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This article is written for qualified aesthetic practitioners (doctors, dentists, nurses and prescribers). It is not intended for members of the public and is not medical advice for patients.
HArmonyCa is Allergan Aesthetics' hybrid injectable: a cross-linked hyaluronic acid gel with calcium hydroxyapatite (CaHA) microspheres suspended in it, plus lidocaine. The HA gives you immediate, mouldable lift. The CaHA is there to stimulate collagen over the following weeks. That dual action makes it a different tool from a pure HA volumiser or a pure CaHA biostimulator. Patient selection, injection plane and complication planning all need rethinking because of it. This guide covers what is in the syringe, where it is indicated, how practitioners are using it, and where it fits alongside the products you already stock.
Allergan Aesthetics launched HArmonyCa with Lidocaine at AMWC Monaco in April 2022, describing it as its first "dual-effect hybrid injectable". It was developed in Israel, first sold in Brazil, Israel and Ukraine, and launched in Europe under a CE mark (Allergan Aesthetics press release, 2022). In the UK it is regulated as a medical device, not a medicine. That is why it can be discussed and supplied as a filler product, unlike toxins and other prescription-only medicines.
The stated indication is facial soft tissue augmentation by injection into the deep dermal and subdermal layers. Allergan's launch materials describe the HA component as giving an immediate lift that the injector can mould after placement, and the CaHA component as supporting collagen production.
A review published in the Journal of Aesthetic Nursing dermal fillers supplement (September 2023) gives the following technical details:
The microsphere size range matches the 25–45 micron CaHA particles described in Radiesse's FDA documentation (FDA PMA P050037). The big difference is the carrier. Radiesse suspends its microspheres in a carboxymethylcellulose, glycerin and water gel that is absorbed fairly quickly. HArmonyCa uses cross-linked HA, which contributes volume of its own.
According to the JAN review, the product is used in two main ways:
In practice, HArmonyCa suits patients who have early laxity and some volume loss in the lower two-thirds of the face, and who want lift now as well as gradual improvement in skin quality. Lateral midface and pre-jowl or jawline support are the areas most often discussed. It is less suited to patients who want a single defined projection point, such as a sharp chin, where a high-G′ HA designed for that purpose still makes more sense.
The same review says the lips and tear trough should be avoided because safety there has not been established. Both are areas where a non-dissolvable component and thin overlying tissue are a poor mix. Its listed contraindications include:
Always check the current Instructions for Use supplied with your stock, because the IFU is the governing document.
What follows summarises approaches described in the published practitioner literature. It is not a substitute for hands-on training with this product.
The JAN authors suggest a 25G cannula or 27G needle. They note that a 25G or 23G cannula causes less tissue trauma than a 27G needle. Deeper supraperiosteal lift points suit a needle. Broader areas, such as a lateral cheek fan or a jawline line, suit a cannula. If you are restocking for hybrid work, it is worth checking that your cannula range covers 23G and 25G in lengths that reach from a single entry point.
The described techniques are retrograde linear threading, serial puncture, fanning, cross-hatching and small boluses, placed subdermally and in the deep dermis. Volumes in the review are conservative: around 0.05–0.1 ml per thread or 0.1–0.2 ml per bolus, an initial total aim of 0.5–1.5 ml, and 0.9–1.5 ml per side in the reported case studies.
Three practical points come up repeatedly:
The JAN article advises patients to avoid exercise for 24 hours and to avoid sunbeds, saunas and UV exposure for one week. The commonly reported reactions are bruising, swelling, pain, tenderness and itching. Allergan's post-marketing data describe these as typically manageable and self-limiting.
This is where HArmonyCa differs most from a pure HA product, and it should shape your consent conversation.
Hyaluronidase breaks down hyaluronic acid. It has no enzymatic action on calcium hydroxyapatite. With HArmonyCa you can degrade the HA carrier, but the CaHA microspheres will stay in the tissue. This matters for two scenarios:
Document this clearly in consent: the product is only partly dissolvable, nodules are possible, and results build over weeks. Good record keeping, including batch numbers from the syringe labels, protects you if anything needs investigating later.
Practitioners often ask whether HArmonyCa is "better" than Radiesse. They are built for different jobs.
Many clinics end up using all three, matched to the patient's tissue quality, budget and appetite for a gradual result. You can compare options across the full dermal fillers range.
Because HArmonyCa is a medical device, it can be bought from reputable UK wholesalers by qualified practitioners. Filler World lists HArmonyCa with Lidocaine (2x1.25ml). When it arrives, check the CE (or UKCA) marking, lot number and expiry, keep packaging intact for traceability, and store it according to the IFU. Record the lot number in the patient's notes at the time of treatment rather than afterwards.
Allergan states that the collagen formation from the CaHA component can last up to 12 months. In its post-marketing satisfaction cohort, patients were followed for up to 19 months. Longevity varies with area, volume, technique and patient metabolism, so avoid promising a fixed duration.
Neither is better in every case. HArmonyCa adds a cross-linked HA carrier for immediate lift and contour. Radiesse uses a CMC carrier and is more flexible for diluted, skin-quality work. Choose by indication.
Only the HA portion. Hyaluronidase does not break down CaHA microspheres. It should still be used in line with an emergency protocol if vascular compromise is suspected.
Published guidance advises avoiding the lips and tear trough, where safety has not been established. Superficial placement should also be avoided because of the risk of visible nodules.
HArmonyCa gives practitioners a single product that lifts on the day and continues to work on collagen afterwards. In return, it is only partly reversible and less forgiving of superficial or perioral placement. Used deep, in conservative volumes, in well-selected patients, with a clear consent process and a tested emergency protocol, it sits comfortably between your HA volumisers and your CaHA biostimulators. Complete product-specific training before adding it to your clinic menu, and always work to the current IFU.
