Hybrid Fillers Personal Experience of Premixing Calcium Hydroxylapatite and Hyaluronic Acid for Natural Face Reshaping

Objective: This retrospective study evaluates the efficacy and safety of premixed calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) hybrid fillers for facial reshaping and rejuvenation, focusing on natural outcomes with long-term follow-up over 12 months. Methods: Forty-six patients (ages 45-65) underwent hybrid filler treatments using a 1:1 premixed formulation of CaHA and HA. Injection techniques targeted specific facial zones using cannulas for subdermal delivery. Standardized 3D imaging and the Merz Aesthetics Scale (CR-MASJ) were used to assess lifting effects and volume restoration. The Global Aesthetic Improvement Scale (GAIS) measured patient satisfaction. Results: Improvements in skin laxity, volume restoration, and facial contouring were noted as early as 3 months post-treatment and sustained through 12 months. Premixed hybrid fillers demonstrated enhanced biostimulatory effects compared with standalone CaHA or HA, promoting neocollagenesis and providing immediate and lasting results. Adverse events were minimal, with no significant complications reported. Conclusion: Premixing CaHA and HA offers a safe, effective, and reproducible technique for natural facial reshaping and rejuvenation. The combination enhances skin quality while providing immediate volumization and long-term collagen stimulation, meeting the aesthetic expectations of patients seeking minimally invasive anti-aging solutions.