When performing collagenase clostridium histolyticum-aaes (CCH-aaes, Qwo, Endo Aesthetics) injections for cellulite, injection technique should vary based on the anatomical area being treated, according to a study published in the Journal of Cosmetic Dermatology (February 12, 2022).
Joely Kaufman-Janette, MD, compared five different injection techniques in the buttock and thighs and assessed both outcomes and rates of adverse events.
The phase 2A, open-label trial enrolled 63 women with mild-to-severe cellulite (Clinician Reported Photonumeric Cellulite Severity Scale) on both buttocks or thighs. Twelve injections of CCH-aaes (0.84 mg) were administered in each of two buttock or two thigh treatment areas (total dose, 1.68 mg) during three treatment sessions (Days 1, 22, 43). The women were sequentially assigned to: technique A = shallow injection/3 aliquots; technique B = shallow injection/1 aliquot; technique C = deep injection/1 aliquot; technique D = deep and shallow injections/5 aliquots; or technique E = shallow injection/4 aliquots.
The investigators found that for buttock cellulite, CCH-aaes injection technique A (shallow injection/3 aliquots) resulted in the greatest improvement in CSS score on Day 71. For thigh cellulite, technique D (deep and shallow injections/5 aliquots) resulted in the greatest improvement in CSS score. Of the five injection techniques, techniques A, D and E were associated with more favorable safety profiles than techniques B and C.