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February 2, 2026Journal of Cosmetic Dermatology0 citationsOpen Access

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

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JKJonathan KadouchRBRolf BartschNFNabil Fakih‐Gomez

Key Points

  • The aim is to establish a consensus on the real-world use of hybrid dermal fillers combining CaHA-CMC and CPM-HA.
  • Conducted a modified Delphi process with 23 international aesthetic healthcare professionals (HCPs).
  • Developed statements from scientific advisory outcomes and literature review.
  • Refined statements evaluated across three rounds to reach consensus.
  • Consensus was achieved on safety, efficacy, and use of the hybrid fillers for volumization 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, injection techniques, and caution around muscle activity areas.

Abstract

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

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Cite This Study

Kadouch et al. (2026) studied this question.

synapsesocial.com/papers/6980fed9c1c9540dea8115d4https://doi.org/10.1111/jocd.70688
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