Current update: On December 6, 2022, Endo announced that it would cease Qwo production and sales, citing concerns about variable bruising and prolonged skin discoloration. This was a manufacturer decision, not an FDA ban. The recording's launch plans, wait list and pricing predictions are historical. Read Endo's announcement.

What causes cellulite, and why do treatments differ? Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains how fibrous bands tether skin and contribute to dimpling. This episode explores Qwo at the time of its introduction and distinguishes discrete dimples from broader wavy skin texture.

Originally published July 23, 2020. This is an archival discussion of a then-new treatment, with current context added above.

Key takeaways from the recording

🧬 Cellulite anatomy

Cellulite involves the relationship between skin, fibrous bands and underlying fat; simply removing fat does not address every contributing feature.

💉 Historical Qwo treatment

Qwo was an injectable collagenase treatment intended to affect the fibrous bands involved in dimpling. Its approved indication was moderate to severe buttock cellulite in adult women.

📚 Evidence in 2020

Dr. Smith reviews the early evidence and uncertainty available in 2020, rather than reporting long-term experience with the product.

🧩 Treatment approaches

He compares approaches that release individual bands with treatments aimed at skin laxity and broader contour irregularities.

⚖️ Weight and skin changes

Weight changes do not predictably improve cellulite; loss of volume can also make skin laxity more apparent.

🎧 Episode guide

00:00 — Introduction

00:37 — What causes cellulite?

02:36 — Qwo and its proposed mechanism

05:54 — Early results and recovery discussion

09:20 — Dimpling versus wavy cellulite

12:11 — Weight changes and cellulite

💬 Common questions

Is this episode an invitation to book Qwo?

No. The wait-list invitation in the original audio predates Endo's decision to stop production and sales. A current consultation can address available options and whether treatment fits your particular concern.

Will losing weight get rid of cellulite?

The episode explains that the response varies. Less fatty volume may reduce prominence in some people, while accompanying skin laxity can make irregularities more visible in others.

ℹ️ Current related information

For today's practice information, see Avéli cellulite treatment and BodyTite skin tightening, or schedule a consultation. These links provide current context; Avéli is not part of the original recording.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information, not individualized medical advice. No cellulite treatment guarantees complete removal or identical results. Show notes updated September 30, 2026.

Full transcript and related resources