Qwo

Do you have cellulite that makes you self-conscious? Fortunately, we have a new non-surgical treatment available for cellulite.

What is cellulite?

Cellulite is the appearance of a dimpled skin surface. Instead of being smooth, the skin has indentations. Sometimes people say it looks like cottage cheese or orange peel. It occurs most commonly on the thighs and buttocks and is much more common in women than in men. In fact, about 90% of women in the United States have cellulite.

What causes cellulite?

Cellulite is a complex condition and the exact cause of it is not known. Studies show that it has to do with the interaction between the connective tissue under your skin and the fat below it. Under your skin you have a layer of fat, and under the fat you have muscles. Within the fat layer, you have fibrous bands called septae that connect the skin to the muscles. These are perpendicular to the skin, so you can imagine that they go straight down. Sometimes these bands get thick and tight, and when this happens, they can pull down on the skin causing an indentation or dimple in the skin. The fat between the bands can bulge through skin, lifting the skin between the dimples, which leads to an uneven skin surface.

Another factor in cellulite formation is thinning of your skin that occurs naturally as you age. You have a layer of collagen in your skin that keeps it firm, tight, and youthful in appearance. Over time, your body stops making as much collagen so this layer gets thinner. When this happens, the fibrous bands can pull down on your skin easier to form cellulite.

Another possible cause of cellulite formation is diet and lifestyle. Eating foods high in fat and carbohydrates and not exercising enough will lead to a buildup of fat in your skin. The more fat in the area, the higher the chance that the fat bulges through the skin around the fibrous bands, leading to an uneven skin texture. However, even though fat is a component of cellulite, even people who are in shape and not overweight can have cellulite. Sometimes cellulite is genetic and you can’t get rid of it even when you lose weight.

Qwo Informational Video

Is cellulite only seen in women?

Cellulite is much more common in women than in men. There are two reasons for this. First, the fibrous bands in the fat under the skin are perpendicular to the skin in women. So they go straight down. In men, these bands are oblique. They don’t go straight down; instead they go at an angle. The indentations of cellulite are much more visible when the bands pulls the skin straight down. The second reason has to do with hormonal differences between women and men. In women, estrogen levels decrease slowly over time. This leads to decreased blood flow to the skin and less collagen formation. This makes the skin thinner and it can therefore be more easily pulled down by the fibrous bands.

What treatments are available for cellulite?

Unfortunately, there have not been many good treatments for cellulite. Until now, almost all treatments for cellulite have been invasive such as having surgery or placing lasers under your skin. For example, manual subcision is where a blade is placed under your skin to directly cut the fibrous bands. Cellfina is a device that uses this method. Lasers and other energy-based devices are used in this way as well as externally to treat cellulite. Cellulaze is a laser that goes under your skin to break up the fibrous bands. We now have a new minimally-invasive way to get rid of your cellulite.

What is Qwo?

Qwo is the first and thus-far only FDA-approved, non-surgical, injectable treatment for cellulite. The active ingredient in Qwo is an enzyme called collagenase derived from the bacterium Clostridium histolyticum. So CCH stands for collagenase Clostridium histolyticum. Collagenase is an enzyme that breaks down collagen. There are actually two different enzymes in Qwo. These enzymes are called AUX I and AUX II. These enzymes break down types I and III collagen, the specific types of collagen found in the fibrous bands that cause cellulite. When Qwo is placed in the fat layer under your skin, it breaks down the fibrous bands in the skin that causes the dimpling. When these bands are degraded, they can no longer pull down on the skin. This will smoothen out the skin surface and improve the appearance of cellulite. CCH is also the active ingredient in other medications such as Xiaflex to effectively treat other conditions where thick fibrous bands of collagen pull on the skin such as Dupuytren’s contracture and Peyronie’s disease.

Why the funny name?

The product is named Qwo because it will change the status quo of your cellulite. It’s spelled Q W O because the W O stands for women.

Where can Qwo be used?

Qwo is indicated for use to treat cellulite on the buttocks but it can also be used off label to treat cellulite in other areas such as the thighs. The first clinical trials studied Qwo for cellulite were performed on the buttocks. There are currently ongoing trials for treatment of cellulite in other areas such as the thighs.

What happens during a Qwo treatment?

First Dr. Alex will examine your skin to make sure you’re a good candidate for Qwo. Before your Qwo treatment, we’ll take pictures of your skin to monitor your progress. Your skin will be marked when you’re standing up. Then we have you lie down for the treatment. The product is placed in the dimpled areas of cellulite with a tiny needle. Dr. Alex uses a painless injection technique to make it easy. We blow cold air on your skin to numb the area. We also place a vibrating distractor on your skin nearby so you’ll hardly feel the needle. Your Qwo treatment will take only a few minutes. After that you can resume your normal activities.

How does Dr. Alex do the Qwo treatment for best results?

Before a treatment such as Qwo is approved by the FDA, it goes through clinical trials. In these trials, a protocol must be followed throughout the entire trial for consistency. After the trial, the manufacturers are required to train doctors based on exactly how the trial was performed. Sometimes, either during or after a trial, it’s found that modifying the protocol may provide better results. Dr. Alex always does research to find better ways of performing treatments. In the case of Qwo, more recent studies have shown that using a longer needle and spreading out the product with a more dilute solution show better improvement of the cellulite. Also, treatments were performed at three-week intervals in the clinical trials. This speeds up the trial, allowing the product to be approved faster.  However, sometimes you still have lumps and swelling at three weeks, which is why Dr. Alex recommends spacing out treatments every six to eight weeks. Additionally, we are able to provide complimentary laser bruise treatments after your Qwo treatment, which was not available during the clinical trials. This is how Dr. Alex slightly modifies his technique from the manufacturer’s recommendations for better results.

How can I get the best results from my Qwo treatment?

Dr. Alex also finds that combining different treatments usually provides better results. In the case of Qwo, Dr. Alex recommends a series of six laser skin tightening treatments in the area. This will further stimulate collagen formation in your skin to help your skin surface become firmer and tighter. You can have the laser skin tightening treatments every two weeks and Dr. Alex recommends two laser skin tightening treatments after each Qwo session. In addition to laser skin tightening, Dr. Alex recommends using the Alastin Transform body treatment twice daily throughout the entire time when you’re having your treatments. This product stimulates collagen production in your skin and helps your body naturally remove any broken-down fat in the area.

What will happen after my Qwo treatment?

Your skin may be sore or swollen and you will likely see temporary bruising that will go away on its own. You may want to avoid exercising the muscles in the area for a few days to avoid soreness. Also, avoid getting a Qwo treatment before an event where you plan to wear a swimsuit or other revealing clothing since bruises may be visible.

How many Qwo treatments will I need?

Dr. Alex recommends a series of three treatments spaced out every six to eight weeks.

When will I see results from my Qwo treatment?

Some people start to see the results of their Qwo treatment in as early as three weeks after their first treatment. But you’ll see your full results about a month after your final treatment. Therefore, it’s important to plan your Qwo treatment well in advance of important events or the summer season when you may plan to wea a swimsuit or other revealing clothing.

Example of Results

Qwo before and after


Qwo before and after


Qwo before and after


How long do the results of a Qwo treatment last?

You’ll have long-term results that last one to two years, or possibly longer. The clinical trials demonstrated that the results with Qwo will last at least one year. Current studies are ongoing to see if the results last longer than that.

Is Qwo safe?

Qwo has been shown to be safe and effective in clinical trials. Over 800 women participated in the clinical trials for Qwo.

What are the side effects of Qwo?

The most common side effect of a Qwo treatment is bruising. Bruising in the area occurs almost all of the time, although women find less bruising after their first Qwo treatment. The bruising occurs because the same type of collagen that is found in the fibrous bands is also found in certain blood vessels. When the collagen in the blood vessels is broken down, blood leaks causing a bruise. The bruises are not painful and they go away on their own. We can treat bruises with a complimentary laser bruise treatment as early as the next day. You can decrease the risk of bruising by avoiding blood thinners such as aspirin, ibuprofen, vitamin E, and Ginko biloba (among others) for several days before your Qwo treatment. Bruises can also be treated with topical or oral arnica as well as bromelain which is found in pineapples. Therefore, people with a bleeding disorder are cautioned when receiving Qwo. If you take aspirin 81 mg daily, you can have a Qwo treatment, but if you take higher doses or take other blood thinners you should not have a Qwo treatment. Other side effects are uncommon but include pain, areas of hardness, itching, redness, discoloration, and warmth in the treatment area.

Who should not have a Qwo treatment?

Do not have a Qwo treatment if you have an active infection in the area that is to be treated. People with a bleeding disorder are cautioned when receiving Qwo. If you take aspirin 81 mg daily, you can have a Qwo treatment, but people taking higher doses or those take other blood thinners should not have a Qwo treatment. Qwo has not been tested on women who are pregnant, trying to become pregnant, or breast feeding. Therefore, if you’re pregnant, trying to become pregnant, or breast feeding, you should wait until you are done breast feeding before receiving a treatment with Qwo. You should not receive a treatment with Qwo if you have an allergy to any of its ingredients: collagenase clostridium histolyticum, mannitol, sucrose, tromethamine, hydrochloric acid, calcium chloride, or sodium chloride.

How much does a Qwo treatment cost?

The pricing for a Qwo treatment varies for each person. Qwo comes in vials. Each vial can treat up to 12 dimples per session and three sessions are required. So if you have more dimples, more Qwo will be needed and the cost will vary. Click the link below for more information on our online store.

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