Dr. Levent Ünal
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CaHa (Calcium Hydroxyapatite).

No. 1 Overview

CaHa (Calcium Hydroxyapatite).

CaHa is an injectable collagen stimulator in which calcium hydroxyapatite microspheres sit in a gel carrier. Calcium hydroxyapatite is a mineral compound that also occurs naturally in the body. On application the carrier gel gives the area immediate tissue support, while over the following weeks the microspheres prompt the body to build its own collagen around them. This two stage behaviour is what separates CaHa both from classic fillers that only add volume and from products that only stimulate collagen.

What it addresses

With age the skin's supporting structure weakens, the dermis thins and the lower face starts to feel heavier. CaHa is considered when the aim is both to support the area and to stimulate the tissue's own collagen production. The point is not to inflate the face or change its lines but to support the lines that are already there.

Areas where it is considered

  • Loss of definition along the jaw line and lower face
  • Flattening across the cheeks and mid face
  • Hollowing at the temples
  • Areas of reduced skin support such as the neck, décolletage and back of the hands

Which areas are suitable depends on skin thickness and the degree of laxity, and is decided during the examination. Some thin, highly mobile areas such as the lips are not considered appropriate for this product.

Who it suits and who needs closer assessment

It is considered for people with mild to moderate laxity who are not looking at surgery and who want gradual support. It may not be appropriate during pregnancy and breastfeeding, when there is an active skin infection or inflammation in the area, or where there is uncontrolled autoimmune disease or a bleeding disorder. A tendency to keloid scarring, any history of permanent filler in the same area and the use of blood thinners must be shared at the examination. Suitability is decided by a medical assessment.

How the session runs

The visit begins by studying the face at rest and in movement. Your expectations are discussed and it is stated plainly whether CaHa fits them. On the day of treatment the area is cleaned and a topical anaesthetic is applied if you wish. The product is then delivered in a measured way into the planned layer with a needle or a cannula. A cannula can allow a safer pass through areas with dense vasculature and can reduce the likelihood of bruising. The area is checked repeatedly during the application, with attention to symmetry. The session is usually short and rarely requires you to change your day.

Onset and duration of the effect

Part of the effect is visible from day one because of the carrier gel, but that phase is temporary. The real change becomes clearer gradually over a few weeks as the collagen response develops. The effect is usually long lasting rather than permanent. How long it lasts depends on skin type, age, metabolism, smoking and sun exposure. Results vary from person to person and no outcome is promised in advance.

Aftercare

  • Avoid heavy exercise, saunas, steam rooms and excessive heat on the first day.
  • Do not massage or press the area beyond what your doctor has described.
  • Skip make up for the first hours and do not rub the area when washing your face.
  • Use sun protection consistently and avoid strong sun in the first days.
  • Mild swelling, tenderness or small bruises can occur and usually settle quickly.

Contact the clinic if you notice unexpected pain, pallor or a colour change in the area, or swelling and firmness that persist. Findings like these are best assessed early.

Points that are often confused

CaHa is frequently mistaken for hyaluronic acid filler. The most important difference is that hyaluronic acid can be dissolved with an enzyme if needed, whereas CaHa has no such reversal agent. That is why the quantity and placement are planned conservatively from the outset. Another misconception is that CaHa is permanent. It is long lasting, but the body absorbs it over time. Finally, expecting the collagen support to appear after a single session is not realistic, which is why a review visit is usually planned a few weeks later.

No. 2 Process

The process step by step

From consultation to the review visit, every stage is planned in advance. An unhurried, transparent flow.

01

Consultation

The face is studied at rest and in movement, assessing laxity, volume loss and the jaw line. Your expectations, medical history and current medication are reviewed, and whether CaHa suits you is discussed openly.

02

Planning and prep

The treatment areas are marked, the skin is cleaned and a topical anaesthetic is applied if needed. Quantity, layer and the choice between cannula and needle are planned in advance.

03

Application

The product is delivered in a measured way into the planned layer, with symmetry checked as the work proceeds. A cannula can allow a safer pass through areas with dense vasculature and reduce the likelihood of bruising.

04

Aftercare and review

Avoid heavy exercise, saunas and excessive heat on the first day. Part of the effect is visible early, while collagen support becomes clearer over weeks, which is why the review visit is set a few weeks later.

No. 01 Is CaHa different from a filler?

Classic hyaluronic acid fillers add volume directly and their effect is seen at once. CaHa works in two stages: the carrier gel gives early support, while the microspheres stimulate the tissue's own collagen formation over the following weeks. The real change therefore settles over time. Which approach suits you is decided by a medical assessment, and results vary from person to person.

No. 02 When does it show and how long does it last?

Part of the effect can be visible from day one because of the carrier gel, but that phase is temporary. The real change from collagen support becomes clearer gradually over weeks. The effect is usually long lasting rather than permanent. How long it lasts depends on skin structure, age, smoking and sun exposure.

No. 03 Is the procedure painful?

Most people describe nothing more than brief pressure and a mild sting. A topical anaesthetic can be used beforehand if you prefer. Where a cannula is chosen there are fewer entry points, so comfort is usually better. Your tolerance is discussed at the examination and the plan is adapted to it.

No. 04 Can CaHa be reversed?

Unlike hyaluronic acid fillers, CaHa has no dissolving enzyme. That is why quantity and placement are planned conservatively from the outset, deliberately leaving room to top up at a second visit if needed. This approach is also safer for a natural looking result. It is one of the reasons planning belongs with an experienced physician.

No. 05 Who is it not suitable for?

It is not suitable during pregnancy and breastfeeding, or where there is an active skin infection or inflammation in the treatment area. Uncontrolled autoimmune disease, a history of bleeding disorders and a tendency to keloid scarring all call for closer assessment. If you have had permanent filler in the same area before, you must say so. Suitability is always decided by a medical assessment.

No. 06 Can I go back to work afterwards?

Most people return to their normal day straight away. Mild redness, tenderness or small bruises can appear in the area and usually settle quickly. Even so, if you have an important event it is more comfortable to schedule the treatment a few weeks ahead. You will be asked to avoid heavy exercise, saunas and steam rooms on the first day.

No. 07 How often is it repeated?

The timing of a repeat depends on how quickly the product is absorbed and how your skin responds. A review visit is usually held a few weeks after the first treatment, and the plan is completed if needed. The interval to the next session is then set individually from that assessment. Reading the skin is more reliable than following a fixed calendar.

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