PRP (Platelet-Rich Plasma) is a common treatment that is being used extensively in the field of Facial Plastic Surgery for hair loss, facial rejuvenation, and multiple other indications. Perhaps, you have heard of men getting scalp injections for baldness or come across the “Vampire Facial” as popularized in the media. Today, I will focus on the scientific background of PRP and the reasons behind why it works. This will allow you to be informed regarding this treatment option that is becoming increasingly popular. Though we will focus on PRP in this article, I would like to mention that newer options such as PRF (platelet-rich fibrin) are being increasingly studied and may represent an evolution in this area.
PRP (platelet-rich plasma) is an autologous (comes from the patient’s own body) concentration of platelets in a small volume of plasma. Plasma, the liquid component of blood, makes up more than half (55%) of whole blood, followed by red blood cells (45%), and then finally leukocytes and platelets (<1% and part of something called the Buffy Coat). As you can see, platelets are a very small component of whole blood but are extremely important to the healing process. Specific components within platelets called alpha granules contain synthesized and pre-packaged growth factors which are released by initiation of the clotting cascade. This is a normal physiologic process that occurs any time there is an injury to tissue. By concentrating platelets, we are able to concentrate the 7 fundamental protein growth factors in platelets. These include 3 types of platelet-derived growth factor (PDGF), 2 types of transforming growth factors – beta (TGF-B), vascular endothelial growth factor (VEGF), and epithelial growth factor (EGF). In addition, since there is a plasma component to PRP, it contains the 3 proteins in blood which are known to act as adhesion molecules as well as serve as a matrix for cell migration and connective tissue formation. These cell adhesion molecules are fibrin, fibronectin, and vitronectin.
The processing of PRP via centrifugation has been simplified so it can be easily obtained in the office setting or operating room. However, the centrifugation process has to be sterile and has to effectively separate platelets from red blood cells in high enough concentrations to be effective and in such a way that the platelets maintain their integrity and growth factors. There are multiple commercial systems available for this process and differences in the end concentration of effective platelets is really what sets them apart. It is also this variance that tends to differentiate the efficacy of PRP in different studies.
PRP, when delivered in the right concentrations, has been shown to be effective in various fields of medicine including Facial Plastic Surgery. Keep in mind that multiple treatments are often required and there might be required maintenance every year or so to see sustained results. I hope that this post answered some of your questions regarding PRP. Please do not hesitate to contact me either through this website or through social media with any further questions.
Additional Reading
Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489-96.
Marx RE, Carlson ER, Eichstaedt R, et al: Platelet rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:638, 1998
Kevy S, Jacobson M: Preparation of growth factors enriched autologous platelet gel. Proceedings of the 27th Annual Meet- ing of Service Biomaterials, April 2001
Weibrich G, Kleis WKG: Curasan PRP kit vs PCCS PRP system: Collection efficiency and platelet counts of two different meth- ods for the preparation of platelet rich plasma. Clin Oral Im- plant Res 13:437, 2002
