Our new dual-effect hybrid injectable contains two active ingredients, calcium hydroxyapatite (CaHA) and hyaluronic acid (HA), and is aimed at improving the skin architecture by providing an immediate and sustained lifting effect by combining CaHA and HA in one treatment.

Dual Effect Hybrid Filler South AFrica

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The ageing face has multidimensional needs.

Loss of volume and poor soft-tissue structural support are common forms of facial ageing. Most single-agent approaches, such as hyaluronic acid (HA) or bio-stimulator injections, are unable to individually provide the combined benefits of a HA lift and lasting collagen stimulation from calcium hydroxyapatite (CaHA).

Wrinkles and loss of volume in the face are a natural part of the ageing process. Therefore, we are fortunate that scientists have developed a range of products to help fight and effectively delay signs of ageing.

What are Dual Effect Hybrid Fillers?

The new dual-effect Hybrid Injectable Filler contains two active ingredients, calcium hydroxyapatite (CaHA) and hyaluronic acid (HA). It is aimed at improving the skin architecture by providing an immediate lift effect from hyaluronic acid and a sustained lifting effect from new collagen production that happens with calcium hydroxyapatite.

Find out more about our approach to Hybrid Fillers below or book a consultation with Dr. Nerina Wilkinson + Associates now!

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Frequently asked questions about Hybrid Fillers

Our approach to Hybrid Filler procedures

At Dr. Nerina Wilkinson + Associates we understand the importance of embracing the facial structures and skin as a whole. The goal is to achieve harmonious results using facial reshaping injectables and state-of-the-art skin rejuvenating treatments. 

No area of the face exists in isolation, all are connected and often corrected indirectly through facial reshaping. Treating areas in isolation leads to exaggerated and aesthetically unattractive features. 

Hybrid Fillers are not just about restoring volume, it is also about the enhancement of skin quality for more holistic facial rejuvenation.

By understanding how all areas of the face are interconnected and how treating one area communicates with another facial area, we are able to use much less product and produce constant and beautifully, natural results.

What is a Hybrid Filler?

HArmonyCa™ is our Hybrid Filler of choice. It contains two active ingredients, calcium hydroxyapatite (CaHA) and hyaluronic acid (HA). This Hybrid Filler may improve the skin architecture by providing an immediate lift effect from hyaluronic acid and a sustained lifting effect from new collagen production that happens with calcium hydroxyapatite.

How do HA and CaHA work?

The hyaluronic acid particles work deep within the skin, where they help plump it up for an immediate lift effect, moreover, calcium hydroxyapatite particles support the body’s own collagen production, so new collagen fibers start to grow. As the gel slowly disappears over time, a firm and dense collagen network is built in its place for gradual, long-lasting lift from calcium hydroxyapatite.

Who is the ideal candidate for Hybrid Fillers?

Once the Doctor has determined and confirmed your areas of concern by means of a detailed consultation, they will proceed. HArmonyCa™ may be suitable for anyone with signs of ageing, who could benefit from potential improvements in skin architecture and facial soft tissue augmentation. It is ideal for the treatment of sagging skin on the lower face and for improving skin quality.

Which areas can Hybrid Filler treat?

Hybrid Filler can be used under the skin, in certain areas of the face, and cannot be injected around the eyes, the lips, or around the mouth. it is ideal for the treatment of lower face sagginess, accordion lines in the cheeks, jawline sculpting, skin tightening, and quality improvement in the lower face


  • Not used in the midface, although its lifting effect can improve the midface
  • Lateral face
  • Lower face


  • Glabellar or periocular areas
  • Lips and perioral areas

How do Hybrid Fillers differ from Bio Stimulators or Dermal Fillers?

Bio-stimulators and hyaluronic acid facial fillers work differently and may not give the same results. Hybrid Fillers combine calcium hydroxyapatite with hyaluronic acid, capturing the potential benefits of both in one treatment. Hybrid Fillers may offer the combined action of hyaluronic acid lift and lasting collagen production from calcium hydroxyapatite in one injection. Hybrid Filler treatments result in an immediate improvement and are followed by sustained tightening for up to 3 years due to the presence of CaHA which stimulates the formation of new collagen.

How long do results from Hybrid Fillers last?

Hybrid Fillers may give you an immediate lift while stimulating your body’s own collagen production. Research shows that our product of choice offers a lifting effect as early as the second week after injection, and results have been demonstrated in 86% of 85 treated areas. In fact, 92% of patients treated with this product reported an improvement in the general appearance of the facial areas that were treated.

Hybrid Fillers have an instant lifting effect, with results that improve for up to 3 months and can last for 1-3 years.

What do Hybrid Fillers cost?

The cost of treatment depends on your face shape, concerns, personal goals, how much product is required, and the treatment(s) required. You will be provided with an estimate after your initial consultation with one of our Aesthetic Doctors.

We are unable to provide you with an exact cost / quotation pre-treatment as an in-depth consultation is part of our individualised and holistic Aesthetic Couture journey to help you achieve the results you desire; we quote on the steps required to achieve this outcome, not simply on the amount of product required.

Please contact us for any more information.

Are Hybrid Fillers safe?

Hybrid Filler procedures are normally safe when performed by a qualified Aesthetic Doctor.

Hyaluronic Acid-based Fillers are substances that have been used for a long time to improve features and surrounding skin. In the past, harmful substances used in Filler procedures could cause adverse reactions and side effects.

As a result, doctors have continuously improved on and sought out better ingredients to help them perform this procedure safely, with minimal or no adverse reactions.

What are the possible risks and complications associated with Hybrid Fillers?

As with other injectable treatments, the most common side effects after injection with Hybrid Fillers include:

  • Redness
  • Swelling
  • Pain
  • Tenderness and itching

These are often mild and typically get better within 24-48 hours, while swelling may take up to a week to completely go away.

Applying ice packs or cold compresses to the treated areas for 24 hours after treatment can help to reduce redness, swelling, and irritation. it is also possible that you may feel small bumps under the skin in the injected areas. If this happens, make sure to massage the skin in these areas. There are other, less common side effects with Hybrid Fillers, which your treating doctor will be able to discuss with you during your consultation.

Remember: It can only be injected in the lower face and should only be injected by an experienced aesthetic doctor.

Hybrid Fillers: Before and After

What to do before a Hybrid Filler procedure


2 Weeks prior to your treatment, we advise you strongly to avoid:

  • alcohol
  • garlic
  • lidocaine
  • fish oil supplements
  • aspirin or any other anti-inflammatory drugs for pain, swelling and/or fever, such as medicine containing diclofenac, mefenamic acid, indomethacin, or ibuprofen. Ask your doctor or pharmacist whether your medication includes any of these ingredients. This will reduce the risk of bruising or bleeding at the point of injection.

Because bruising and swelling are the most common side effects, especially in the lower face, schedule appointments at least 48 hours before any major event. Please let us know if you have been to the dentist / oral hygienist or if you are planning to go to the dentist/ hygienist in the next 4 weeks. Why? When your teeth are cleaned, bacteria are released into your mouth and travel into the bloodstream. CaHA injectables of any kind are considered an implant, a foreign substance in the body, and these excess bacteria increase the risk of infection and the formation of Biofilm (bacterial infection). If this is your first visit you will need to provide us with information regarding your medical history and any medical concerns, as well as details of any allergies you have or medications you are taking.

Day of Hybrid Filler procedure

Please note that you will have to arrive without make-up to prevent any Biofilm (bacterial infections) when doing HArmonyCa™ treatments.

Once the Doctor has determined and confirmed your areas of concern by means of detailed consultation, they will proceed. It’s important that you’re honest with the doctor about your medical history, medication, and expectations during this time. So that, if they’re not in line with the treatment, then another can be recommended instead.

What to do after a Hybrid Filler procedure

Please follow these instructions carefully to aid in achieving optimal results:

For 2 hours: Avoid make-up at the injection site to avoid contamination in the area.

For 4 hours: Do not lie down or do strenuous exercise and similar activities, nor should you do anything that increases the blood flow to the injected area

For 12 hours: Massage the treated areas if you feel any small bumps

For 24 hours: Avoid any high-intensity exercise or activities, exposure to sunlight, tanning beds, or extreme weather conditions

For 24 hours: Apply an ice pack or cold compressions to the treated areas as with most injectable treatments there may be some redness, swelling, and irritation.

For 1 month: Avoid dental procedures and any invasive skin treatments

For 3 months: Avoid any other injectable treatments, such as Dermal Fillers.

Please follow these instructions carefully to aid in achieving optimal results: Please note that no treatment can halt the ageing process completely, you will require top-up treatments if you want to maintain the effect, so please ask your doctor when she would recommend rescheduling another appointment.

Where are Hybrid Filler procedures performed in Cape Town?

Dr Nerina Wilkinson + Associates is a private, high end, luxurious clinic located in the prestigious V&A Waterfront in Cape Town. Dr Wilkinson founded the House of Aesthetic Couture and Skin Science. Your treatment will be performed at Dr. Wilkinson’s clinic.

What is the type of anaesthesia used during a Hybrid Filler procedure?

HArmonyCa™ contains 0.3% lidocaine hydrochloride, an anaesthetic, to reduce pain during treatment. It is as comfortable as other fillers.


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The Aesthetic Couture Team

Dr Nerina Wilkinson - experienced cosmetic surgeon in Cape Town

About Dr Nerina Wilkinson FCS (Plast SA)

Dr. Nerina Wilkinson is considered the “go to” expert for patients seeking a highly personalised bespoke facial rejuvenation treatment plan. She takes her clients on an ultimate curated journey to beauty and confidence..

The Aesthetic Couture Team

Known as facial rejuvenation experts with an artistic eye for detail, our team of Aesthetic couture doctors have pioneered industry changing dermal filler treatments such as LipStrobing TM and our trademarked signature non surgical Natural-Lift TM

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“Every day I look in the mirror, I can’t believe that this new skin in mine! I reached a point in my life where I thought that I would have to live with the consequences of the severe sun damage I have caused myself through years of surfing. Not only have you given me new skin Nerina, you have actually given me a new life.”

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“Dr Wilkinson’s team of doctors and highly experienced practitioners show such kindness and attention to detail and are not in a hurry to spend my money on unnecessary treatments, but sincerely want what they feel is best for my personal needs to improve my skin’s appearance as best they can.”

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