Harmonyca

What is it?

Harmonyca is a hybrid filler that combines cross-linked hyaluronic acid and calcium hydroxylapatite microspheres in a single product. The hyaluronic acid gives volume and support at the time of treatment; the calcium hydroxylapatite stimulates the tissue's own collagen production over time.

For this reason it sits between two classes: it is neither only a volume filler nor only a biostimulator. It is considered for areas that need both volume and tissue support, such as the mid-face, cheeks and lower face.

An important limit: hyaluronidase dissolves only the hyaluronic acid part; the calcium hydroxylapatite part cannot be reversed. It should therefore not be thought of as a fully reversible treatment.

How does it work, and when is the result visible?

The volume seen at the time of treatment belongs to the hyaluronic acid part and is noticeable the same day. Over the following weeks the collagen response stimulated by the calcium hydroxylapatite microspheres comes into play; the result deepens and settles over time. The appearance in the first days is not the final result.

1. Treatment: the hybrid gel is placed in the target layer.
2. Same day: the hyaluronic acid part gives volume and support.
3. Over weeks: the calcium hydroxylapatite stimulates the collagen response.
4. Result: the combination of the two effects settles over time and is assessed at the review.

Treatment Areas

• Cheekbones and mid-face — volume and tissue support
• Cheeks — firmness
• Lower face and jawline — contour
• What it cannot do: lips and under the eyes — calcium hydroxylapatite is not considered suitable for these areas

Procedure Steps

1. Assessment

   Rather than applying a standard protocol to everyone, skin quality, signs of ageing, the treatment area and your expectations are assessed first. The aim is not to do more procedures but to apply the right protocol, to the right patient, in the right area. Situations where a hyaluronic acid only or a biostimulator only class would be more suitable are discussed separately.

2. Information on partial reversibility

   It is explained clearly that hyaluronidase dissolves only the hyaluronic acid part and that the calcium hydroxylapatite part cannot be reversed.

3. Preparation and treatment

   The area is cleaned with antiseptic and a topical anaesthetic is applied. The product is placed at the appropriate depth in controlled amounts; superficial placement is avoided.

4. Follow-up

   The volume seen on the same day and the tissue response that develops over weeks are assessed together; no decision is made on the basis of the early appearance.

Duration and Longevity

The hyaluronic acid part is absorbed over time; the collagen response stimulated by the calcium hydroxylapatite continues for a period that varies from person to person. No fixed duration is given in advance. The effect fading does not mean that the calcium hydroxylapatite part can be dissolved.

Who is it suitable for?

• Adults describing a loss of both volume and firmness in the mid-face and cheeks
• People who accept that part of the result settles over time
• People who come knowing that it is only partly reversible

Who is it not suitable for?

• Pregnant and breastfeeding people
• People with an active infection, a cold sore (herpes) flare or an open wound in the treatment area
• People with a bleeding disorder, and people taking blood thinners without their physician's approval
• People with an uncontrolled autoimmune disease
• Under 18s
• People who want a fully reversible treatment
• People looking for a solution for the lips or under the eyes
• People expecting an immediate and final result — the result is completed over weeks

Aftercare

• Do not apply pressure to or massage the area in the first days.
• For the first 24–48 hours, avoid alcohol and any blood thinners your physician has not approved.
• Stay away from hot environments and strenuous exercise in the first days.
• Allow weeks before assessing the result.
• In case of increasing pain, blanching of the skin or a spreading colour change, contact the clinic without waiting.

Possible Side Effects

• Temporary swelling, redness and bruising
• A slight receding of the appearance in the early period — due to absorption of the carrier gel
• Palpable firmness or nodules — reported particularly with superficial placement
• Asymmetry — the options for correction are more limited than with hyaluronic acid fillers
• Rare but serious: filler blocking a blood vessel. Because there is no enzyme to reverse it, this situation is harder to manage than with hyaluronic acid fillers.

Frequently Asked Questions

References

• Meçani R et al. Combined and Hybrid Treatments of Hyaluronic Acid (HA) and Calcium Hydroxylapatite (CaHA): A Systematic Review. Aesthetic Plast Surg. 2025
• Urdiales-Gálvez F et al. Facial rejuvenation with the new hybrid filler: clinical and aesthetic outcomes assessed by 2D and 3D photographs, ultrasound, and elastography. J Cosmet Dermatol. 2023
• Gritti A et al. A Prospective, Open-Label, Post Marketing Study of the Safety and Effectiveness of a Hyaluronic Acid and Calcium Hydroxyapatite Hybrid Injectable. J Cosmet Dermatol. 2025