QWO (collagenase clostridium histolyticum-aaes) is the first and only FDA-approved injectable for the treatment of moderate to severe cellulite in the buttocks of adult women. QWO (pronounced kwhoa) contains two types of collagen-degrading enzymes that eat away at the fibrous bands (or fibrous septae) connecting skin to muscle, gradually dissolving the tethers and allowing the skin to float up and smooth out.
What is Cellulite?
Cellulite is a localized alteration in the contour of the skin that has been reported in approximately 90% of adult women of all races and ethnicities.
What Causes Cellulite?
There are many misconceptions about cellulite. People think it is tied to fat, and that changes in diet and exercise could remove their cellulite. That’s not the case. Losing a lot of fat will lessen the appearance of cellulite somewhat, but it won’t make it go away. That’s why you’ve probably noticed, and been surprised to see, skinny women with cellulite.
That’s because fat isn’t the problem: the structural makeup of women’s skin is the cause. Women have connective tissue bands under their skin that are like vertical bars, trapping pockets of fat between them. The fat trapped by these tight bands pushes upward against the skin, creating lumps on the surface next to depressions where the connective tissue is separating the fat beneath. Yes, it’s the orange peel look of cellulite. And it only gets worse as we age and our skin thins.
Who Gets Cellulite?
Women are more likely to have cellulite than men, and it affects women of all shapes, sizes, ages, and races.
Why aren't men prone to developing cellulite?
Men have thicker skin than women do, and their collagen bands are oriented in a crisscross fashion, essentially eliminating the ability of the fat lobules to bulge through. If a man is given estrogen hormones (as in some cancer treatments), they can develop cellulite if there is enough fat.
Are Fat and Cellulite the Same?
Fat is not cellulite and does not cause it, but fat cells getting bigger between fibrous bands under the skin can contribute to a bumpy appearance.
How Does QWO Work?
As mentioned above, women develop cellulite due to the connective bands attaching the skin to the structural tissues beneath. Fat is trapped inside the pockets between the bands, and it pushes up against the surface skin, creating the signature cottage cheese appearance of cellulite.
QWO™ works in three ways to improve the appearance of cellulite:
- It releases some of those fibrous bands
- It redistributes fat cells when those bands are broken
- It stimulates the production of new amounts of collagen
Is QWO a Surgical Procedure?
No. QWO is an injectable treatment option that is thought to target a primary structural cause of cellulite— the fibrous septae. The exact mechanism for the treatment of moderate to severe cellulite is unknown.
What can I expect during my QWO injection session?
Your West End surgeon begins by marking the dimpled areas on your buttocks that are to be injected. QWO™ is then injected with a very small needle. Injections do not need to be made to great depth. Topical numbing cream is not necessary. Because there is much more fat and far fewer nerves in the buttocks, these injections are not painful. Patients have told us they hurt less than Botox® injections, which also don’t necessitate the use of topical anesthetic cream when being delivered.
QWO™ sessions are completely non-invasive and take just 10-20 minutes or so.
Are there any risks associated with QWO?
QWO™ does have a risk of side effects. The most common side effects after QWO™ injections include bruising, pain, areas of hardness, itching, redness, discoloration, swelling, and warmth in the treated areas.
More serious side effects are possible. These include allergic (hypersensitivity) reactions, including anaphylaxis. Bruising decreases with each subsequent treatment. In clinical trials, patients did not require any downtime and any residual bruising resolved in under 21 days.
Can QWO be used to treat cellulite in other areas besides the buttocks?
QWO is only approved for treatment of moderate to severe cellulite in the buttocks of adult women. Endo Aesthetics is continuing to investigate additional areas of treatment.
How many treatments will I need?
The FDA has approved QWO™ to be administered in three injections sessions separated by 21 days between each session.
How long will it take to see my results from QWO?
At West End, we deliver QWO™ injections in three sessions separated by three weeks between each session. That adds up to a total of about 10 weeks. That’s about the time frame you can expect to see visible smoothing of the areas on your buttocks that were treated. It takes time for the enzyme reactions to break down more and more of the connective bands and free those connections to lessen the dimpled appearance of cellulite. This is a new treatment at West End, and there is variability between patients on their results and how soon they see them.
Are these results with QWO permanent?
QWO is a new treatment, so there aren’t any long-term results to use, but because QWO™ works on the structural causes of cellulite, it is assumed these are permanent changes. QWO™ is made from collagenase clostridium histolyticum, and this works to break down the septae, the connective collagen bands that attach the outer skin to the muscle beneath. When QWO™ breaks these bands, it allows the fat to spread out instead of being trapped in between the bands. It is not thought that once these bands are broken, they will re-form. Initial data supports longevity of at least a few years for the improved appearance of the patient’s cellulite.