Plump Up Sunken Cheeks with the New HArmonyCa

Discover the new HArmonyCa, the innovative method to plump up sunken cheeks and regain your youthful appearance. Learn everything about this cutting-edge treatment – and why it might be the right choice for you.

Modern Cheek Augmentation with HArmonyCa

Cheek augmentation is about improving the appearance of sunken cheeks. Sagging cheeks can also be corrected with it. The goal is to replenish lost volume and thereby tighten the skin. This can be achieved in various ways. In the past, surgery was the go-to option. Today, non-invasive treatments dominate.

This includes, above all, injections with fillers made of hyaluronic acid or hydroxyapatite. They differ in the type and duration of their effects: while hyaluronic acid binds water and provides an immediate effect, hydroxyapatite works long-term by stimulating the production of new collagen.

An innovative method is the new HArmonyCa. HArmonyCa is a filler that combines the benefits of hyaluronic acid and hydroxyapatite. It promises both quick results and long-lasting effects. Sunken cheeks appear fuller again. Sagging cheeks are visibly lifted. Often, the results last a full 18–24 months or longer.

Causes of Sunken Cheeks

Sunken or sagging cheeks are usually a result of the natural aging process. Over time, the skin loses elasticity and firmness, making it look less taut and youthful. Additionally, the body’s production of collagen and elastin decreases. These are two essential proteins responsible for the elasticity and firmness of the skin. Moreover, the content of hyaluronic acid, which binds moisture in the skin, decreases over time. All of this leads to visible volume loss.

There are also changes in the adipose tissue, muscle, and connective tissue. Over the years, the adipose tissue loses volume, while muscle and connective tissue slacken. This causes the skin and tissue to sag downward. The cheeks lose their original, youthful bounce, leading to the permanent impression of sunken or sagging cheeks.

HArmonyCa: Dual Action

Cheek augmentation with HArmonyCa can counteract these visible signs of aging. By replenishing lost volume and restoring the skin’s firmness, it provides a more youthful, fresher appearance. The hyaluronic acid in HArmonyCa creates an immediately visible effect, but it is gradually broken down over several months. The hydroxyapatite, on the other hand, gradually unfolds its effect – but retains it much longer than pure hyaluronic acid.

Why HArmonyCa is Ideal for Cheek Augmentation

Hyaluronic Acid for More Volume

Hyaluronic acid is a natural component of skin and tissue. It can bind large amounts of water. In the body, it is naturally found wherever moisture and suppleness are important: in the eyeballs, joints, and skin. Natural hyaluronic acid gives the skin volume and firmness. Both are gradually lost as the natural hyaluronic acid diminishes over the years.

However, when hyaluronic acid is injected in the form of a filler, it replenishes the space under the skin. This replaces lost volume. The result is an immediate improvement in cheek contour, leading to a fuller and more radiant appearance. Additionally, hyaluronic acid has the advantage of being biocompatible and biodegradable. Therefore, the risk of allergic reactions is minimal.

Hydroxyapatite for new collagen

Hydroxyapatite, on the other hand, is an inorganic substance. It is also found in the body, in bones and teeth. In HArmonyCa, it is contained in the form of fine beads. After injection, hydroxyapatite acts as a scaffold into which collagen-producing cells, called fibroblasts, can grow. This leads to the formation of a stabilizing structure that strengthens the tissue. It contributes to the firm, elastic appearance of the cheeks. Unlike hyaluronic acid, which is broken down by the body over time, hydroxyapatite has a long-term effect. This is because it promotes collagen production and thus strengthens the skin structure from within.

The combination of hyaluronic acid and hydroxyapatite in HArmonyCa thus represents an optimal solution for building up sunken cheeks. Through the combined effect of the two fillers, HArmonyCa can achieve quick results that last a long time. This is also relevant from a financial perspective. Besides the lower risks, choosing a minimally invasive method is also a matter of cost.

Sabrina’s Story

Sunken cheeks are not always a sign of aging. Among athletes, they often appear at a young age. This is due to intense training and a low percentage of body fat. Athletes tend to lose facial fat quickly, leading to a loss of volume.

Low Body Fat Percentage with Consequences

This is most evident in endurance sports such as marathons or triathlons. But it is also common in weightlifting and bodybuilding. HArmonyCa can help restore lost volume and skin firmness. The combination of hyaluronic acid and hydroxyapatite ensures a natural result. This way, athletes can look fresher and younger without affecting their performance.

Sabrina, one of my patients, is such an athlete. Sabrina is in her early 30s, she is successful in bodybuilding and strictly monitors her body fat, especially during the competition season. As a result, her face looked harder and more angular, and her cheeks appeared sunken, no longer round and fresh as before.

Sabrina Opts for Cheek Augmentation with HArmonyCa

With HArmonyCa, I was able to replenish Sabrina’s cheeks and restore the youthful freshness to her face. Thanks to the hyaluronic acid in HArmonyCa, Sabrina saw an immediate effect. And because the hydroxyapatite stimulates new collagen, which tightens the skin in the long term, she can expect long-lasting results.

Picture showing the treatment of a patient with the new HArmonyCa by Dr. Eva Maria Strobl of LIPS and SKIN in Munich.
To add volume to Sabrina’s sunken cheeks, I injected the new HArmonyCa using the fan technique. This makes the result particularly harmonious. The risk of redness and hematoma is also minimized.

How Does the Treatment Work?

Like all my treatments, the procedure for cheek augmentation is also designed for careful and safe implementation. My primary goal is to achieve optimal results and minimize possible risks. The treatment includes several steps, which are described below.

Consultation and Examination

First, there is a detailed consultation and analysis to discuss the individual needs and expectations of the patient. A thorough examination of the cheek area helps to determine the optimal injection points and the required amount of HArmonyCa filler. In this first step, possible risks and side effects are also addressed.

Cleaning and Disinfection

Before each injection, it is important to carefully clean and disinfect the skin. This is to avoid possible infections, which are always a potential risk with treatments involving injections. Therefore, the skin is first thoroughly cleansed of makeup or other residues and then treated with a skin-friendly disinfectant. This effectively kills bacteria and germs.

Local Anesthesia

The decision on whether local anesthesia is required depends on the sensitivity of the patients. HArmonyCa already contains 0.3% lidocaine, a local anesthetic that helps alleviate pain during treatment. To enhance comfort during the procedure, I usually apply an additional numbing cream or inject a local anesthetic for cheek augmentation.

Injection Using Fan Technique

When injecting the HArmonyCa filler, I like to use the so-called “fan technique” on my patients. In this technique, the filler is injected in fan-shaped patterns into various layers of the skin and subcutaneous tissue. This technique allows for an even distribution of the filler and helps achieve a harmonious, natural-looking result. Additionally, the fan technique reduces the risk of bruising and swelling as it affects the blood circulation of the treated region less.

In choosing the injection points and technique, I also consider whether the cheeks should primarily appear fuller or rather lifted. Sagging and sunken cheeks can also be corrected in one treatment. Cheek augmentation is also often necessary, often to optimally smooth a nasolabial fold.

After the Injection

When injecting the HArmonyCa filler, I like to use the so-called “fan technique” on my patients. In this technique, the filler is injected in fan-shaped patterns into various layers of the skin and subcutaneous tissue. This technique allows for an even distribution of the filler and helps achieve a harmonious, natural-looking result. Additionally, the fan technique reduces the risk of bruising and swelling as it impacts the blood circulation of the treated region less.

In deciding the injection points and technique, I also consider whether the cheeks should primarily appear fuller or rather lifted. Sagging and sunken cheeks can also be corrected in one treatment. Cheek augmentation is also often necessary, often to optimally smooth a nasolabial fold.


After the treatment, I strongly recommend my patients to adhere to certain behavioral rules to support the healing process and avoid possible complications. This includes refraining from intense training, sauna visits, sunbathing, or other activities that could strain the treated area heavily for the first 24 hours after the injection. Dental appointments should also be scheduled a few weeks after the treatment.

Additionally, applying makeup or other cosmetic products to the affected area should be avoided for the first few days after treatment to minimize the risk of infection.

It is also advisable to gently cool the treated area regularly to reduce swelling and redness. If necessary, painkillers can be taken to alleviate any discomfort.

Who is Suitable for Cheek Augmentation with HArmonyCa?

Whether cheek augmentation with HArmonyCa is the best option for patients depends on several factors. Individual preferences and conditions play a significant role in determining if the treatment can achieve the desired results.

Degree of Volume Loss and Skin Laxity

Cheek augmentation with HArmonyCa is particularly suitable for individuals who notice a moderate loss of volume in the cheeks, leading to a tired, sagging appearance. The combination of hyaluronic acid and calcium hydroxyapatite allows for effective restoration of volume and firmness, resulting in a visible rejuvenation of the face.

However, for people with significant skin laxity, the treatment with HArmonyCa may only be partially suitable. In such cases, filling the volume alone often isn’t enough to achieve the desired result. Alternative or complementary procedures such as surgical cheek lifting or skin tightening may be necessary to remove excess skin and effectively tighten the cheek area.

Elastosis and Skin Texture

The suitability of HArmonyCa for individuals with elastosis, which is a degeneration of the elastic fiber network in the skin, depends on the severity of the condition. In cases of mild to moderate elastosis, HArmonyCa can contribute to restoring the volume and firmness of the skin by stimulating the production of collagen and elastin, and improving the overall skin structure. In such cases, it may make sense to opt for HArmonyCa treatment, considering the expected results.

However, in cases of advanced elastosis, HArmonyCa may not deliver satisfying results. This is because the treatment may not be able to fully address the underlying structural issues of the skin. In such cases, alternative or additional treatment approaches such as laser therapy, microneedling, or radiofrequency therapy may be considered to improve skin structure and elasticity.

Allergies and Intolerances

Since HArmonyCa consists of materials that naturally occur in the body, the risk of allergic reactions or intolerances is generally low. However, it is important to assess possible allergies or intolerances to the components of the filler, especially Lidocaine, before the treatment.

Individuals who are known to have allergies or intolerances to any of the ingredients should consider alternative treatment methods. Pregnant or breastfeeding women, as well as individuals with inflammatory skin conditions, should also refrain from the treatment for as long as their condition persists.

Risks of HArmonyCa treatment

The augmentation with HArmonyCa is generally considered safe and effective. However, there are some potential risks that should be taken into consideration when deciding on the treatment. These risks can be categorized as general and specific.

General risks that can occur with any injection-based treatment include swelling, redness, pain, and bruising at the injection site. These side effects are typically temporary and resolve within a few days.

Specific risks associated with the treatment include:


As mentioned in a previous section, there is a risk of infection with any injection. Thorough cleaning and disinfection of the skin before the treatment is crucial to minimize this risk. Additionally, the treated area should not come into contact with cosmetic products or other substances that could increase the risk of infection. If any signs of infection occur, such as severe pain, redness, swelling, or the formation of pus, it is important to seek medical attention immediately.


In some cases, after a treatment with HArmonyCa, there may be irregularities or asymmetries in the treated area. These can be due to uneven distribution of the filler or individual reactions to the material. To reduce this risk, it is important to choose an experienced and qualified physician or practitioner for the treatment. If any irregularities occur, corrections or adjustments can be performed to improve the appearance.

Arterial occlusion

A rare but serious risk associated with the use of fillers like HArmonyCa is an arterial occlusion. This refers to the blockage of an artery by the injected material, leading to reduced blood flow and potentially tissue damage or necrosis. Arterial occlusion is a medical emergency that requires immediate medical attention. To minimize this risk, the treatment should only be performed by experienced and trained professionals who are familiar with facial anatomy and potential complications.

Allergic Reactions

Although allergic reactions to the ingredients of HArmonyCa are rare, they can still occur. These reactions often occur within the first few days after treatment, but in some cases, they may occur weeks or even months later. In mild cases, allergic reactions can be managed with medication, such as corticosteroids. However, if medication is not effective, the only option may be to dissolve the filler using Hyaluronidase. Individuals with known allergies or intolerances to the components of the filler, especially lidocaine, should discuss this with their doctor before undergoing treatment.

What is the Cost of Cheek Augmentation with HArmonyCa?

The cost of cheek augmentation with HArmonyCa can vary depending on the extent of the treatment and individual factors. In my practice in Munich, prices for HArmonyCa treatments start at around €580. A simpler cheek augmentation procedure typically ranges from €1,000 and up. For a more extensive cheek augmentation, using around 6 ml of HArmonyCa, the cost starts at approximately €2,100.

It is important to note that the actual costs may vary based on the specific circumstances of each case and the amount of filler used. The mentioned indicative prices serve only as guidelines. The individual billing is always done according to the regulations of the German Medical Fee Schedule (GOÄ), which is the basis for billing private medical services.

It is always advisable to assess whether the cost of a HArmonyCa treatment is reasonable in relation to its benefits. I place great importance on providing my patients with a clear understanding of the expected costs and comparing them to the realistically expected results.

Conclusion: Quick Results and Long-lasting Effects For Sunken Cheeks

Cheek augmentation with HArmonyCa offers an innovative non-surgical procedure to replenish lost volume. It is an effective solution for correcting both sunken and sagging cheeks. The treatment provides immediate results while also delivering a long-lasting effect. This is achieved through the combination of hyaluronic acid and hydroxyapatite fillers.

With minimal risks and side effects, this method is suitable for individuals seeking visible rejuvenation of the cheek area without undergoing surgery. The cost of the treatment may be slightly higher compared to hyaluronic acid injections alone, but the benefits typically last much longer.

If you require supplemental information about this or would like to discuss your personal situation, I would be happy to help. Just contact me by e-mail. Or better yet, schedule your personal, no-obligation consultation in my office.

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About the author:

Dr. med. univ. Eva Maria Strobl is the owner of LIPS and SKIN Aesthetic Medicine practice in Munich. She is a trained specialist in general medicine (MedUni Vienna) and has over 10 years of specialization in non-surgical aesthetic procedures. Dr. Strobl is a member of the German Society for Aesthetic Botulinum Therapy e.V. (DGBT), the German Society of Anti-Aging Medicine e.V. (GSAAM) and of Network Global Health. She publishes regularly on her blog and on DocCheck.

Sources of this article:

Allergan Aesthetics, HArmonyCa technical information and product website, link
de Maio/Rzany, Injectable Fillers in Aesthetic Medicine, Springer
Seo, Facial Volumization with Fillers, Springer

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