Platelet Preparations for Use in Facial Rejuvenation and Wound Healing: A Critical Review of Current Literature

Abstract

In facial plastic surgery, the potential for direct delivery of growth factors from platelet preparations has been of particular interest for use in facial rejuvenation, recovery after facial surgery, and wound healing. A literature search was conducted through PubMed for the terms PRP, PRFM, platelet-rich plasma, platelet-rich fibrin matrix, platelet preparations, platelet therapy, growth factors, platelet facial, platelet facial rejuvenation, platelet wound healing, platelet plastic surgery. Articles pertaining to the use of platelet preparations in facial surgery and wound healing in plastic surgery after 2001 were included. Thirteen in vitro studies showed use of platelet-rich plasma (PRP) and platelet-rich fibrin matrix (PRFM) had a significant effect on cellular activity. Twenty-four out of 28 animal studies exhibited favorable results with use of a platelet preparation, including five of six studies that showed enhanced fat graft survival with addition of a platelet preparation. Twenty-three case series and clinical trials were identified, only two of which showed no differences. Twenty-one reported favorable results with use of various platelet preparations. A total of 47 studies used PRP, four studies evaluated Leukocyte-rich PRP, and fourteen studies used PRFM. The vast majority of studies examined show a significant and measurable effect on cellular changes, wound healing, and facial esthetic outcomes with use of platelet preparations, both topical and injectable. One must also consider possible publication bias against null results that may have had an influence on the data that were available for review. However, the preponderance of studies suggests that platelet preparations might represent an as-of-yet untapped adjunct in facial plastic surgery.

A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification

“…More recently, the interest in the application of PRP in dermatology; i.e., in tissue regeneration, wound healing, scar revision, skin rejuvenating effects, and alopecia, has increased [1,6,7,8,9,10,11,12,13,14]. …”

Fat, Stem Cells, and Platelet-Rich Plasma

“…72,73 PRP may also have applications for hair regrowth. A double-blind placebo-controlled randomized controlled trial found that PRP was able to significantly improve hair regrowth in alopecia areata better than either placebo or steroid cream.…”

Use of platelet‐rich plasma to facilitate wound healing

“…Disregarding the fact that there are plenty of positive clinical studies that reaffirm the positive effect of PRP on healing processes, there are a number of studies where the authors have concluded that there are no substantial differences between two groups under analysis and indicated limited efficiency of plasma or no differences in the speed of wound healing in compared groups, which points to the fact that more in‐depth research is required in this area. According to various studies under review, there are a number of inconclusive results of the use of PRP in maxillofacial surgical interventions, especially in bone surgeries .…”