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New FDA-approved cellulite treatment promises to improve dimpled look with injection

The treatment is now becoming available in doctors' offices.
Up to 90% of adult women have cellulite, typically on the abdomen, buttocks and thighs. It’s rare in men.
Up to 90% of adult women have cellulite, typically on the abdomen, buttocks and thighs. It’s rare in men.Luis Alvarez / Getty Images
/ Source: TODAY

Even the most flattering swimsuit can’t hide cellulite, that dreaded area of dimpled skin most every woman can point to on her bottom and thighs.

Lots of home remedies promise results, but none really deliver because they don’t target the root cause of the problem — the architecture of fat, experts say.

Cellulite is one of the most misunderstood phenomena in cosmetics among both among patients and physicians, said Dr. Mathew Avram, director of dermatologic surgery at Massachusetts General Hospital in Boston and head of its Dermatology Laser & Cosmetic Center.

“People think it has something to do with them not exercising well or being overweight, when in fact it's an architectural phenomenon,” Avram told TODAY.

“It bothers patients tremendously, they're very interested in treatment, but they're also very wary of kind of snake oil solutions that that haven't helped them in the past.”

Now a new option, Qwo — the first injectable treatment for cellulite in the buttocks approved by the U.S. Food and Drug Administration — is becoming available in doctors’ offices. Avram has been among physicians taking part in an early launch over the past few weeks.

Qwo is made of enzymes that target the structural causes of cellulite under the skin. Here’s what prospective patients need to know:

What is cellulite?

It’s estimated up to 90% of adult women have cellulite, typically on the abdomen, buttocks and thighs, according to the American Board of Cosmetic Surgery. It’s rare in men, Avram said.

As women go through puberty, there are hormonally-based changes in the way their fat is organized, he noted. Fibrous bands that anchor the skin to the muscle, called septae, pin down fat tissue, resulting in the dimpled “cottage cheese” look.

How does the new treatment work?

The injected enzymes are thought to break and release those fibrous strands, redistributing fat cells. “It goes from kind of the dimpling to a smoother surface of the skin,” Avram said.

Before the treatment begins, the patient stands so that the doctor can circle any dimples that should be treated. The patient then lies down and Qwo is injected into those spots. Each buttock can receive up to 12 injections during a session, which takes about 15 minutes.

A total of three visits, at least 21 days apart, may be needed to get the best results. The number of treatments depends on the amount of improvement a doctor is seeing and the amount improvement the patient desires, Avram noted.

His office charges about $1,000 per treatment for a total of $3,000 for the full course of three visits. The cost varies by region and doctor, said a spokesperson for Endo Aesthetics, the company that makes Qwo.

What kind of changes should patients expect?

“In terms of treating the dimples, there should be a significant improvement, but maybe not a clearance,” Avram said.

“I'm actually happy with the product… for years, we've had some false promises with a lot of different devices, so for me this offers a change in terms of what we can treat. It’s a game changer.”

A patient before and after treatment with Qwo.
A patient before and after treatment with Qwo.Courtesy Endo Aesthetics

What are the side effects?

The injections themselves aren't necessarily painful, but patients can experience bruising that can sometimes be quite significant and stick around for a week or two or longer, Avram said. Other common side effects include areas of hardness, itching, redness, discoloration, swelling and warmth in the treatment area.

Serious allergic reactions, including anaphylaxis, are also possible.

How long does the effect last?

It’s not clear yet, though Avram was optimistic the results should last for several years.

What other cellulite treatments are available?

Cellfina is an FDA-cleared minimally invasive procedure. Avram described it as “like a little saw that goes underneath the skin” to release the fibrous bands that cause the dimpled look.

There are also laser treatments, vacuum-assisted precise tissue release, plus creams and lotions that can make cellulite less obvious, according to the American Academy of Dermatology.

In February, the FDA cleared the Soliton’s Rapid Acoustic Pulse device — which breaks apart the fibrous bands beneath the skin using high-pressure acoustic shockwaves — for the short-term improvement in the appearance of cellulite.

As for home remedies purporting to help with cellulite, Avram recommended people save their time and money because the changes — if any — tend to be minor and temporary.