Applications of Platelet-Rich Fibrin Matrix in Facial Plastic Surgery

Director of Facial Plastic Surgery, The New York Eye and Ear Infirmary, New York, New York 10003, USA.
Facial Plastic Surgery (Impact Factor: 0.64). 11/2009; 25(4):270-6. DOI: 10.1055/s-0029-1242033
Source: PubMed


Platelet concentrates enjoyed some clinical popularity in facial plastic surgery several years ago. However, interest waned due to expense, amount of blood required, equipment, space, and staff needed, and lack of clinically significant benefit. A novel, simple method of preparing an autologous platelet derivative (Selphyl; Aesthetic Factors, Princeton, NJ) allows rapid and inexpensive generation of a platelet-rich fibrin matrix (PRFM) that can be used to enhance healing after facial procedures as well as to rejuvenate the face without tissue manipulation. PRFM provides autologous, natural, but concentrated platelet growth factor release and stimulation of surrounding tissue. This article describes its use for cosmetic facial applications.

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    • "At present, however, no study has used bioluminescence imaging (BLI) to evaluate the effect of PRP on VEGFR2. PRP is a rich source of growth factors, has been found effective in accelerating significant tissue repair and regeneration, and releases massive quantities of platelet growth factors [24] [25]. It is a concentration of autologous platelets in a small volume of plasma containing several growth factors including epidermal growth factor (EGF), fibroblast growth factor (FGF), insulin-like growth factor (IGF), keratinocyte growth factor (KGF), platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-b) and vascular endothelial growth factor (VEGF) [26] [27]. "
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    ABSTRACT: To improve skin flap healing, one promising strategy in reconstructive surgery might be to optimize platelet rich plasma (PRP) bioactivity and the ischemia-altered expression of genes. We studied both the effect of PRP on ischemic flaps, and whether in vivo bioluminescence imaging (BLI) is a suitable method for the longitudinal monitoring of angiogenesis in surgical wounds. Axial murine skin flaps were created in four experimental groups. In vivo measurements of VEGFR2 expression levels were made every other day until the 14th day. The local VEGF level and microvessel density were quantified on the 14th day via ELISA and immunohistochemistry, and flap survival rates were measured. We demonstrated that PRP and induced ischemia have a beneficial influence on angiogenesis and flap healing. Combining the two resulted in a significantly robust increase in angiogenesis and flap survival rate that was corroborated by bioluminescence imaging of VEGFR2 activity. This study shows that angiogenic effects of PRP may be potentialized by the stimulus of induced ischemia during free flap harvesting, and thus the two procedures appear to have a synergistic effect on flap healing. This study further demonstrates that BLI of modulated genes in reconstructive surgery is a valuable model for longitudinal in vivo evaluation of angiogenesis.
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    ABSTRACT: Platelet-rich plasma (PRP) is researched and used in many clinical fields as it contains an abundance of various growth factors. Recently, a topical injection of PRP has been clinically tried for treatment of photoageing-related skin wrinkles. Nevertheless, there have been only a few studies including objective data or explaining the mechanisms of PRP. Therefore, the authors performed animal experiments to collect laboratory data and to infer the basal mechanism of the effect of PRP on skin rejuvenation. Mice photoaged by ultraviolet B (UVB) irradiation for 8 weeks were divided into three groups (no-treatment group, saline injected group and PRP-injected group) with 10 mice in each group. After 4 weeks, the degree of wrinkle formation was compared among three groups by replica analysis, and skin biopsies were performed. An additional in vitro assay with growth-factor-neutralising antibodies was performed to evaluate whether growth factors contained in PRP could accelerate fibroblast proliferation and collagen production, which may play a major role in skin rejuvenation. The wrinkles in the PRP-injected group were significantly reduced than in the other groups. Biopsy results indicated that the dermal layer was remarkably thicker in the PRP-injection group. In in vitro assay, fibroblast proliferation and collagen production were increased in the experimental group through growth factors in the PRP. Although more in vivo studies and research about the mechanism of PRP are required, the results of this study indicate that PRP is effective in the rejuvenation of photoaged skin.
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