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The buildup of fat underneath the skin — known all too well as cellulite — is something most women experience at some point in their lives. The amount of cellulite a person has depends upon multiple factors, including genetics, body fat percentage, and the thickness of your skin. One fact, however, is certain: Anyone can get cellulite.

“It doesn’t matter what size you are,” says Susan Griffin, CEO and co-founder of Nashville Cosmetic Surgery. “It doesn’t matter whether you have a healthy lifestyle or not; it doesn’t matter whether you’re a size 0, 10, or 22, cellulite affects people of all ages [and] all size ranges.”

Dr. Danielle Levine of Levy Dermatology adds that people once believed cellulite was caused by fat, but that isn’t the case. “It’s just the fibrous bands causing that dimpling,” she explains. “It’s a fascinating realization that we can use a collagenase to break apart those fibrous tissues.”

The collagenase Dr. Levine is referring to is QWO, the first and only FDA-approved, non-surgical, prescription injectable for treating moderate to severe cellulite in the buttocks of adult women. “There really has been no great solution for cellulite until QWO entered the market,” Susan Griffin says. “There are treatments that claim to help, but none of them actually have been effective long term at addressing cellulite.”

Woman holding bottle of QWO dosage

QWO the first and only FDA-approved injectable for treating moderate to severe cellulite in the buttocks of adult women. Image: Ona Skincare

Before and after photos of new cellulite treatment

These before-and-after images speak for themselves! Image: QWO®/Endo Aesthetics®

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QWO, a cellulite treatment that actually works

Administered via a small needle inserted directly into targeted dimples, QWO injections are simple, and take just 10 minutes or less. Patients receive a total of three injections, each spaced 21 days apart — but many women begin seeing results early on. “I will tell you from our experience,” says Dr. Levine, “… women who have had even just one treatment have a very nice improvement. Like anything in cosmetics, if someone is happy after one or two treatments — even though the standard of care because of the way the [clinical] study was done would be three — if they’re happy after one or two, then we’re happy to take a break and not do the next treatment. It’s not mandatory; it’s cosmetic.”

Kelley Cupac*, a 24-year-old patient at Nashville Cosmetic Surgery, attests to the ease and efficacy of QWO, saying her treatments were relatively quick and painless. She adds that she learned a lot about cellulite throughout the process. “I valued the information I gained about cellulite,” she says. “You get so much education as the patient. Cellulite isn’t just affecting a certain group of people; it’s affecting almost all women, and it’s nothing to be ashamed of.”

Three QWO doses

Administered via a small needle inserted directly into targeted dimples, QWO injections are simple and take just 10 minutes or less. Image: Ona Skincare

There are a few common side effects with QWO, including bruising at the injection site, pain, areas of hardness, itching, redness, discoloration, swelling, and warmth. Kelley describes her experience as being nearly void of side effects, with the exception of bruising.

“As a patient, you definitely need to be prepared for bruising,” she says. “If you’re adequately prepared for the bruising and you expect it, then it’s a lot less jarring. The thing to realize is that the bruising is a natural part of the way QWO works when dissolving the fibrous bands that cause cellulite. It’s all a part of the process, and I’ve been happy with the results.”

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Melissa Rhodes, a nurse practitioner at Ona Skincare in Nashville, agrees that bruising after QWO treatments is the most common side effect. “Bruising is expected,” she says. “One way that we found that we can minimize the bruising a little bit is by having [patients] bring in some type of a compression legging. [Wearing it] immediately after the treatment can help.”

Bruises tend to be the norm with QWO, but it’s worth noting that in the clinical trials, no post-treatment downtime was necessary. “One of our patients went whitewater rafting two days later and had a completely fine experience,” Dr. Levine says. “It didn’t hurt, even though she was bumping around in the water.”

Though QWO hasn’t been around for very long, Dr. Levine adds that it was developed off a widely used orthopedic treatment. “[It] was formulated after a cousin that’s used in orthopedics to release Dupuytren’s contractures, which is like a trigger finger in people who have arthritis,” she explains. “It’s a molecule that’s very similar to QWO. It releases the fibrous bands in the finger to pop up the finger. In the dermatology world, we took that medicine and formulated it for cellulite.”

Before and after photos of cellulite treatment at Ona Skincare

Another satisfied customer! Image: Ona Skincare

If the injection created for cellulite in the buttocks was developed from a treatment used in hands, it begs the question: Can QWO be utilized in other parts of the body? “On-label, it’s only for the buttocks,” Dr. Levine says, explaining that though it can and has been used on other parts of the body, those treatments have not been tested and approved. “It’s really on a case-by-case basis, with the patient’s agreement that it’s not FDA approved … but [they] want to try it, anyway.”

She adds that when used as approved, the results from QWO treatments are expected to last at least a year or two. “A lot of people are [hesitant to get it] done because they’re afraid that it’s going to be painful or [require downtime],” she says. “Yes, there is bruising, and yes, it is a lot of little needles in the buttocks. But the needle is so small that most women don’t even feel it, so it’s very well tolerated.”

Think QWO might be right for you? Visit for more information or speak to your aesthetic specialist.   

*Name has been changed. 


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