Platelet Rich Plasma-The Future? Maybe!

I am often asked by patients what I think of Platelet Rich Plasma (PRP) treatment for cosmetic improvement of the face. As an early adopter of this treatment I must confess that as a stand alone treatment I was not convinced that I was achieving all that much benefit for my patients and no longer offer it in that way. Nevertheless other practitioners have success with this treatment so in their hands it seems to work for their patients. My excellent colleague Dr. Naomi has a recent blog on this subject and I link to it here. http://drnaomi.blogspot.com/2011/07/platelet-rich-plasma-facts-interview.html

However I'm pleased to report my observation that admixed with autologous fat harvested for grafting, PRP does appear to significantly improve the graft success and I do believe there is supporting evidence in the medical literature for this benefit. Accordingly I use this combination in most of my fat graft cases.

 

A recent commentary has been published online by US Plastic Surgeon Dr. Barry Eppley and provides another point of view and is reproduced as follows:

 

March 4, 2011

The Vampire Facelift - Cosmetic Application of Platelet-Rich Plasma Concentrates

Author: barryeppley

One new interesting, but unusually named, cosmetic procedure is that of the “Vampire Facelift.” In truth, it is not really a facelift nor is it used by vampires or will make you look like one. The  Vampire Facelift is far less scary and has much more science to it than most science fiction tales. It is based on the more well known and highly popular injectable filler concept.

It works by injecting its magical potion underneath the skin, much like its man made counterparts such as Juvederm or Radiesse. But instead of using a prepackaged synthetic material, the Vampire Facelift (trademarked name by the company Selphyl) uses the patient’s own blood to make the injectable filler. A small amount of blood is first extracted from the patient. Then a device separates the platelet portion from the red blood cells. The concentrated platelets are then combined with the company’s  proprietary synthetic mixture and the composite is now ready for injection. The entire preparation process takes less than ten minutes to complete and can be done in an office setting.

The principle of this approach is that platelets are heavily endowed with growth factors. These potent little growth stimulants can induce the growth of new collagen. Collagen, of course, is what gives skin its fullness and suppleness. The implantation of a concentrated platelet mixture could help rejuvenate thin and aging tissues and overlying skin…in theory. It is also appealing to patients in that it is an organic approach to rejuvenation using one’s own tissues to help repair itself.

While this cosmetic application of a platelet concentrate is new, the concept is not. PRP (platelet-rich plasma) concentrates have enjoyed widespread use in healthcare in the past decade, particular in orthopedic and musculoskeletal medicine. Numerous companies have PRP technology and application devices. What makes Selphy unique is that they have made a more simple in-office device at a low cost, which are the requirements needed if cosmetic use will gain any popularity.

While the Vampire facelift (perhaps better understood as a PRP filler) treatment sounds intriguing, it is not known if it will last any longer than that of off-the-shelf injectable fillers. The theory is biologically appealing but whether it actually works has not been conclusively shown. I commonly mix PRP concentrates with fat injections with the theory that the platelets may stimulate better fat preservation or stem cell conversion into adipocytes and/or fibroblasts. This is employing the identical approach but with a different substrate. Time will tell if these biologic injectable mixtures will live up to their theoretical benefits.  

Dr. Barry Eppley

www.eppleyplasticsurgery.com

Indianapolis, Indiana