The Collagen Conversation

Dr Sophie Shotter answers our burning questions about the hybrid HArmonyCa™ collagen stimulating injectable by Allergan Aesthetics

This article is produced and funded by Allergan Aesthetics and is intended for healthcare professionals.

Why is the ‘collagen conversation’ trending right now? The importance of healthy skin to the ageing process is now well understood.1 But, we are realising that using one tool to target all signs of ageing can produce unnatural results, so practitioners and patients alike have landed on collagen as the key. We always talk about the importance of combination treatments to get best patient results, but HArmonyCa™ combines two technologies in a single hybrid product.2 HArmonyCa™ addresses an unmet need for patients and I’ve found it has very high patient (and injector) satisfaction.3

What is HArmonyCa? HArmonyCa™ breaches a new frontier in aesthetic medicine. It’s a new generation of hybrid injectable – combining two technologies in a single syringe.2 It combines cross-linked hyaluronic acid (HA) with calcium hydroxyapatite (CaHA) microspheres2 to create a gel with a moderate lifting capacity that gradually improves overlying skin quality over time.3-7 HArmonyCa Lidocaine is a dermal filler intended for facial soft tissue augmentation and should be injected into the deep dermal and sub-dermal layers.2 For use in patients over the age of 18.

How can this benefit patients? Patients notice an immediate result in the mirror7-10 – they have the ‘wow’ moment – and this lift is sustained over time.3,5,6,7,11 This is because the cross-linked HA isn’t purely a carrier gel, but gives the sustained improvement that a pure HA filler does.12-18 The difference with HArmonyCa™ is that patients continue to have ongoing improvements over the coming three to six months – I have observed that the overlying skin improves in texture and firmness, fine lines and wrinkles soften and dynamic lines reduce. HArmonyCa™ gives the benefits of two wellestablished technologies in a single syringe.2,4,7

Who is HArmonyCa™ suitable for? I actually think the better question is ‘Who isn’t HArmonyCa™ suitable for?’ I genuinely feel the majority of patients in our aesthetic practices will benefit. Although, unlike products like VOLITE®19 this isn’t a product I’d use for ‘pre-juvenation’. A good candidate will have some mild to moderate volume loss as well as skin laxity or lines and wrinkles at rest or on animation.2 We often see patients in their 30s with skin laxity and sun damage who would be good candidates, and we see patients in their 60s who have always looked after their skin and whose skin aged very well. HArmonyCa™ is a suitable choice for both male and female patients. As with all products, it is important to consult the product directions for use first to read the full contraindications, warnings and precautions to check if your patient is suitable. What results can you expect? I’ve used HArmonyCa™ on patients between the ages of 35 and 65 over the past 12 months, and have been delighted to see the differences. Even as early as two weeks they can feel the difference in their skin quality – it’s firmer and smoother.6,7 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.6

What’s your top tips for treatment success? 1. Selection: The right patient has mild to moderate volume loss with overlying skin laxity and fine lines and wrinkles.2 2. Combine with HA fillers: remember HArmonyCa™ provides a different kind of tissue lift compared to a more volumising filler like VOLUMA®20-23 or VOLUX™.18,21,24 Imagine it as more of an intermediate lift, like VOLIFT®.21,23,25 Use the two in combination in a treatment plan to help a patient achieve more volumisation. 3. Inject subcutaneously: HArmonyCa™ needs to be injected in the subcutaneous layer, as close to the underside of the dermis as possible.2 The fibroblasts are within the dermis,26 and so we need the CaHA to be able to reach the fibroblasts.7

How can practitioners find out more about HArmonyCa™? Allergan Aesthetics is running 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. Please note, the Allergan Medical Institute® is promotional – Allergan products will be discussed.

Before After

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.

©AbbVie 2022. All rights reserved. Material produced and funded by Allergan Aesthetics, an AbbVie company. www. allerganaesthetics.co.uk UK-HAR-220187 | Date of preparation June 2022

47-year-old patient before and 3 months after 6ml of HArmonyCa™

HArmonyCa™ is only licensed for patients over the age of 18.

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

REFERENCES: 1. Coleman SR and Grover R. Aesthet Surg J. 2006;26(1S):S4-9. 2. Allergan Aesthetics. HArmonyCa™ Lidocaine IFU. M032 V01. 2021. 3. Allergan Aesthetics. Data on File. INT-HAR-2150007. HArmonyCa™ Lidocaine. Clinical study report. Apr 2021. 4. Gonzalez N and Goldberg DJ. Dermatol Surg. 2019;45(4):547–51. 5. Allergan Aesthetics. Data on File. INT-HAR-2150036. HArmonyCa™ Lidocaine. Lift capacity. Jul 2021. 6. Allergan Aesthetics. Data on File. INT-HAR-2150040. HArmonyCa™ Lidocaine. Collagen stimulation. Jul 2021. 7. Gonzaga da Cunha M et al. Surg Cosmet Dermatol. 2020;12(2):109–17.] [REF Hee C et al. Dermatol Surg. 2015;41(Suppl 1):S373–81. 8. Niforos F et al. Dermatol Surg. 2017;43(10):127-1271-1280. 9. Oglivie P et al. Dermatol Surg. 2020;46(3):376-385. 10. Phillipp-Dormston WG et al. J Cosmet Laser Ther. 2014;16(4):171-179. 11. Hee C et al. Dermatol Surg. 2015;41(Suppl 1):S373–81. 12. Eccleston D and Murphy DK. Clin Cosmet Investig Dermatol. 2012;5:167–72 13. Callan P et al. Clin Cosmet Investig Dermatol. 2013;6:81-89. 14. Niforos F et al. Clin Cosmet Investig Dermatol. 2019;12:791-98. 15. Jones D and Murphy DK. Dermatol Surg. 2013;39:1602-12. 16. Niforos F et al. Dermatol Surg. 2017;43:1271-80.37. 17. Dayan S et al. Aesthet Surg J. 2020;40:767-77.39. 18. Ogilvie P et al. Aesthet Surg J. 2020;40:NP499-510. 19. Juvéderm® VOLITE DFU. 73655JR10. Revision 2019-09-09. 20. Juvéderm® VOLUMA with lidocaine DFU. 73650JR10. Revision 2019-09-09. 21. Kapoor KM et al. Clin Cosmet Investig Dermatol. 2021;14:110518. 22. Dhillon B and Patel T. J Clin Aesthet Dermatol. 2020;13:33–40. 23. Goodman GJ et al. Plast Reconstr Surg. 2015;136:S139–48 24. Juvéderm® VOLUX DFU. 73651JR10. Revision 2019-09-09. 25. Juvéderm® VOLIFT with lidocaine DFU. 73652JR10. Revision 2019-09-09. 26. Gray’s Anatomy. The Anatomical Basis of Clinical Practice. Chapter 7. Skin and its appendages P. 141-161e1