Cellulite release: Avéli and subcision
Mechanical release of fibrous septa · the discontinued Qwo
When Qwo, the injectable cellulite enzyme, was withdrawn in late 2022 over bruising and skin discolouration, clinics and patients moved to Avéli, a light-guided hand tool that cuts the bands under the skin.
A dimple is a tether, and the only treatments that last are the ones that cut it.
Reviewed against the Aesthetics International standard. Category: Body.
Does Cellulite release work?
Established. A dimple is a tether, and the only treatments that last are the ones that cut it. The 12-month pivotal study of Avéli reported sustained improvement in cellulite severity scores with mild adverse events; a 2024 systematic review and meta-analysis comparing collagenase with tissue subcision found both effective, with subcision durable and collagenase carrying more bruising.
- Verdict
- Established Long clinical track record. Results depend on selection and technique more than on the device.
- Evidence base
- 3 PubMed-indexed studies cited below, including systematic reviews, randomised trials.
- Suits
- Discrete, pinchable dimples on the buttocks and thighs in someone at a stable weight with reasonable skin tone, who wants a one-off procedure rather than a course.
- Not for
- Diffuse 'mattress' texture, loose skin or fat excess, which release will not fix and may worsen. Bleeding disorders or blood thinners.
- In Singapore
- Qwo was, to our knowledge, never launched in Singapore.
- Category
- Body
- Reviewed
- 1 October 2026 by Aesthetics International. Revised as evidence and regulation change.
What it is
Cellulite dimples are pulled in by fibrous septa anchoring skin to deeper fascia. Subcision releases those bands with a needle or small blade under local anaesthetic. Avéli is a refined version: a hooked device with a light at its tip, passed under the skin through a small entry so the physician can see and feel each septum and confirm it has been released. Cellfina is an older vacuum-assisted version. Qwo was an injectable collagenase that dissolved the bands chemically.
How it works
A dimple that flattens when the septum is cut stays flatter as long as the band does not re-form, which is why mechanical release lasts longer than heat. The skill is in selecting dimples caused by discrete tethers, releasing only those, and avoiding over-release that leaves a soft bulge. Buttocks and thighs are the usual sites; the procedure is done awake in a single session.
What the evidence says
The 12-month pivotal study of Avéli reported sustained improvement in cellulite severity scores with mild adverse events; a 2024 systematic review and meta-analysis comparing collagenase with tissue subcision found both effective, with subcision durable and collagenase carrying more bruising. Qwo's two phase 3 trials showed improvement over placebo, but bruising and prolonged skin discolouration led the manufacturer to stop production for commercial reasons. The evidence is manufacturer-funded and single-arm, but the mechanism is direct and the results are visible.
What people are saying
Paraphrased from public discussion on TikTok, Instagram, Reddit and in the press. Not testimonials, and not about any one clinic. Reported in: healio.com, americanboardcosmeticsurgery.org, investor.endo.com.
What the studies show
- cohort
A single targeted verifiable subcision treatment produced a sustained improvement in cellulite severity scores at 12 months, with mild adverse events that mostly resolved.
Multicenter Pivotal Study Demonstrates Safety and Efficacy of a New Cellulite Procedure: Final Results at 12 Months. — Aesthet Surg J, 2023. PMID 36351188.
- systematic review
Both injectable collagenase and tissue subcision improved buttock and thigh cellulite, with subcision durable and collagenase associated with more bruising.
Comparing Collagenase and Tissue Subcision for Cellulite Treatment of the Buttock and Thigh Regions: A Systematic Review and Meta-analysis. — Plast Reconstr Surg Glob Open, 2024. PMID 38911581.
- RCT
Two placebo-controlled phase 3 trials found collagenase injections improved buttock cellulite, with injection-site bruising as the dominant adverse event.
Collagenase Clostridium Histolyticum-aaes for the Treatment of Cellulite in Women: Results From Two Phase 3 Randomized, Placebo-Controlled Trials. — Dermatol Surg, 2021. PMID 33840781.
Studies are selected for relevance and quality, not for agreement with the verdict; PubMed records are linked so the reader can check them.
Who it suits
Suits
Discrete, pinchable dimples on the buttocks and thighs in someone at a stable weight with reasonable skin tone, who wants a one-off procedure rather than a course.
Not for
Diffuse 'mattress' texture, loose skin or fat excess, which release will not fix and may worsen. Bleeding disorders or blood thinners.
Alternatives
The two reviewed treatments most often weighed against Cellulite release, on the same standard.
| Cellulite release | Fat freezing | Emsculpt Neo | |
|---|---|---|---|
| Verdict | Established | Established | Established |
| What it is | Cellulite dimples are pulled in by fibrous septa anchoring skin to deeper fascia. | A suction cup cools a pinched fold of fat to a temperature that triggers fat-cell death while sparing skin and nerves. | A paddle delivers high-intensity focused electromagnetic energy that forces supramaximal muscle contractions — tens of thousands in a session — combined with radiofrequency heating of the overlying fat layer. |
| Evidence base | 3 PubMed-indexed studies cited below, including systematic reviews, randomised trials. | 3 PubMed-indexed studies cited below, including systematic reviews. | 3 PubMed-indexed studies cited below, including systematic reviews. |
| Suits | Discrete, pinchable dimples on the buttocks and thighs in someone at a stable weight with reasonable skin tone, who wants a one-off procedure rather than a course. | Discrete pinchable pockets — flanks, lower abdomen — in people with good skin recoil who want reduction, not definition. | Fit people with small, stubborn fat pockets who want more definition; post-partum abdominal tone as part of a broader plan. |
| In one line | A dimple is a tether, and the only treatments that last are the ones that cut it. | Reducing fat under skin that has already lost its recoil leaves the same outline and looser skin — settle which is dominant first. | For the rest, map the fat and skin first — the plane decides the tool. |
Risks
Bruising that can last weeks, soreness, small entry scars, temporary numbness and, with over-release, a soft contour irregularity. Infection is rare.
In Singapore
Qwo was, to our knowledge, never launched in Singapore. Avéli is not, to our knowledge, widely available here; needle subcision for cellulite is a doctor-performed procedure. Confirm the device's HSA registration with any provider offering it.
“A dimple is a tether, and the only treatments that last are the ones that cut it.”
Vetted protocols on the same problem
Questions
Why was Qwo discontinued?
Is subcision a one-time treatment?
Avéli or Emtone?
Cite this review
Aesthetics International (2026). Cellulite release: Avéli and subcision: does it work? Evidence, risks and verdict. https://aesthetics-international.org/treatments/cellulite-release-aveli/ (reviewed 1 October 2026).
Editorial, unpaid and independent of any manufacturer. Verdict: Established. See what works and what doesn't across all 153 reviews. Spotted an error or a newer study? Suggest a correction — changes are logged on the corrections page. Terms are defined in the glossary.
Where this review is used
Have a question about this treatment?
Ask us — or ask to be matched with a practitioner in Singapore who follows evidence-based treatment. Whether it is right for you is decided at an in-person assessment, not by a review; sometimes the answer is a different treatment, or none.
WhatsApp +65 8023 7170Suggest a treatment to review
Physicians, manufacturers and readers can propose a treatment for review. Reviews are editorial and are not paid for.
[email protected]