Calcium hydroxyapatite is explored as a versatile bioregenerative ingredient that can restore facial volume while stimulating long-term collagen production. This episode introduces HArmonyCa, a newer injectable that combines calcium hydroxyapatite with hyaluronic acid to deliver both immediate lifting and ongoing skin rejuvenation. The discussion also compares HArmonyCa with Radiesse, highlighting how each treatment fits into a personalized approach to facial aging.

Dr. Christelle Oliver-Dussault, Dr. Harpreet Lotay, and Amanda Manholt explain how these treatments work, who may benefit most, and why different formulations are used for different areas of the face and body. They discuss treatment longevity, safety considerations, and the advantages of combining structural support with collagen stimulation. With a practical, patient-focused perspective, the conversation highlights how regenerative injectables can deliver natural-looking results while improving overall skin quality.

Key Takeaways

• HArmonyCa combines hyaluronic acid with calcium hydroxyapatite for immediate lift and long-term collagen stimulation.
• Radiesse and HArmonyCa each have unique strengths and are suited to different treatment areas.
• Collagen stimulation can improve skin quality, firmness, and overall radiance over time.
• Treatment selection should be tailored to a patient's anatomy, goals, and aging pattern.
• Results typically last 12–18 months, depending on the product and individual factors.

Disclaimer: The Beauty Equation is for informational purposes only and not medical advice. This podcast does not create a doctor–patient relationship. Always consult a qualified healthcare provider before making medical or aesthetic decisions. Information may change as the field evolves.

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About the Hosts:

Dr. Harpreet Lotay is a family physician specializing in aesthetic medicine. She is the founder of Sona MD in Kamloops, BC, and serves as Chief Medical Officer at Bios Wellness Clinics. Known for her artistic approach and comprehensive non-surgical treatments, Dr. Lotay combines medical expertise with an eye for natural results. She is also an educator, a national trainer and holds academic appointments where she shares her knowledge in clinical dermatology and aesthetics. You can get in touch with her on Instagram @hlotaymd

Dr. Christelle Oliver-Dussault is a family physician specializing in aesthetic medicine, women’s health, and psycho-education. She brings a holistic, whole-person perspective to her clinical work, blending science with a deep understanding of the mind-body connection.

She is also the founder of Reclaim The Pink Within, a movement that empowers women to rediscover themselves during life’s most transformative stages. In addition, she is passionate about medical education and mentors the next generation of family physicians through her work with the department of Family Medicine at the University of British Columbia.

You can connect with her on Instagram @drchristellemd

Amanda Manholt is a clinic manager, patient consultant, and co-host of The Beauty Equation Podcast. With over 30 years of experience in beauty, aesthetics, and leadership, she has guided patients and teams alike toward confidence, growth, and empowerment. Known for her ability to connect with people and simplify the often-overwhelming world of aesthetics, Amanda brings a warm, practical, and relatable perspective to every conversation. You can find her on Instagram @crowsfeetandconfidence.

Websites

https://sonamd.ca/

https://www.getyourpinkbackproject.com/

It's two great ingredients we're familiar with and know how behave hyaluronic acid

gels, which can come in different concentrations. And Radiesse, which we

didn't really talk about yet, but we've used it a long time. And

based on how we dilute it, we can use it, as you mentioned, on the

accordion lines. We can use it on the back of the hands or

in the chest to really help those that creppier skin that gets

really, really fine and you're really looking to thicken it. But the

harmonica sounds to me like it is a little bit different and it's really on

a deeper plane. And lifting effect, which is quite exciting

as a tool. Yeah, absolutely. Lifting effect is right. And

I still love Radiesse just for those reasons,

for that improvement in skin quality and the ability

to use it in so many different areas, including on the

body and the hands, as you mentioned. So it is wonderful for skin

rejuvenation. Absolutely. Welcome to the Beauty equation.

I am Dr. Christelle Oliver Dusseau. I'm Amanda Manholt.

And I'm Dr. Harpreet Lotte. Today we're going to keep our

conversation on bioregeneration, focusing

on an ingredient called calcium hydroxyapatite,

or caja. It's a mouthful and it is one

of those ingredients that has lots of different ways

to help you regenerate your skin, regenerate

what's going on underneath your skin. And it comes in different forms. You may have

heard of Radiesse, which we've had for years. And we'll talk a little bit about

that. But first, I want Harpreet to tell us about

harmonica, because she was one

of few physicians invited to the launch of this new product

in Montreal. And I can't wait to hear about what

that weekend was like. And I know that you've used a lot in clinics since

you've come back. She's used a ton. So let's just say I think I'm on

my third order for her. Wow. Where did it go?

Yeah. So I want to hear more about this. Yeah, it's

truly a innovative product that was just launched in Canada,

but it's not new to the world. It's been around for 15

years in over 50 countries, primarily South

America. And it does have

calcium hydroxyapatite in it, but it also has

a unique way of bonding

hyaluronic acid to that molecule as well. So

it's dual action. It not only lifts and

volumizes, but it also gives ongoing

skin rejuvenation which is super exciting. And

what I love is that it is wonderful for treating the

lateral part of the face, you know, so if you have ever looked in the

mirror and done a little lift by your ear and

thought, hmm, that looks much better, this product could be

you. It is usually

injected in that lateral aspect where we lose volume. And when you

leave the office, you see an immediate effect. But what I love is that you

do get that bioregenerative effect as well over

that three to six to nine month period. So you're actually improving

your skin, which we know ages just

like the rest of us. It's not just volume loss, it is also changes

in our skin and laxity and all that. So it's

really exciting. How do you find it's

performing in terms of those little accordion smile lines that people

don't like, you know, when we start to lose that volume

in there? Well, this is the interesting thing that you'll

see the effect of that over a three to six month period, but you generally

don't inject it into that area where we see those

accordion lines. So it's lovely to have two

options. It's lovely to have Radiesse, which is what we have

used in Canada for a long time as a caja

biorejection degenerative treatment. This area I would still address

with hyper dilute Radiesse because we don't want to

volumize the front of the face. We know that as we age,

the front of the face gets heavier and

looks like it's fuller because the lateral part of the face

loses volume. So yeah, harmonica is

reserved at this point for behind the line of

ligaments, what we call the line of ligaments. So it's sort of this,

this line that goes from the edge of your

eyebrow on the side down your

cheekbone down to kind of where your

marionette line would end in that region generally.

And so you want to use it behind that line

and kind of low down because we don't want to induce

some fullness. So it sounds like a treatment to me

that really gives immediate results, but also has the

added benefit of giving you an improvement in

skin quality in a few months time. And patients walk out seeing a result right

away, which, when we talked about sculpture a few weeks ago,

that patients really have to trust that yes, this will work because they don't

necessarily see the result right away. So probably would be better for someone

who is looking to have that immediate result. And volumization almost

sounds like a mini facelift done from under the skin.

And addressing that loss from the different layers. Yeah, you're

exactly right. So it is perfect for people who want to see an

immediate change and, you know, are ready for something

more. So. Definitely. And it can be used in combination

where you're using hyaluronic acid fillers in other areas of the

face as well. So it gives us an additional

tool and a lot of versatility, for sure.

Yeah, that's great because we already know quite a lot about. It's combining two

great ingredients we're familiar with and know how behave hyaluronic acid

gels, which can come in different concentrations. And Radiesse, which

we didn't really talk about yet, but we've used it a long time and

based on how we dilute it, we can use it, as you mentioned, on the

accordion lines, we can use it on the back of the hands or

in the chest to really help those. That crappier skin that

gets really, really fine and you're really looking to thicken it. But the

harmonica sounds to me like it is a little bit different and it's really on

a deeper plane. And lifting effect, which is quite exciting

as a tool. Yeah, absolutely. Lifting effect is right. And

I still love Radiesse just for those reasons

for that improvement in skin quality and the ability

to use it in so many different areas, including on

the body and the hands, as you mentioned. So it is

wonderful for skin rejuvenation. Absolutely.

There is a recent study as well too, which I haven't had a chance to

read, but I'll mention it anyways, that Radiesse seems to have

an impact on hyperpigmentation. So

skin discoloration and darker spots, it seems to improve

that as well. So I might bring that up in a

few weeks time once I have a chance to read it fully, which is always

an interesting application because oftentimes we'll see that as the skin ages, those

years of exposure to UV light and sunshine do

appear on your skin. Because let's face it, most of us

weren't paying attention to putting sunscreen on when we were younger. I know I

didn't. So anything that helps with that is always an added little bonus.

Yeah, absolutely. That's part of how the skin ages. That dyspigmentation

and then also that loss of glow, which I love to see when we're using

these injectables, even sculpture, anything where we're

improving collagen, you. You get this glowy

look because collagen is white. So it gives this reflectiveness to the

skin which we Lose. One of the things

that you both do often is mix

radiesse and for example, one of the

beloteros, which essentially I'm

thinking, well, gee, well, that's calcium hydroxyapatite and ha.

And you're mixing your own little version of

it first, depending on where you're using it different ways.

And then I'm thinking, well, what's the difference then? So if harmonica is like already

done for you, well, I think that's one thing that it's

already done for you, but it is a different process. So if

you imagine, let's see, blending

a thick custard with a slightly thinner

jelly and swishing it back and forth trying to mix it, it's

hard to get a homogeneous blend.

So that's one aspect to consider. But

the process of making harmonica is different than just

blending the two products together. You have

molecules of the caja and you have

molecules of the hyaluronic acid and they get stuck together

with binding proteins called bde.

And then those clump of bonded

materials then get bonded to other clumps. So it's a

completely different process. So it's not something you can

replicate by blending the radius. Although

that is something that we have done for a long time as well, where we

blend it and we give people instant volumization

and that's that we can still certainly do that.

If we're trying to give volume in areas where we don't typically use

harmonica and we want to see some skin improvement

and then maybe speak to longevity of these products. What can people expect?

How often are they coming to see us? Yeah, I

would say with the harmonica, you. You should get an

effect that's lasting a good 12 to 18 months.

And then you may want to do a redo. The. The

jury's really out on that. We may see a longer lasting effect

on that. In my practice, when people do Radiesse, I would

say it's 12 months or so.

Yeah, great. Yeah, similar. Sometimes longer, I find with the Radiesse

combined with the ha. I really like that combination as

well. So particularly patients who have had that hyaluronic acid on

its own for lifting, and for whatever reason, they're

quite fast metabolizers. I've noticed that when the two are combined,

they seem to get a bit more longevity out of the procedure than

used alone. Maybe that's because the skin

improves. I would. To me, that's what makes the most sense, is that that bioregenerative

component will have an impact on the duration as opposed to just

the Hyaluronic acid on its own. Yeah. It's great to have both

tools, that's for sure. And I like to hear that it's been around for a

long time. So I think that always puts

my mind at ease. I'm not really excited when

they're like, new. Okay, well, how many people have

used it and how many times did it not go well? And, you know, so

the fact that it's been used in other countries for

years is always a good thing. Have you noticed any adverse effects

with harmonica? Or was that something that was discussed that would be

different from what we already know in terms of, like,

traditional fillers or bioregenerative ingredients that we have?

No, they're right in line with what we already know. So there's no

new new adverse effects due to the

novel integration of the two materials. So everything

stands. You want to be careful with how you're injecting it, obviously.

And caution around being mindful

of where vessels are and all that is all the same. And we

wouldn't want to use it in people who are. Who have

autoimmune issues or have, you know, unchecked inflammation.

That still is a caution.

Great. Well, I'm excited because again, I. I have to keep

ordering it. So I just like that we have more and more

options that we can tailor our treatment plans for

the person in front of us. Absolutely. And I think sometimes

it can be overwhelming when patients come in for a first consult because it does

take some time to tease out what they see, what their goals

are. But for me, it's nice knowing that there's an

additional tool in our pocket now because, yeah,

I have really enjoyed mixing

radiesse with hyaluronic acid or even hyper diluting it with

saline for seeing that improvement in skill

skin, the volumization that you can do. But I'm quite excited to try

this and see how it compares. Awesome. Well, if you

liked this episode, please remember to like and

subscribe and tune in next time. Like when we

get together for another little chat. Yeah. I think we might talk about

pigmentation, sunspots, things you can do in the summer. Yeah.

As we're sitting here looking out at blue skies. Yes. Might be a good one

to talk about. Until next time. We'll see you

next time.