Efficacy and safety of plasma gel versus platelet-rich plasma in periorbital rejuvenation: a comparative split-face clinical and Antera 3D camera study

Abstract

Background
Periorbital skin is the thinnest. That is why, it is the easiest to wrinkle and the most challenging to rejuvenate. Platelet-rich plasma (PRP) as well as plasma gel have been used for skin rejuvenation and considered relatively safe and effective.

Methods
This split-face study was conducted on forty female patients seeking periorbital rejuvenation where PRP was injected in the right (Rt) side and plasma gel in the left (Lt) side, two treatment sessions 4 weeks apart (week 0 and week 4). Patients were followed up 2 weeks after each treatment session (week 2 and week 6) as well as 12 weeks after the last session (week 16) using both subjective [physician assessment through Global Aesthetic Improvement score (GAIS) and patient’s satisfaction (Likert scale)] and objective [Antera 3D camera] assessment methods.

Results
Both modalities yielded a significant improvement of periorbital wrinkles after the 2nd session, with significantly better results on the plasma gel injected side; however, the improvement achieved through both modalities could not be maintained for the following 3 months. Besides, objective assessment could not prove any improvement in periorbital hyperpigmentation.

Conclusion
Two sessions of both PRP and plasma gel are effective for periorbital rejuvenation, with plasma gel showing significantly better results. However, improvement was not maintained for 3 months.

Full text

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Archives of Dermatological Research (2022) 314:661–671
https://doi.org/10.1007/s00403-021-02270-7
ORIGINAL PAPER
Efficacy andsafety ofplasma gel versusplatelet‑rich plasma
inperiorbital rejuvenation: acomparative split‑face clinical andAntera
3D camera study
HebaM.Diab1· RaniaElhosseiny1· NermeenIbrahimBedair2 · AhmadHamidKhorkhed2
Received: 2 April 2021 / Revised: 11 June 2021 / Accepted: 30 June 2021 / Published online: 6 July 2021
© Springer-Verlag GmbH Germany, part of Springer Nature 2021
Abstract
Background Periorbital skin is the thinnest. That is why, it is the easiest to wrinkle and the most challenging to rejuvenate.
Platelet-rich plasma (PRP) as well as plasma gel have been used for skin rejuvenation and considered relatively safe and
effective.
Methods This split-face study was conducted on forty female patients seeking periorbital rejuvenation where PRP was
injected in the right (Rt) side and plasma gel in the left (Lt) side, two treatment sessions 4weeks apart (week 0 and week
4). Patients were followed up 2weeks after each treatment session (week 2 and week 6) as well as 12weeks after the last
session (week 16) using both subjective [physician assessment through Global Aesthetic Improvement score (GAIS) and
patient’s satisfaction (Likert scale)] and objective [Antera 3D camera] assessment methods.
Results Both modalities yielded a significant improvement of periorbital wrinkles after the 2nd session, with significantly
better results on the plasma gel injected side; however, the improvement achieved through both modalities could not be
maintained for the following 3months. Besides, objective assessment could not prove any improvement in periorbital
hyperpigmentation.
Conclusion Two sessions of both PRP and plasma gel are effective for periorbital rejuvenation, with plasma gel showing
significantly better results. However, improvement was not maintained for 3months.
Keywords Platelet-rich plasma· Periorbital· Wrinkles· Pigmentation· Plasma gel
Background
Being the thinnest skin of the body, mainly because of its
diminished dermis, the eyelid skin is almost transparent
and easily wrinkles [1, 2] The periorbital facial subunit
consists of the eyebrows, upper and lower eyelids, glabellar
region, and pericanthal area. It is one of the first regions to
reveal signs of aging and plays an important role in overall
facial appearance. The aging process is ruled by genetic as
well as environmental factors. Aging skin manifests by the
appearance of coarse and fine rhytides (wrinkles), uneven
texture, dryness, and mottled pigmentation [3, 4]
Hyperpigmentation of the periorbital area can be divided
into primary (idiopathic) that occurs in individuals with
otherwise healthy skin, and secondary types [5]. Second-
ary type may be caused by many etiologic factors such as
familial or ethnic tendency, periorbital edema, and post-
inflammatory hyperpigmentation, caused by atopic or aller-
gic contact dermatitis, medications, and systemic diseases.
Other factors that can be included are fatigue, smoking,
excessive sun exposure, superficial location of vasculature
of the eyelids, tear trough depression, and shadowing due to
laxity of the skin [6, 7]
Platelet-Rich Plasma (PRP), an autologous source of
platelet-derived growth factors, could play a role in skin
rejuvenation. Several hypotheses were suggested for mecha-
nisms of rejuvenation by PRP such as increased prolifera-
tion of human dermal fibroblasts, increased expression of
Matrix Metalloproteinase (MMP-1 and MMP-3), increased
* Nermeen Ibrahim Bedair
nermeen.bedair@med.helwan.edu.eg
1 Department ofDermatology, Veneriology andAndrology,
Faculty ofMedicine, Ain Shams University, Cairo, Egypt
2 Department ofDermatology, Veneriology, Andrology,
Sexual Medicine andSTDs, Faculty ofMedicine, Helwan
University, Cairo, Egypt
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