Tweakment aficionados have come to realise that dermal fillers are good for more than just bigger lips or more projected cheekbones and chins. They are widely used to restore lost volume in areas like the temples and tear troughs, and ingeniously placed to provide support and a subtle lift where skin shows signs of drooping.

But so far, they’ve not been able to successfully treat the soft tissues of the cheek and jaw area, nor have they been good for smoothing wrinkles.

Cue, a new hybrid injectable called HArmonyCa that is promising to change the status quo. The big selling point is that it doesn’t only provide instant volume, but long-term firmer, smoother skin as well, as it’s teamed with an agent that’s proven to stimulate fibroblast activity to induce collagen and elastin generation.

But as far as I’m concerned, equally exciting is the fact that it’s the first injectable that visibly tackles thinning, slackening skin in the ‘lateral’ parts of the lower face. Think, the lower cheeks that can be prone to drooping, and those vertical lines spreading from the corners of the mouth towards the lower cheeks.

How does HArmonyCa work?

HArmonyCa is an injectable “made of 70 per cent cross-linked hyaluronic acid (or HA) gel (for immediate plumping) and 30 per cent calcium hydroxyapatite (CaHA) microspheres (which boost collagen synthesis),” says Surgeon and Cosmetic Physician Dr Apul Parikh, one of the first UK doctors to offer the treatment. “It also incorporates numbing agent lidocaine to take out the sting of the injections.”

The product is administered to the lower dermal layer via an extra-long cannula, using up to three injection points in each cheek. “Thanks to the length of the cannula, we can spread it under the entire cheek and jaw area, depositing the gel right where the calcium hydroxyapatite can get to work: throughout the dermis. The CaHA will have a noticeable effect in one skin cycle, so after about six weeks,” says Dr Parikh.

Who is HArmonyCa for?

This filler is squarely aimed at laughter lines, also referred to as ‘accordion’ or ‘concertina’ lines, which on the whole don’t set in until your 40's when collagen levels drop and skin loses its density and spring. But the application technique, which allows an even layer of the product to settle under the lower cheeks’ skin surface, can also help firm up and thicken tired-looking, loosening skin.

Profhilo (which is injected into a number of points around the face then spreads under the skin) is often touted as doing this, but in truth its densifying benefits are minimal: the skin booster is mostly meant to deeply hydrate.

At 52, with deepening smile lines, a narrow face with not much fat left in it, and definite menopause-related skin thinning, I always have an ear out for treatments that might add plumpness and density without blowing up parts of my face to what I deem preposterous proportions.

But I’m wary of energy-based devices and their potential for causing fat loss under the skin; most surgeons I speak to will advise that people with my type of face and skin should err on the side of fillers rather than things like radiofrequency and ultrasound when it comes to skin tightening and volumising. Sadly, an injectable that could do this successfully for the cheeks didn’t exist – until now.

What’s it like to have HArmonyCa?

The 30-minute procedure is simple: your face is cleansed and marked for injection points. The jabs that follow are quite nasty, but there’s only four of them in my case. The exceptionally long cannula, which is inserted then swiped around under the skin, doesn’t really hurt until it reaches the far end of my face near the jaw, where it exerts a horrible pressure.

The upshot is that the thin, flexible tube moves around freely under the skin without doing any damage: apparently, explains Dr Parikh, there’s plenty of space between the skin layers to fiddle about. All in all, the treatment is hardly fun but it’s quite bearable and once done, I only feel a slight tenderness in my jaws and can see nothing but some redness at the injection points.

What are the results of HArmonyCa?

There’s an instant subtle but nonetheless noticeable added width to my cheeks that makes them look far less hollow. My skin itself, which is normally stretchy like chewing gum, feels thicker and firmer when I squeeze it. Also, the finer laughter lines that have etched their way into my cheeks over the past year have practically gone.

Right now, it’s the extra volume that’s slightly stretching the skin, but even when the filler wears down over a period of about 18 months (which is on average how long treatment results last), the calcium hydroxyapatite in the product will continue to induce smoother, tighter skin that’ll keep deepening and multiplying lines at bay.

Why hybrid fillers are the future

“For women in particular, there’s a definite transition point after age 40 when they start to see accelerated collagen decline,” says Surgeon and EV Editorial Panel member Dr Jonquille Chantrey, who performs HArmonyCa at her ØNE Aesthetic Studiø.

“For over 16 years I have collaborated closely on the research and development of HA fillers, and have developed an expertise in combining them with hydrating injectables and collagen-stimulating devices with excellent results,” she says.

“CaHA is already well-established for stimulating collagen, but to have it available in a combined ‘package’ with HA represents an exciting frontier in the mid to longer-term treatment of cheek lines, skin firmness and skin laxity. I think this breakthrough will inspire more multi-functional hybrids in the aesthetic field.”