| FACIAL AESTHETICS | PEER-REVIEW regulators, type I collagen and MMP-1, thereby
accelerating the wound healing process. Ablative CO2 fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and oedema, which may affect the daily
lives of patients. Treatment with PRP after ablative CO2 fractional resurfacing enhances recovery of laser- damaged skin and synergistically improves the clinical appearance of acne scarring43, 44
. Significantly faster recovery of TEWL (transepidermal
water loss) was seen on the PRP-treated side. The erythema index and melanin index on the PRP-treated side were lower than on the control side. Biopsy specimens from the PRP-treated side showed thicker collagen bundles than those from the control side. Findings from a histological examination by Sclafani et support the clinical observations of soft-tissue
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augmentation. As early as 7 days post-treatment, activated fibroblasts and new collagen deposition were noted and continued to be evident throughout the course of the study. Development of new blood vessels was noted by day 19; also at this time, intradermal collections of adipocytes and stimulation of subdermal adipocytes were noted. Injection of PRFM into the deep dermis and subdermis of the skin stimulates a number of cellular changes that can be harnessed for use.
Key points
■ Platelet-rich plasma (PRP) is based on the healing and regenerative effects of growth factors in the patient’s own plasma product
■ There are more than 6500 medical publications related to PRP listed on Medline
■ The quality of PRP is definitely linked to specific harvesting kits and preparation protocols
■ PRP is the safest and most versatile treatment in aesthetic medicine (e.g. deep injections, subdermal injections, with or without dermaroller, with or without fractional laser, with needles or cannulas, mixed or not with hyaluronic acid)
Conclusions Since 1950 and the discovery of growth factors, and the fast developments of aesthetic medicine, there have been increasing numbers of research and study publications. As doctors, we are always looking for safe and effective treatments. With the accumulated knowledge on this procedure, we now have the most complete, versatile and active treatment for skin rejuvenation and anti-ageing. Dermal fillers will replace the lost volume that comes
with ageing, and lasers will act on collagen. However, as the facial ageing process involves more than just collagen depletion and gravity, but also bone resorption, with PRP a natural, safe, and efficient treatment is available to act on all aspects of ageing compartments (including bone loss).
Declaration of interest Dr Sister works in private practice,
and is consultant speaker and tutor for Health Technology. This article received no funding source and is written purely from Dr Sister’s experience.
Figure 2 ©Dr Daniel Sister
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