Effects of PRP

The author’s own investigations into the impact of PRP on dermal augmentation found that dermal intensities increased following treatment. The author used meso- and filling methodologies for full facial rejuvenation to objectively evaluate the effects of three PRFM treatments spaced 1 month apart, then analysed the effects of superficial dermal stimulation and augmentation using 20 MHz ultrasound measurements. Treatments were administered to the nasolabial folds, tear trough, and cheeks, with significant preliminary results in skin thickness and neocollagenesis after only one treatment (Figures 5 and 6).

In a separate analysis to evaluate the effect of PRP on the tear trough, Katz32 studied the effects of treatment on 10 patients using Selphyl® (Aesthetic Factors LLC, Bethlehem, PA, US) injections at baseline in all patients and again at 6 weeks for half of the patient group. Quantificare 3D imaging technology (San Mateo, CA, US) was then used to assess treatment results (Figure 7).

The author of the present article also assessed hypervascularisation in patients following treatment with PRP/PRFM. In this instance, confocal laser microscopy (CLM) was used to assess the results, comprising a laser beam in the near infrared range with a lens system and bean splitter on the area of the skin to be examined. Light is reflected by the different components of the tissue and captured by the microscope to generate an image. The patient received one PRFM treatment using the meso technique (i.e. micropapular intradermal injections) to the marionette line, and was analysed with CLM immediately after treatment. Blood flow is immediately increased, resulting in the hypervascularisation of the injected dermal tissue, which in turn increases blood supply and consecutively the supply of growth factors.

Figure 7 Tear trough depth after PRP injection

Figure 7 Tear trough depth after PRP injection

Hypervascularisation to the fat has also been found in investigations using the Selphyl product. In one 37-year-old female scheduled for an avelar lift, four treatments to the abdominal pannus with fat alone and fat with an increasing ratio of PRFM were histologically evaluated at 6 weeks post-treatment and showed increased vascularity with PRFM (assessed using CD34 Staining)33.

Conclusions

Figure 8 Capillary dermis before injection

Figure 8 Capillary dermis before injection

PRP and its mechanism of action have been proven to have a significant impact on the clinical aspects of aesthetic treatment. The removal of white and red blood cells from the formulation is desirable, and the anti‑coagulation process shouldn’t lower the pH. The controlled activation of treatment builds up a scaffold for the platelets, but a low variation in platelet recovery efficiency is also desirable.

Recent clinical studies with PRFM have proven reproducible superficial dermal stimulation and augmentation29–33, and the immediate and long-term hypervascularisation. However, more research is needed in this area of aesthetic medicine to fully study the role and mechanism of action surrounding the use of PRP.