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PRP therapy, also known as autologous rejuvenation therapy, continues to enjoy growing popularity. The American Society of Plastic Surgeons has been following this procedure since 2015 and reported in its last Plastic Surgery Statistics Report from 2020 an awesome increase by 130% in the annual number of PRP treatments in the US in the last five years. The increase, as is also the case with many beauty treatments, is mainly due to the popularity of cosmetic treatment among Hollywood divas - above all Kim Kardashian.
Despite a lack of standardized protocols for PRP preparation and of extensive follow-up studies to verify the long-term efficacy of the new method in probands, there is convincing experimental evidence of the positive effects of this therapy on skin rejuvenation, hair growth, wound healing and engraftment of autologous fat. However, given the abundance of information about this therapy and its possible applications, it is not easy to understand the full extent of its benefits, disadvantages and limitations. What is the treatment really about? How does it work?
In this therapy, platelet-rich plasma is extracted from the patient's own blood by means of special PRP tubes and injected into the treatment area in a processed form. PRP tubes are used for the preparation of PRP using different centrifugation methods. In all of these methods, a small of the patient's blood is separated into single components. The red blood cells are removed and the remaining liquid portion of the blood (plasma) then has a high concentration of platelets. Platelets or thrombocytes are blood cells that play a key role in blood clotting. In the case of tissue damage, thrombocytes accumulate at the diseased area, triggering a cascade of events that lead to the stopping of bleeding and healing of the wound. Thrombocytes release over 30 growth factors and other biologically active proteins, which stimulate, among other things, the neoformation of blood vessels and tissue growth. This mixture of natural growth factors is very likely to lead to the wide range of therapeutic effects reported in connection with PRP therapy.
Originally used to treat skin diseases and to promote bone graft healing, PRP is increasingly used in various surgical specialties, including plastic surgery. In the United States alone, more than 275 thousand minimally invasive cosmetic procedures have been performed, according to the 2019 Statistics Report, published annually by the American Society of Plastic Surgeons. PRP is exceedingly attractive for plastic surgery thanks to many of its properties: It can be produced easily and cost-effectively from the patient's own blood and has little or almost no risk of adverse effects. However, PRP use, especially for cosmetic purposes, can be time-consuming and require multiple treatments. Dr. Edward Chamata et al. from the Baylor College of Medicine in Houston recently published a review, providing a row of clues to promising PRP applications in four key areas:
Facial skin rejuvenation – Vampire facelift is a relatively new anti-aging procedure for rejuvenating the facial skin and reducing wrinkles. In the classic layout, PRP, optionally enriched with additional active ingredients, is injected under the skin. Another efficient way of bringing PRP into the skin has recently emerged and makes uses microneedling with subsequent topical application of PRP in the form of a cream. According to some recent studies, microneedling should increase collagen production, skin tightening and rejuvenation processes. Microneedling in combination with PRP has also proved to be a good treatment strategy for atrophic acne scars and skin pigmentation disorders.
Hair growth – PRP therapy alone or as a supplementary therapy for hair transplantation is used to stimulate the growth of the cells of the dermal papilla, which act in the skin as the control center of hair growth and hair follicle respectively, and is equally effective in stimulating hair growth for both men and women. According to the study, the growth factors and interactions between the dermal papilla and primitive stem cells activate the proliferative phase of the hair cycle, resulting in the formation and maintenance of hair follicles.
PRP and laser resurfacing therapy – PRP therapy in combination with fractional laser treatment demonstrated excellent therapeutic effects in rejuvenation of the facial skin and in the treatment of acne
scars. The effect of the therapeutic approach is exactly the same as in the case of PRP combination with microneedling: In order to achieve a certain penetration depth for the autologous growth factors and added active ingredients, micropores are created in the skin by means of this special laser. In addition to promoting the healing of target symptoms, the growth factors provided by PRP can also reduce the redness and inflammation caused by laser treatment.
PRP and autologous fat grafting – PRP application with fat grafting, which is used in a wide range of cosmetic and reconstructive procedures, is another expanding therapeutic approach in plastic surgery that improves the supply of fat cells and thus the growth rate of autologous fat. In some studies, even dramatic improvements in skin contour and volume have been reported with PRP application compared to fat grafting alone.