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The evolving role of PRP in plastic surgery

Photo by Dr. Alice Pien

Despite a lack of standardized protocols for platelet-rich plasma (PRP) preparation and few large-scale studies, research led by the Baylor College of Medicine found there is sufficient evidence, with objective measurement modalities, to show positive outcomes after treatment for skin rejuvenation, hair regrowth, wound healing and fat graft take.

In the study published in the journal Plastic and Reconstructive Surgery (Jan. 2021; 147(1):219-230), researchers aimed to describe the preparation process of PRP, discuss the proposed science behind PRP regarding its evolving role in hair restoration and facial rejuvenation and highlight the recent literature examining its widespread use.

“PRP has emerged as one of the most desired non-surgical treatments for a range of different cosmetic procedures—although in some cases the claims may exceed the available evidence,” said Dr. Edward Chamata in a press release. Dr. Chamata is a resident physician in the division of plastic surgery at the Baylor College of Medicine in Houston. He is also the lead author of the study.

“Plastic surgeons are on the leading edge of identifying promising uses for PRP—including developing standardized procedures and building a body of evidence for good patient outcomes.”

The study’s authors found that, based on the available literature, there is a therapeutic advantage to the use of PRP as a single treatment modality for alopecia and skin rejuvenation and in approaches combining PRP with laser resurfacing therapy and fat grafting. They also discovered there is a considerable amount of variability in processing, preparation and treatment modalities.

The investigators note that current evidence suggests microneedling can increase collagen production, skin tightening and rejuvenation. Microneedling in conjunction with PRP has also emerged for the treatment of atrophic acne scars and skin pigmentation disorders.

Additionally, PRP increases the proliferation rates of human dermal papilla cells that regulate hair follicle growth. According to the study, through the binding of growth factors as well as interactions between dermal papilla cells and primitive stem cells, activation of the proliferative phase of the hair cycle begins, leading to hair follicle formation and maintenance.

In addition to promoting healing, the growth factors provided by PRP may help to reduce redness and inflammation caused by laser treatments, the researchers found.

“Treatments using PRP show great promise for harnessing the body’s own natural tissue repair processes to help our patients achieve improved form and function,” Dr. Chamata said.

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