PRP mechanism
and
indications
Dr Gita Faghihi
Assoc.Professor,dermatology
department
Isf Uni.Med.Sci.
The most
natural
injectable
Definition:
BUFFY COAT =PLATELETS + LEUCOCYTES
• Platelet-rich plasma (PRP) is blood plasma that
has been enriched with platelets.
• As a concentrated source of autologous platelets,
(17-19 folds / 3.3million /mm3)
PRP contains ,and releases (through degranulation)
several different growth factors and other
cytokines that
stimulate healing of bone and soft tissue.
‫فاکتورهای مترشحه از پالکتها‬
PDGF
(3 isomeres of platelet-derived growth factor (PDGFaa, PDGFBB, and PDGFaB),
significant role in blood vessel formation,
the cellular division of fibroblasts (the most
common cells in connective tissue),
and in synthesizing the extracellular matrix and
collagen
Other important growth factors
include:
(TGFB1 and TGFB2),
vascular endothelial growth factor,
and
epithelial growth factor.
PRP
PRP
stem cells
• Biosynthesis Collagen Elastin and
• Angiogenesis
growth factors
Main indications
of PRP:
Sport related injuries:
Aschilles tendinitis,,
teniss elbow...
osteoarthritis,
muscle injuries
bone repair
regeneration
nerve injury
Clinical applications
In humans, PRP has been investigated and
used as clinical tool for several types of
medical treatments, including:
• cardiac muscle injury,
• plastic surgery, and maxillofacial
surgery.
anti-aging medicine and
beauty sciences.
Indications as a whole
The most favorite area for
PRP
is around the eyes.
Peri-orbital
rejuvenation
is a difficult area
Botulinum toxin
limited benefit for lines not
due to muscle activity.
dermal fillers are generally used to establish the
volume loss in the tear trough,
can’t really use
fillers for the fine lines.
This is where PRP
really useful as it really helps
thinning eyelid
Very important indications
of PRP
• Periorbital (wrinkles fat pads and
dark circles)
• Loose skin
• Saggy skin
biostimulation technique with own
patient”s cells
autologous cellular regeneration
( ACR)
Xylocaine-P gel before injection for
giving anesthesia
Injection levels are both in dermis and
hypodermis,,some what overcorrected
Frequency and intervals of treatments:
For:
anti-aging procedures
Most patients will require 2-5 treatments two
months apart with results starting to show after
3-4 weeks.
Another protocol (Asian Clinic)
Dr Naomi..
2 to 3 sessions of PRP each spaced about 1-2
months apart.
reassess the patient about a month after the last
treatment (usually at about 3 to 7 months after the
first session)
to determine whether the patient has achieved the
expected results or whether more sessions are
required. the older patients probably need another
treatments every 6 months or so ,..
Other indications:
stimulating hair regrowth,
skin laxity on the body and
improving the appearance of stretch marks and
scars
Androgenetic alopecia one important
indication of
PRP
especially when other treatments and HT surgery
are not accessible.
Hair follicle stem cells are
activated and enhanced
growth, and the results are
better to be seen after
hair transplantation.
Effective improvement (hair loss)
by PRp
lasts about one year
Advantages of PRP therapy
• Autology: your own blood
• Tissue regeneration and rejuvenation
• Safety: non-allergenic and free from concerns over
transmissible diseases such as HIV, Hepatitis B & C, CJD and so
on
• Faster healing: no fibrosis formation compared to some long
term fillers, for example
• Easy to use: dermal and hypodermal injections require only
one syringe and one needle
• Convenience: PRP harvesting can be easily and quickly
performed in clinic. A sterile and registered specific kit for the
blood puncture, the preparation of the plasma and the
materials is used.
• Cost effectiveness
SIDE EFFECTS OF PRP FACIAL
REJUVENATION
• Pain and faint , headache, for first 12-24 hours are mild
• Swelling and redness 1-3 days
• bruising (2 weeks,, masked by make-up,,)
• In rare cases, skin cellulitis may occur which can be treated
with antibiotics and cold compresses
• Possibility of small venule thrombosis,,
• hyperpigmentation
PRP
in people over 60 years of age
Although not impossible but they
are poor responders.
Exclusion criteriae for PRP
• Persons with active skin disease (such as : SLE,
porphyria, )
• cancer chemotherapy,
• severe metabolic and systemic
disorders(especially advanced diabetes and
severe asthma….)
• abnormal platelet function (i.e. blood disorders)
• Anti-coagulation therapy
• underlying sepsis
Exclusion criteriae for PRP
• NSAIDS drugs during one week before
• History of recent stroke
• (heavy) Cigarette smoking
• Active infection at the inject. site
What to avoid
post—op care
• Avoid massaging or rubbing the treated
area for first 48 hours after the treatment.
• Also avoid facial peels , and laser
treatments for the first 4 weeks.
HPL(human platelet lysate)
• 2-10 times more growth factors than PRP and
long term storation time
• Readily available growth factors faster
regeneration
• Do not have platelet membrane ,no risk of
allo-immunization
Reference:
Platelet-Rich Plasma: Evidence to Support
Its Use
CLINICAL CONTROVERSIES IN ORAL AND MAXILLOFACIAL SURGERY: PART TWO
J Oral Maxillofac Surg
62:489-496, 2004
Robert E. Marx, DDS*
University of Miami
, FL, US
e-mail: rmarx@med.miami.edu
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