Platelet Rich Plasma

Platelet Rich Plasma


Platelet Rich Plasma (PRP) is cutting edge therapy in the field of cosmetic enhancements. Although the procedure is relatively new in aesthetics in the U.S.,PRP has been recognized as an effective treatment in sports injury, diabetic ulcer treatment, and orthopedics to name a few. Now patients who wish to use their own body’s regenerative power can do so without the concerns for infection, foreign material, or surgical interventions. Studies are now showing promise for patients looking for that younger renewed look. It is also beneficial for those wishing to have a fuller facial feature without the use of commercial fillers. This new addition in cosmetic enhancements has many possibilities such as eliminating skin wrinkles, rejuvenating the skin, improve the appearance in those with acne scarring, and hastening the healing process after a facial peel.

The therapy begins by first drawing the patient’s own blood into a specially prepared test tube. The tube is then spun down in a centrifuge to separate out the precious platelets. The platelets are an important component in our blood and are necessary for normal clotting. However, these very same platelets when activated release several proteins that are beneficial for increasing collagen formation, connective tissue formation,skin tightening, and overall rejuvenation. The separated platelets are then activated with calcium and then injected to the face or neck area. The injections are performed using very small needles similar to those used in Botox injections. The results are normally seen within 2-3 months and may require 2 separate sessions.

The repair response
The repair response of musculoskeletal tissues generally starts with the formation of a blood clot and degranulation of platelets, which releases growth factors and cytokines at the site. This microenvironment results in chemotaxis of inflammatory cells as well as the activation and proliferation of local progenitor cells. In most cases, fibroblastic scar tissue is formed. In some settings, however, such as in a fracture callus, these conditions can also facilitate the formation of new bone tissue.

The following growth factors can be found in the environment of a blood clot:

  • transforming growth factor beta (TGF-b)
  • platelet-derived growth factor (PDGF)
  • insulin-like growth factor (IGF)
  • vascular endothelial growth factors (VEGF)
  • epidermal growth factor (EGF)
  • fibroblast growth factor-2 (FGF-2)


Fat transfer has seen a revival in recent years. Although the first reported cases of transplanting a patient’s own fat to other areas date back to the late 19th century, it has not held much promise until the last few decades. The main reason why fat transfer was slow in becoming was due its poor tenacity. Fat has a very limited blood supply; and needs to be handled very carefully. The original fat harvesting technique involved anesthetizing the donor area with a lidocaine solution; and aspirating the fat into a large barrel syringe. The collected fat then needed to be separated by centrifuge. Both of these steps are highly operator dependent; and even in the best of hands, the fat is only partially viable with this method. There is a certain amount of trauma to the fat cells, during the harvesting and separating technique, that can injure the cell membrane of fat cells – making them useless for grafting.

The next step needs close attention to detail as well; and that involves injecting the fat into the recipient area. We already know that the fat is very sensitive to any trauma. It cannot be injected through very small needles or cannulas; since that can be harmful to the fat. It’s also very important to make sure that the fat is injected evenly, and to areas where blood supply is not questionable. Once the fat is placed into the recipient area, the goal is to have the fat cells develop connections to a nearby blood supply by a process called angiogenesis, or neovascularization.  It stands to reason that the best chance of survival is at the interface (of fat and blood supply). Fat surrounded only by other fat does not do well; and undergoes what’s termed central necrosis. This means that unless the transplanted fat is “touching” other tissue with good blood supply, it will not survive.

Recently there has been a great interest in adding PRP to the transplanted fat. The goal is to improve the fat retention, or survival, rate. Several well conducted studies have shown exciting and very promising results. Recently at the annual cosmetic conference sponsored by the National Society of Cosmetic Physicians (NSCOP) in Tucson Arizona, the subject of PRP in fat transfers was a hot topic. The results showed increased retention, and overall enhanced wound healing. No doubt we are witnessing a very promising role of PRP in fat transplantation.