What is Cellulite?
Cellulite is a term that describes the dimpled appearance of skin caused by fat deposits just below the skin’s surface. It is found in women, typically in the skin of the abdomen, lower limbs, and pelvic region.
What Causes Cellulite?
Many women believe cellulite is a fat problem that can be eliminated through diet and exercise. Truth is, you can lessen the appearance of cellulite somewhat by decreasing the fat cells under your skin, but you can’t get rid of it completely no matter how slim you become.
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.
This is the explanation of why skinny people can have cellulite, while heavy people may not. And men? Less than 10% have cellulite because, unlike the vertical connective tissue under women’s skin, men’s connective tissue is in an X pattern. For women, genetics plays a big role — if your mom had cellulite, you have cellulite. Hormones, aging, and weight also play a part.
Who Is At Risk For Developing Cellulite?
Cellulite affects approximately 85% of post-pubescent women. Women are more likely to experience cellulite results in dimpled, uneven skin with an “orange peel” appearance.
Can you prevent cellulite from forming?
There isn’t a thing you can do to prevent cellulite formation. It’s both a part of being a woman. It’s simple anatomy.
What Is QWO®?
Qwo® is a new injectable product that is FDA approved to help get rid of cellulitis dimples of the buttocks.
Who Is A Good Candidate For QWO® Injections?
After examining your cellulite, Dr. Bertolino will ascertain if he believes QWO® is a good treatment for you. To gain FDA approval, Endo Aesthetics (the makers of QWO®) had to prove that QWO® showed a two-point improvement in cellulite severity. QWO® was tested in clinical trials with women of all ethnicities and skin tones. In most cases, if you have moderate to severe cellulite on your buttocks, odds are you’d be a good candidate for these exciting new treatments.
What Areas Of The Body Can Be Treated With QWO®?
QWO® is FDA approved for cellulite of the buttocks but has been used off label for the posterior thighs.
How Does QWO® Work To Treat Cellulite?
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
What Can I Expect From My QWO® Treatment?
QWO® is administered in a series of three treatment sessions, separated by 21 days between each session.
Dr. Bertolino first marks the dimpled areas on your bottom that are to be injected. He then injects QWO® with a very small needle. Injections do not need to be made to great depth. Topical numbing cream is not necessary. Because the buttocks area has more fat and fewer nerves, 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.
How Many QWO® Treatments Will I Need?
QWO’s FDA approval is for three treatments separated by 21 days between each session. In each session, Dr. Bertolino can inject up to 12 different cellulite dimples on the buttocks.
What Are The Potential Side Effects With QWO® Treatments?
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 lessens with each subsequent treatment. In clinical trials, patients did not require any downtime and any residual bruising resolved in under 21 days.
When Will I See My Results From QWO®?
QWO® is delivered in three sessions; each session is spaced three weeks apart. About one week after your third session, at roughly 10 weeks from your first session, most patients see a visible improvement and smoothing of their treated cellulite locations. Results may vary between different patients.
How Long Can I Expect My Results To Last?
QWO® is made from collagenase clostridium histolyticum. It smooths dimpling on the buttocks from cellulite by releasing the septae, the collagen bands that tether the skin to the muscle. As fat is deposited between the skin and the muscle, the telltale dimples of cellulite form due to the septae tightening the skin to the muscle between the pockets of fat.
QWO® loosens the septae chemically. These are thought to be permanent changes in the connective bands creating the dimpling, but QWO® is a new product, so there are not any long-term studies to know if the septae tighten again or not. Initial data supports longevity of at least a few years for the improved appearance of the patient’s cellulite.
Does QWO® Remove Fat?
No. QWO® releases the connective bands that create pockets of trapped fat. The fat is then dispersed, but it is still there.
What Is VASERsmooth™?
VASERsmooth is a cellulite reduction device that reduces cellulite through tissue tightening, cuts cellulite-causing fibers and promotes the creation of new collagen fibers within your body.
Benefits Of VASERsmooth™
VASERsmooth is safer and more predictable than competing laser technologies because the procedure is 50% faster and works at lower temperatures. Lasers require heat to perform the cellulite reduction procedure. The necessary operating temperature for lasers is very near the point at which skin burns. In addition, lasers by design, destroy the cells they remove. Consequently, the fat cells and stem cells cannot be transferred to indented areas that may require filling.
How is VASERsmooth™ different from other cellulite treatment options?
Cellulite is an almost universal bane for all women. Treatments that have promised to address the appearance of cellulite have had little, if any, effect at all. Topical balms and creams don’t work because they cannot break the fibrous bands that attach the skin to the muscles beneath. It’s those fibrous bands that trap fat and create the dimpled, cottage cheese appearance of cellulite.
VASERsmooth™ uses ultrasound energy to break those connective bands.
This is similar to two other relatively new cellulite treatments, Cellfina and QWO®. QWO® was only introduced in early 2021, and it uses injected collagenase enzymes to break down the connective bands. Cellfina uses a tip that is inserted through a small incision. The tip manually breaks the collagen bands one by one to release the skin and smooth the dimpling of cellulite.
Are VASERsmooth™ Treatments Painful?
Dr. Bertolino applies topical numbing cream to the treatment areas. This keeps the patient comfortable. Because VASERsmooth™ utilizes high-frequency ultrasound energy rather than laser energy, there isn’t any danger of the burns that can occur when laser energy is delivered directly into the dermis.
How Many Treatments You May Need
These are meant to be single treatments on a targeted area. Of course, once you see your results from one area, you’ll likely want to have VASERsmooth™ used on a second or third area with cellulite.
Since the body readily accepts ultrasound energy (it has been used for decades for fetal ultrasound and other diagnostic imaging), there isn’t any reason a patient can’t have VASERsmooth™ done a second time on an area if more cellulite reduction is desired.
How VASERsmooth™ Cellulite Reduction Works
VASERsmooth™ uses a high-frequency ultrasound at 36,000Hz known as VASER technology. VASERsmooth is specially designed with a cutting edge about 2 cm from the tip of the wand. This instrument cuts the fibrous material that causes the dimpling effect on the skin. Furthermore, the tip of the ultrasound probe delivers energy to mobilize the fat, helping to even out adjacent areas.
“Great experience with Dr Jack, he is always so kind and approachable. He recommends what he thinks is best and right for me. I got filler done, not much, as he suggested we start off minimal and can always add if needed. Well the minimum was just enough and so natural looking. Very happy! 🙂”
Are VASERsmooth™ Cellulite Treatments Permanent?
VASERsmooth™ is a relatively new treatment. VASERsmooth™ is an extension of the VASERLipo platform. The handpiece for VASERsmooth™ breaks the fibrous bands that are the root cause of cellulite.
At this point, without long-term results, it appears the broken cellulite bands are severed for good, but time will tell. It’s unknown if the bands will re-form or if the skin will create new bands to replace those that were severed. These are long-term improvements, and they may turn out to be permanent improvements in cellulite appearance.
PRP And Cellulite Removal
Excess bulging fat can be smoothed out, and areas of persistent indentations can be filled in by redistributing the fat loosened during the procedure, stem cells and/or platelet rich plasma (PRP).
Does Cellulite Come Back After It Is Treated?
As mentioned above, this is unknown. VASERsmooth™ breaks the connective bands that trap fat and create the dimpling of cellulite. Since this is a new treatment, it’s not known whether new connective bands will form or not. As more and more people have this treatment, along with Cellfina and QWO®, it will be interesting to see if these are permanent improvements in cellulite.
At this point, VASERsmooth provides enduring results. The only question is whether they are permanent or not.