Facial rejuvenation with the new hybrid filler HArmonyCa™: Clinical and aesthetic outcomes assessed by 2D and 3D photographs, ultrasound, and elastography

J Cosmet Dermatol. 2023 Aug;22(8):2186-2197. doi: 10.1111/jocd.15706. Epub 2023 Apr 18.

Abstract

Objective: Facial aging is a complex process that involves genetic, biological, and environmental factors. This paper aimed to present the first aesthetic and safety outcomes of a hybrid filler that combines hyaluronic acid (HA) (20 mg/mL) and calcium hydroxyapatite (HA/CaHa).

Methods: Prospective and non-randomized interventional study conducted on consecutive healthy patients who attended the clinic for an aesthetic facial rejuvenation procedure. HA/CaHa was injected with 23G cannula (retrograde threads, 1.25 mL per side) in the preauricular region. Ultrasound examinations, elastography images, and 2D and 3D photographs were performed before and after treatment. The primary endpoint were the volumetric changes at Day 180.

Results: Fifteen patients were included in the study. At Day 180 after treatment, median (interquartile-range) volume increased by 2.1 (1.9-2.3) cc and 2.1 (1.8-2.2) cc in the right- and left-side, respectively, p < 0.0001 each. As compared to pretreatment values, facial-tension vectors significantly increased by 2.2 (1.6-2.2) mm and 2.0 (1.7-2.2) mm in the right and left side, respectively, p < 0.0001 each. Elastography images demonstrated an increase in collagen fibers at post-treatment Day 60, which was confirmed on Day 90, and reached the peak effect between Days 90 and 180. Regarding safety, there were no either unexpected or serious treatment-related adverse events. Most patients experienced a mild redness and inflammation that resolved within the first 48 h without treatment.

Conclusions: The HA/CaHa hybrid filler (HArmonyCa™), besides its volumizing and lifting properties, was associated with an increase in the viscoelasticity, both at the level of the reticular dermis and the subcutaneous cellular tissue, which might be indicative of the formation of new collagen fibers.

Keywords: calcium hydroxyapatite; collagen stimulators; facial rejuvenation; hyaluronic acid; hybrid filler.

Publication types

  • Clinical Trial

MeSH terms

  • Collagen / adverse effects
  • Cosmetic Techniques* / adverse effects
  • Dermal Fillers* / adverse effects
  • Elasticity Imaging Techniques*
  • Esthetics
  • Humans
  • Hyaluronic Acid / adverse effects
  • Patient Satisfaction
  • Prospective Studies
  • Rejuvenation
  • Skin Aging*

Substances

  • Hyaluronic Acid
  • Collagen
  • Dermal Fillers