Platelet-Rich Plasma: Evolving Role in Plastic Surgery

Abstract

Background: The use of platelet-rich plasma has emerged as one of the most desired nonsurgical treatments for facial rejuvenation and hair restoration. It has grown to encompass a wide variety of applications within the field of plastic surgery, including its use in combination with microneedling, laser, and fat-grafting procedures. Methods: In this article, the authors aim to (1) describe the preparation process of platelet-rich plasma; (2) discuss the proposed science behind platelet-rich plasma with regard to its evolving role in hair restoration and facial rejuvenation; and (3) highlight the recent literature examining its widespread use. Results: Based on the available literature, there is a therapeutic advantage to the use of platelet-rich plasma as a single treatment modality for alopecia and skin rejuvenation and in combination with laser skin treatment and fat grafting. There is, however, a considerable amount of variability in the processing, preparation, and treatment modalities. Conclusions: Despite a lack of standardized protocols for platelet-rich plasma preparation and a scarcity of large-scale studies with long-term follow-up, there is convincing evidence with objective measurement modalities that display positive outcomes after treatment for skin rejuvenation, hair regrowth, wound healing, and fat graft take.

Efficacy and Safety of Autologous Platelet Concentrate in the Treatment of Photoaging on the Back of the Hands

“…In response to tissue and vascular damage, a platelet plug is formed, with the subsequent release from its alpha granules of more than 30 biologically active proteins, including: transforming growth factor β, platelet-derived factor, growth factor, vascular endothelial growth factor, fibroblast growth factor, and epithelial cell growth factor. These factors not only aid in clotting but also drive angiogenesis and promote tissue repair and regeneration [10]. Multiple authors have shown that topical application or intradermal injection of PRP and its growth factors produce favorable cutaneous changes: clinical (restores its vitality, increases its thickness, recovers its elastic consistency, improves blood circulation, increases its smoothness, decreases its wrinkles and improves their appearance) [2,10,11] histopathological (increases the number of fibroblasts, collagen fibers and blood vessel basement membranes) [2,10,12] immunohistochemical (improves collagen expression type I, III and IV) [13][14][15] and the genetic material (through the polymerase chain reaction expression of three target genes, such as: collagen IA, matrix metalloproteinase gene 1 and protein rich in proline of keratinocytes) [13,14].…”

“…These factors not only aid in clotting but also drive angiogenesis and promote tissue repair and regeneration [10]. Multiple authors have shown that topical application or intradermal injection of PRP and its growth factors produce favorable cutaneous changes: clinical (restores its vitality, increases its thickness, recovers its elastic consistency, improves blood circulation, increases its smoothness, decreases its wrinkles and improves their appearance) [2,10,11] histopathological (increases the number of fibroblasts, collagen fibers and blood vessel basement membranes) [2,10,12] immunohistochemical (improves collagen expression type I, III and IV) [13][14][15] and the genetic material (through the polymerase chain reaction expression of three target genes, such as: collagen IA, matrix metalloproteinase gene 1 and protein rich in proline of keratinocytes) [13,14]. PRP has been used as an adjunct to multiple skin rejuvenation treatments (lipotransference, laser, peeling, lifting).…”

Platelet-Rich Plasma in Plastic Surgery: A Systematic Review

“…The considerable variations in PRP extraction, activation, and frequency of application can lead to significant discrepancies between study results and diminish comparability. Furthermore, the vast majority of the authors did not dis- The issue of high variation in PRP preparation protocols has been addressed on several occasions [3][4][5]. One of the contributing factors is the broad range of suggested classification systems.…”

Efficacy and Safety of Autologous Platelets Concentrate in the Treatment of Crow's Feet Photo Aging

“…Adverse events reported in the reviewed literature are pain, edema, and ecchymosis at the microinjection site [1,2].…”

“…Platelet Rich Plasma (PRP) is an autologous serum that contains high concentrations of platelets and growth factors. These growth factors are responsible for the mitogenesis and differentiation of monocytes, fibroblasts, stem cells, keratinocytes and endothelial cells, as well as inducing cell proliferation, angiogenesis and chemotaxis, in addition to containing serotonin, dopamine, histamine, adenosine and calcium, which increase the permeability of the membrane [1,2]. These qualities have made PRP a versatile therapy in dermatology; however, few studies objectively evaluate its efficacy, which motivated the conduct of the present investigation.…”