PRP Facelift: A Guide Through the Pros and Cons

A facelift, or rhytidectomy, is a procedure in aesthetic medicine that aims to mitigate the manifestations of facial aging through the repositioning and reshaping of facial and neck skin and, in some instances, the underlying musculature. This intervention primarily addresses skin laxity, wrinkles, and folds, with the ultimate objective of promoting a more youthful appearance.

In this context, platelet-rich plasma (PRP) therapy emerges as an innovative approach within the domain of aesthetics. Leveraging the patient's autologous platelets to stimulate collagen production and cellular health [1], PRP therapy proposes a less invasive alternative with a focus on enhancing skin texture and volume.

Understanding Platelet Rich Plasma Therapy

PRP therapy is based on the autologous utilization of platelets, crucial components of blood integral to healing processes and tissue response to injury. This modality exploits the concentrated presence of platelets, harvested from the patient’s own blood, to potentially amplify the body's natural response mechanisms.

PRP Preparation

The methodology for preparing PRP commences with venipuncture to collect the patient's blood, which is then subjected to centrifugation. This process separates the blood into distinct layers, including red blood cells, platelet-poor plasma, and the buffy coat, which is rich in platelets. The buffy coat is further processed to enhance platelet concentration.

Mechanisms of Action

• PRP can influence the production of collagen and elastin, which are crucial for maintaining the structural integrity and elasticity of the skin [2].
• PRP is suggested to promote angiogenesis, the development of new blood vessels [3].
• Through the stimulation of collagen and elastin production as well as angiogenesis, PRP therapy may impact skin quality and texture [4].
• PRP's role extends into other areas of medicine where enhancement of the body's natural tissue response is desirable, including orthopedics and dentistry [5][6].

PRP Facelift Procedures: Techniques and Considerations

Techniques for PRP Facelift Procedures

PRP facelift techniques are characterized by the strategic administration of platelet-rich plasma into targeted areas of the face. The procedure involves precise injections at varying depths and volumes, tailored to address specific aesthetic concerns. Injection sites are typically chosen based on areas that would benefit from increased volume and improved skin quality, such as under-eye hollows, cheeks, and areas with fine lines and wrinkles [7].

Combination Therapies with PRP

Combining PRP with other aesthetic therapies can synergistically enhance outcomes. Hyaluronic acid (HA) fillers are frequently used in conjunction with PRP [8]. Microneedling, another adjunctive technique, creates micro-injuries to the skin, theoretically enhancing the penetration and efficacy of PRP [9].

Considerations for Patient Selection

Ideal candidates are those who are experiencing signs of aging but still retain a degree of skin elasticity. It is crucial for patients to have realistic expectations regarding the outcomes of PRP facelift procedures. Patients with certain medical conditions, such as blood disorders, acute infections, or certain chronic illnesses, may not be suitable candidates for PRP therapy.

Post-treatment Protocol and Potential Side Effects

Following PRP facelift procedures, patients may be advised to avoid strenuous activities and direct sun exposure for a short period of time. Potential side effects include transient redness, swelling, bruising, and tenderness at injection sites, which generally resolve within a few days.

Effectiveness and Safety of The “Vampire Facelift”

One notable investigation documented the clinical outcomes of face and neck revitalization using PRP in a series of 23 patients over three months, revealing satisfactory results with no serious persistent side effects [10]. Another retrospective analysis found that PRP significantly reduced recovery times in facial lipofilling procedures and improved aesthetic outcomes [11]. A double-blinded prospective trial comparing PRP with platelet-rich fibrin (PRF) in combination with fat grafts highlighted a preference for PRF over PRP [12].

Comparing PRP Facelifts to Traditional Techniques

PRP facelifts function both as an adjunct to and an alternative to traditional surgical methods [13].

Ethical Considerations and Patient Communication

Healthcare professionals are urged to base their patient communications and treatment recommendations on the most current, evidence-based information. Informed consent is a critical component of the ethical delivery of PRP facelifts.

Potential Limitations and Risks

PRP therapy is marked by a scarcity of extensive, longitudinal clinical studies. While the instruments and protocols for PRP preparation have received clearance from regulatory entities, specific uses of PRP therapy lack explicit FDA endorsement [14]. Despite PRP's autologous origin, there remains a possibility for adverse effects.

SELPHYL® Disclaimer

Instructions for the use of SELPHYL® can be found here and here.

SELPHYL® has not been approved by the FDA for subcutaneous, submucous, or intradermal injections in aesthetic medicine, and the safety and effectiveness of SELPHYL® for these conditions have not been established.

SELPHYL® is designed to be used for the safe and rapid preparation of autologous platelet-rich plasma (PRP) from a small sample of peripheral blood at the patient's point of care. The PRP is mixed with autograft and/or allograft bone prior to application to a boney defect to improve handling characteristics.

As of the time of writing, SELPHYL® has no known serious, life-threatening, or fatal risks apart from the adverse reactions described above.

SELPHYL® Limitations, Restrictions, Cautions, and Warnings

• Prescription only.
• Do not use the kit if the sterile packaging is damaged or compromised.
• Follow universal safety precautions for blood collection and sharps disposal.
• During blood draw, failure to align and properly seat tubes in the tube holder can result in a loss of vacuum and a loss of blood draw.
• During PRP transfer, failure to align and securely seat tubes simultaneously in assembled blood transfer device tube holders can result in a loss of vacuum and the failure of PRP to transfer to the red-top PRFM tube.
• Do not initiate the transfer of PRP into the red-top PRFM tube until the physician is ready to complete the procedure.
• Do not reuse.

SELPHYL® Contraindications

These are not in FDA-required labeling and are part of SELPHYL®’s clinical evaluation for EU CE requirements.

• Direct connection to a patient’s vascular system of circulating blood volume.
• Other health conditions and diseases may also contraindicate the use of autologous PRP, including but not limited to low platelet count, sepsis, localized infection in the treatment area, anemia, malignancy with hematologic or bony involvement, and anticoagulation therapy.

Conclusion

PRP facelifts present a less invasive option for individuals seeking to address certain aspects of facial aesthetics. Healthcare providers are enjoined to exercise discernment in patient treatment plan selection, ensuring that candidates for PRP treatments and facelifts are chosen based on objective criteria.

About the author: Dr. Ali is a medical professional, journalist, and copywriter, currently partnering with Selphyl® to write medical-related articles.

References

1. Selphyl. About PRFM. Published June 1, 2023.
2. Lei X, Xu P, Cheng B. PRP in Facial Rejuvenation. Aesthetic Plast Surg. 2019;43(2):457–469.
3. Xiao H, et al. PRP in Facial Rejuvenation. Clin Cosmet Investig Dermatol. 2021;14:1697–1724.
4. Tsai YW, et al. PRP Versus PPP for Treating Facial Photoaging. Aesthetic Plast Surg. 2024.
5. Everts PA, et al. PRP in Orthopedic Surgical Medicine. Platelets. 2021;32(2):163–174.
6. Xu J, Gou L, Zhang P, Li H, Qiu S. PRP and regenerative dentistry. Aust Dent J. 2020;65(2):131–142.
7. Chamata ES, et al. PRP in Plastic Surgery. Plast Reconstr Surg. 2021;147(1):219–230.
8. Ulusal BG. PRP and hyaluronic acid for face rejuvenation. J Cosmet Dermatol. 2017;16(1):112–119.
9. Chawla S. Microneedling with PRP vs Vitamin C. J Cutan Aesthet Surg. 2014;7(4):209–212.
10. Redaelli A, Romano D, Marcianó A. Face and neck revitalization with PRP. J Drugs Dermatol. 2010;9(5):466–472.
11. Willemsen JC, et al. PRP recovery time and aesthetic outcome in facial rejuvenation. Aesthetic Plast Surg. 2014;38(5):1057–1063.
12. Keyhan SO, et al. PRF and PRP with fat graft. J Oral Maxillofac Surg. 2013;71(3):610–621.
13. Alam M, et al. PRP Injection for Photoaged Facial Skin. JAMA Dermatol. 2018;154(12):1447–1452.
14. Johns Hopkins Medicine. Platelet-Rich Plasma (PRP) Injections.