# Real‐World Usage of CaHA‐CMC:CPM‐HA Hybrid Dermal Fillers: Findings From a Delphi Panel

## TL;DR

Experts reached consensus on the safe and effective use of a hybrid dermal filler combining CaHA-CMC and CPM-HA for aesthetic treatments.

## Contribution

Established standardized guidelines for CaHA-CMC:CPM-HA hybrid filler use through a Delphi panel of aesthetic professionals.

## Key findings

- Consensus was reached on the safety, efficacy, and use of CaHA-CMC:CPM-HA for volumization and skin quality improvement.
- Recommendations included dilution ratios, injection techniques, and avoiding high muscle activity areas.
- Experts emphasized the synergistic benefits of the hybrid filler but noted the need for long-term safety research.

## Abstract

The popularity of minimally invasive aesthetic procedures has increased globally, with a 40.9% increase in non‐surgical procedures between 2019 and 2023. Dermal fillers have gained popularity for delivering visible results with short recovery times. Among these, hybrid dermal fillers combining calcium hydroxylapatite‐carboxymethyl cellulose (CaHA‐CMC) and cohesive polydensified matrix‐hyaluronic acid (CPM‐HA) offer tailored treatment with demonstrated efficacy and tolerability. However, standardized guidance for use remains limited.

To establish consensus among a panel of aesthetic healthcare professionals (HCPs) on the real‐world use of CaHA‐CMC:CPM‐HA hybrid dermal fillers.

A modified Delphi process was conducted with 23 international HCPs. Statements were developed from scientific advisory board outcomes and a literature review, refined by a scientific steering committee and evaluated across three rounds. Consensus was defined as ≥ 80% agreement/disagreement.

Consensus was reached on the safety, efficacy, and use of CaHA‐CMC:CPM‐HA hybrid dermal fillers for volumization, contouring, and skin quality improvement. Of 43 statements, 27 reached consensus in Round 1, 7 in Round 2, and 3 in Round 3. Recommendations included dilution ratios, the “foaming” technique, subdermal injection, and avoiding high muscle activity sites. Experts highlighted the synergistic effects and convenience of CaHA‐CMC:CPM‐HA fillers, while noting the need for further research on long‐term safety and rheological properties.

These results provide a base for standardized hybrid dermal filler use. Agreement on topics including indications, efficacy, and safety underscore the experts' unified stance on hybrid dermal filler usage. These consensus statements can serve as guidelines to ensure effective and safe clinical practice.