr. Fettig came to AboutSkin in 2019 after completing her Boston University residency.READ MORE