Harmonising With Hybrid Injectables

Dr Tapan Patel provides his tips for successful treatment using the new hybrid HArmonyCa™ collagen stimulating injectable

This article is produced and funded by Allergan Aesthetics and is intended for healthcare professionals. UK-HAR-220207 | Date of preparation July 2022

I always felt there was a missing piece from the treatments we had to offer our patients. We had great innovations for building volume, treating pigmentation and improving skin texture, but there were a lot of patients who we couldn’t help – those with poor skin architecture. With dermal fillers, you might be able to improve patients to a certain extent, but they would still have some lines and creases and accordion lines, which are those that form from the corner of the mouth and go across to the lower part of the cheek. Of course, there was calcium hydroxyapatite (CaHA), which could create positive results, but the problem was that it didn’t last very long. That’s why we have a place for the new hybrid HArmonyCa™ collagen stimulating injectable, which combines CaHA and hyaluronic acid (HA) in a single syringe for both an immediate and sustained lifting effect.1-3 I was part of Allergan’s ‘experience phase’ so I’ve been using this product in my practice for about 15 months. I’ve treated many men and women with all different skin types using the product. It has become my go-to product for my established patient database – I’m currently treating around five people per day, with positive results and patient feedback. Here, I provide my top tips for using this new hybrid injectable so you too can implement it successfully into your practice. 1. Understand the science The first step to getting excellent results with HArmonyCa™ is to understand its mechanism of action. Supporting the body’s own collagen production,4 CaHA works deep within the dermis to form a scaffold for internal growth of fibroblasts.5,6 Pre-clinical data has shown this can help produce new collagen fibres as early as one week after injection2 and induce related remodelling of the extracellular matrix.4,7 HA particles integrate with collagen fibres of the lower dermal layer, which may create volume for an immediate lifting effect.1,8

2. Select the right patient Fundamentally, the best candidate for HArmonyCa™ is men and women who already have fairly good volume who could benefit from a potential improvement to their skin architecture.1 They should have Tapan Patel is a consultant lines and wrinkles at rest or on animation, who also may require a bit to Allergan and part of its AMI faculty. of skin tightening. My patient age tends to range from 30-80 and it’s strictly for use in patients over the age of 18.1 3. Know your injection depth We know that anatomical knowledge is key to successful results, but specifically with this product it’s about also being comfortable with the injection depth and the injection equipment.2,9,10 The depth is superficial – you should be injecting into the deep dermal and sub-dermal layers.1,2 I would stick to the lateral area of the face – so typically the best zones are the jawline and under the cheek bone.. 4. Always under correct It’s more important than ever not to overtreat when using HArmonyCa™. Remember, the immediate effect will be enhanced over time and the results progress over three to six months;2,6 although, in my personal practice I’m seeing ongoing improvements for up to a year. Always under correct to avoid unnatural results. Common postoperative adverse events include erythema, oedema (swelling), pain, tenderness, and itching. Treatment site reactions typically resolve within 24-48 hours and swelling within a week.1 5. Ensure you seek training with HArmonyCa™ It’s vital that you are adequately trained in all new products that you are thinking of adding to your treatment portfolio, particularly if you don’t have any previous CaHA experience. Allergan Aesthetics runs regular training days for healthcare professionals, and it’s a great opportunity to come and get hands on with HArmonyCa™. To find out the next training days, contact Allergan Medical Institute® Training at amitraining@allerganeventsteam.com. Note that the Allergan Medical Institute® is promotional – Allergan products will be discussed.

©AbbVie 2022. All rights reserved. Material produced and funded by Allergan Aesthetics, an AbbVie company. www. allerganaesthetics.co.uk

Adverse events should be reported. Reporting forms and information can be found at: UK adverse events reporting https:// yellowcard.mhra. gov.uk/ Adverse events should also be reported to Allergan Ltd. UK_medinfo@allergan.com or 01628 494026 Irish adverse events reporting https://www.hpra.ie Adverse events should also be reported to Allergan Ltd. UK medinfo@allergan. com or 01628 494026.

Disclaimer: this article is based on Dr Patel’s personal experience and ultimate decisions regarding patient care lies with the treating HCP and the patient.

REFERENCES1. Allergan Aesthetics. HArmonyCa™ Lidocaine IFU. M032 V01. 2021. 2. Allergan Aesthetics. Data on File.INT-HAR-2150040. HArmonyCa™ Lidocaine. Collagen stimulation. Jul 2021. 3. Allergan Aesthetics. Data on File. INT-HAR-2150036. HArmonyCa™ Lidocaine. Lift capacity. Jul 2021 4. Gonzaga da Cunha M et al. Surg Cosmet Dermatol. 2020;12(2):109–17. 5. Segal T et al. Post marketing study of safety and efficacy of Crystalys, a calcium hydroxyapatite based filler for facial soft tissue augmentation. Kosmetische Medizin online. https://www.kosmetischemedizin-online.de/uebersichtsarbeit/post-marketingstudie-zursicherheit-undwirksamkeit-von-crystalys-einem-auf-calcium-hydroxyapatit-basierenden-fillerfuer-die-weichteilaugmentation-im-gesicht/ Accessed July 2022 6. Berlin A et al., Dermatol Surg 20008 ;34(1 Suppl)S64-67 7. Gonzalez N and Goldberg DJ, Dermatol Surg. 2019;45(4):547-51. 8. Hee C et al. Dermatol Surg. 2015;41(Suppl 1):S373–81 9. Braz A and Cazerta de Paula Eduardo C. Indian J Plast Surg. 2020 Aug; 53(2): 230–243. 10. Fallacara A et al Facial Plast Surg. 2017 Feb;33(1):87-96