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PEER-REVIEW | BODY CONTOURING | influencing the initiation and progression of the


normal wound healing process. Such factors coordinate the processes of epithelialisation, angiogenesis, and collagen-matrix formation, the key steps in the wound healing sequence. Growth factors function in paracrine, endocrine, and


autocrine manners in order to guide the dynamic stages of wound healing. No single growth factor appears to maintain a total physiologic task, but instead these peptides work in a coordinated fashion to orchestrate the normal wound healing processes. Besides the initiation of coagulation processes, the


platelets undergo a degranulation process which releases a complex group of growth factors and cytokines (peptides) essential for wound-healing mechanisms. In Table 1, it is possible look at the different actions of


the platelet-derived growth factor over the extracellular matrix and tissue maturation, against the free radicals, and in relation to angiogenesis and epithelisation. PRP under the concentration of the growth factors


PLATELET-DERIVED GROWTH FACTORS


EXTRA CELLULAR MATRIX


PRODUCTION MATURATION TISSUE MITOCHONDRIA ANGIOGENESIS EPITHELISATION


form the basis of the new dermis


components that


Produce and secrete the


Remodels the scar and fibrosis after filler treatment


MMPS TIMP


GAG proteoglycan Fibronectin


Collagen


scavenging enzymes SOD


vitamins and ROS


PRP is rich in antioxidant


Induce the growth of new blood vessels


Restores normal epithelisation


gives a strong and autologous medicine for the fibroblast stimulation, helps the recovery of the ECM, increases the angiogenesis and helps the recovery of the skin with the production of collagen. This is a process of biostimulation and is the main motivation for the PRP. Biostimulation activates the biological functions of the skin with the purpose of optimising its physiology and consequently leading to aesthetic improvement. This is part of the author’s base treatment in all cases of cellulite.


Table 1 Actions of Platelet- Derived Growth Factor (PDGF)


Obtaining PRP There are many kits for obtaining PRP. In the author’s opinion the best kits have gel inside the tubes to allow a perfect separation between blood, white inflammatory cells, and plasma.


Figure 4 Separation of PRP using a cell selector gel


The author’s preferred kit to take PRP are the tubes that have gel inside to allow a perfect separation between blood, white blood cells, and the platelets after a


special centrifugation. They also allow for a larger amount of PRP to be taken.


ANTICOAGULANT


8 ML OF BLOOD + 1 ML


CELL SELECTOR GEL


SELECTOR GEL


CELL CENTRIFUGATION BEFORE CENTRIFUGATION POST The biologically active signal peptides released from local tissue or


5 ML OF PRP


CELLULAR ELEMENTS


BLOOD CELLS


RED


blood products (particularly the platelet fraction) play a critical role in influencing the initiation and progression of the normal wound healing process.


clinical procedures. The amount of the injection is determined by the proximity of the injection site to the site of the pathology34,35


. 46 ❚


Five-stage treatment with mesotherapy Mesotherapy, along with carboxytherapy and manual lymphatic drainage, is recommended by the author as the first step in treating cellulite. The author’s favoured


January/February 2015 | prime-journal.com


Mesotherapy Mesotherapy consists of the introduction of drugs into the superficial subcutaneous skin34


. The injections use minimal amounts of drugs as a complement to routine


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