What is it?
PRP stands for Platelet-Rich Plasma. Platelet-rich plasma (PRP) is prepared from a small amount of blood drawn directly from the patient. After blood is collected, platelets and plasma are extracted using a FDA-approved device designed specifically for this purpose1. Platelet-rich plasma (PRP) is then harvested, because platelets can be beneficial. They contain many biologically active proteins that naturally promote tissue repair2. The resulting product is autologous; this means that it comes from the same individual’s body.
Normal blood contains about 200,000 platelets per microliter. PRP contains about 1.5 million or 1,500,000 platelets per microliter.1
PRP has been used in cardiac surgery, dentistry, sports medicine, veterinary medicine, and most recently for cosmetic medicine.
How does PRP Work for you?
The idea behind PRP is that we are using materials from your “self” to stimulate and enhance your body’s own healing process. We are essentially helping you heal thyself.
Did you know that there are four phases of wound healing (healing cascade)? They are:
Of course, we don’t expect you to remember this, but want to give you an idea of how your body heals itself. The process is ordered and complex.
Platelets contain signaling proteins (cytokines) and a variety of growth factors that help your tissue heal at the site and time of injury. Platelets must be activated for these substances to be released and go to work. Platelet activation occurs automatically if you accidentally cut yourself, or even bruise yourself from bumping into something. The trauma to tiny blood vessels begins a natural cascade of healing events.
Since PRP is extracted with care, the platelets obtained are in their natural inactive state. We add a small amount of anticoagulant (acid citrate dextrose or ACD) to prevent them from clotting.
For the skin rejuvenation procedure, we activate platelets by adding a very small amount of calcium to the PRP preparation. This activation causes the platelets to degranulate and release its growth factors and other bioactive substances. The PRP is then introduced into your skin using fine needle technique in a fashion similar to the way dermal fillers are often injected. Your own skin collagen also helps activate the platelets. An added benefit is that platelets normally function to help stop bleeding, so bruising is usually minimal.
A small amount of trauma to the skin is caused by the procedure, and this is good, because the body will now try to repair the skin via the healing cascade. We enhance the healing process with platelet-rich plasma, and make the skin to heal to a state better it was before the procedure. We can even further enhance the intended trauma with the use of micro-needling or fractional laser resurfacing. The multitude of released growth factors and cytokines helps the skin heal in a variety of ways. We get a locally enhanced immune system response, increased collagen production, fibrin deposition, stimulated cell replication (mitogenesis), improved blood supply to the area (angiogenesis) and enhanced skin rejuvenation at the sites of treatment. A study done by Carter, et al., 2002, examined wounds that were treated with PRP gel. Not only did these wounds show enhanced wound repair, but also more organized collagen when compared to tissue controls.3
“The binding of secreted proteins within a developing fibrin mesh or to the extracellular matrix can create chemotactic gradients favoring the recruitment of stem cells, stimulating cell migration and differentiation, and promoting repair.”2,4
Important platelet-derived growth factors include:
- Connective Tissue Growth Factor (CTGF)
- Platelet Derived Growth Factor (PGDF)
- Transforming Growth Factor-beta (TGF-β)
- Epidermal Growth Factor (EGF)
- Insulin Growth Factor (IGF)
- Basic Fibroblast Growth Factor (BFGF)
- Vascular Endothelial Growth Factor (VEGF)
What Results Should I Expect?
Although the phases of healing and collagen production take months, you can expect to see an improvement in your skin texture and tone within weeks. Patients often say that skin has a “glow,” appears plump and smooth “like a baby’s butt.” They feel better about their skin appearance, and more comfortable not wearing make-up. As with most minimally invasive aesthetic procedures, the cosmetic benefit is cumulative. We recommend a minimum of three PRP treatments performed 6 to 8 weeks apart.
PRP is not a dermal filler, and certainly not a one-to-one volume replacer, but a biologically active stimulator of healing—which includes skin cell proliferation and remodeling. To be clear, there are dermal fillers that contain substances considered to be bio-stimulatory. These currently include Artefill®, Sculptra® and Radiesse®, but these products have different mechanisms of action, and are used primarily to volumize the skin.
How long do results last?
Results vary from person-to-person, depending on age, skin and body health, environmental factors, skin care habits, and whether or not other aesthetic procedures are being received. Consumers now have many minimally invasive procedures to choose from. The use of these procedures in combination show synergy to help us age gracefully, but we nonetheless continue to age as time goes by.
Anecdotally, one might expect to see results last about a year following a recommended series of treatments.
Is it Safe?
We are using your own blood for the procedure, so there is no chance of person-to-person disease transmission. Autologous (patient-derived) PRP has been used for decades in multiple specialties to help facilitate healing. Its safety is well established, and has been documented in a plethora of scientific research articles.
Our doctor uses strict aseptic and sterile technique to obtain a small sample of blood (54 cc) to minimize contamination.
Prior to your treatment, as with all our procedures, we will thoroughly educate you about the procedure and answer any questions you may have.
1We utilize the SmartPREP®2 APC+™ from Harvest Technologies Corp., Plymouth, MA 02360
2Front Biosci. 2008 May 1;13:3532-48.
3Carter, C.A., Jolly, D.G., Worden, C.E., Hendren, D.G., Kane, C.J.M., Plate-rich plasma gel promotes differentiation and regeneration during equine wound healing, Experimental and Molecular Pathology, 74, (2003), 244-255.
4Declair, V., 1999. The importance of growth factors in wound healing. Ostomy Wound Manage. 45, 64-68.
5The bio-stimulatory ingredients for Artefill®, Sculptra® and Radiesse® are polymethylmethacrylate (PMMA), poly-L-lactic acid (PLLA), and calcium hydroxylapatite (CaHA) respectively.