What is QWO?
QWO ™ is the first FDA-approved injectable cellulite treatment. According to studies, approximately 90%
of women have cellulite, dimples in areas of the body that hold more fat, such as the buttocks or thighs.
Men can get cellulite, as well, but this is uncommon. Historically, cellulite has been associated with fat
due to the areas in which it occurs. Through research, we have learned that this condition is more so
related to the fibrous septae that tether the dermis to underlying muscle. These bands of connective
tissue press down while fatty tissue presses up toward the skin. The result is dimpling in the area where
fat is being compressed.
QWO is injectable collagenase clostridium histolyticum, which is deposited around moderate to severe
dimples in the buttocks. This substance breaks down types I and III collagen. Collagenase clostridium
histolyticum has been used therapeutically for several years, both in orthopedics and in urology. QWO is
the first cosmetic application, and one that is achieving outstanding results.
How does QWO compare to other cellulite treatments?
QWO is the first treatment of its kind. Other cellulite treatments improve the appearance of the skin by
mechanically severing the fibrous septae involved in the dimpling problem. Cellfina® does this using a
tiny blade. Cellulaze™ reduces cellulite by severing connective tissue bands with thermal laser energy.
QWO dismantles the septae chemically.
Rather than using a blade or thermal device, the QWO provider injects the product directly around the
cellulite dimples in the buttocks. A dozen or so injections may be administered during the appointment,
with three appointments scheduled in all. Three sessions scheduled three weeks apart achieved the best
results during clinical studies.
What areas of the body are treated with QWO?
This drug is currently approved for the treatment of cellulite on the buttocks. Like other injectable drugs,
doctors may eventually use QWO off-label to treat areas such as the thighs. However, doctors are slow
to attempt this while studies are ongoing. The maker of QWO did include the thighs in one phase of its
clinical trials but shifted away from the broader view to a more refined lens on the buttocks area alone.
At this time, clinical research into QWO for thigh cellulite is in process. These studies will help the
manufacturer determine the correct dosage, application, and technique for the drug on that specific
part of the body.
Who is a candidate for QWO treatment?
Adult women of all ages, skin tones, and of varying weight can be good candidates for QWO treatment,
according to clinical trials. More than weight and age, it is the condition of the skin that may disqualify a
person from QWO treatment. This drug is useful in correcting cellulite caused by fibrous septae. It is not
useful in correcting tissue laxity.
During our consultation, we observe the area to ensure that it is, in fact,
cellulite that is causing the appearance of dimples in the skin. Patients with poor skin firmness and
elasticity may achieve better results from a treatment that increases the production of collagen and
elastin, such as EmSculpt NEO.
How Can I Prepare for QWO Treatment?
Patients who receive QWO injections can expect to develop significant bruising after their first
appointment. This side effect is much subtler after subsequent treatments. To prepare for QWO, it is
beneficial to avoid medications and supplements that have blood-thinning effects. Examples include
aspirin, vitamin E, and prescription blood-thinners. It is also helpful to avoid alcohol for 24 hours before
How is QWO performed?
QWO is an office treatment that is performed while the patient lies comfortably on the treatment table.
To begin, the provider observes the buttocks while the patient is standing. Each dimple is marked using
an erasable surgical marker. This creates a treatment “map” that outlines where injections should be
administered. The injection process typically takes less than 15 minutes. The patient may remain lying
on their stomach for another 5 minutes after the procedure is done to allow the product to absorb.
Is Cellulite Treatment with QWO Painful?
QWO treatment involves multiple injections, but patients remain quite comfortable during their
appointment. This is because the provider uses a very small needle to insert the product and also
because the buttocks is mostly fatty tissue.
What is the Recovery from QWO Cellulite Treatment?
There is no true recovery period after QWO treatment. Patients may resume their normal activities
immediately and as they feel comfortable. Minor soreness or tenderness may occur. If these side effects
do develop, they should fade in a day or two. Bruising is the most common side effect after QWO, and it
According to the authors of the clinical trials, 84% of patients developed relatively
dramatic bruising after their first treatment. The second and third treatments were much less severe.
Researchers believe that this side effect could have to do with the drug temporarily weakening the walls
of blood vessels in the treatment site, causing excess blood to leak into tissues.
What Results Should I Expect from my QWO Procedure?
Patients may begin to see a noticeable decrease in cellulite within 4 weeks of their first appointment. It
is important to understand that QWO may smooth the appearance of cellulite dimples but may not fully
eradicate them. Due to the recent development of this treatment, we are not yet sure how long the
results of QWO may last. Clinical researchers involved in trials speculate that the effects of QWO may
last a year or more.