PRIME North America Vol. 6 Issue 1

prime-journal.com | January/February 2018 61 “Typical uses for PRF in my clinic include injection under the eyes with a 25 Gauge blunt microcannula, in or above the mucosa of the lip area for volume or vertical lines, microneedle treatments, and hair preservation and restoration.” provider dissatisfaction. Hyaluronic acid by nature attracts water; a property ill desired in the periocular region. Platelet-Rich Fibrin injected through a cannula to form a fibrin clot used as a stand-alone or combined with fillers represents an alternative leading to high patient satisfaction. Formore information, visit: ezprf.com Bibliography 1. BalaramNetal. Roleofplateletrichfibrin inwo undhealing:acriticalreview.JConserv Dentistry2013;(16)4:284–293 2. NishimotoSet.Al.Growthfactor measurementandhistologicalanalysis in PlateletRichFibrin.Apilotstudy. JofMaxillofc OralSurg2015;14(4):907–13. 3. KawazoeT,KimHH.Tissueaugmentation bywhitebloodcell-containingplatelet-rich plasma.CellTransplant2012;21(2-3):601-7 4. NooriA,AshrafiSJ,Vaez-GhaemiR, Hatamian-ZaremiA,andWebsterTJ.Areview offibrinandfibrincompositesforbonetissue engineering.IntJNanomedicine.2017;12: 4937–4961 5. DohanD,DePeppoG,DoglioliP, SammartinoG.Slowreleaseofgrowthfactors andthrombospondin-1 inChoukroun’s platelet-richfibrin(PRF):agoldstandardto achieveforallsurgicalplateletconcentrates technologies.GrowthFactors2009;27(1):63-9 6. RachelJDetal. Incidenceofcomplications andearlyrecurrence in29patientsafterfacial rejuvenationwithbarbedsuture lifting. DermatolSurg2010;36:348–354 7. BalaramNetal. Roleofplateletrichfibrin inwo undhealing:acriticalreview.JConserv Dentistry2013;(16)4:284-293 scaffold not only gives a sustained volume effect but seems to play a role in the longer-term health of the skin and fat in the injected areas 6 . Injections should occur within 10–15 minutes after preparation so the PRF can be injected as a liquid and allowed to clot once activated at the injected tissue site. To date, I have injected almost 500 under eyes with 1.5 cc per side of PRF with extremely high patient satisfaction with PRF alone. Downtime is minimal with an average of 2.5 days of swelling and almost no bruising. Vertical lip lines and lip mucosa are also successful regions for injection all showing reduction in fine lines, some volume enhancement and improved skin texture and radiance. Hyaluronic acid or PLLA (Plasmasculpt™) can be added to the supernatant in specific concentrations for further volume and collagen enhancing effects. With an absence of anticoagulant in the PRF tubes, the working time is reduced once other substances such as these are mixed, but results are excellent with synergistic properties. Typical uses for PRF in my clinic include injection under the eyes with a 25 Gauge blunt microcannula, in or above the mucosa of the lip area for volume or vertical lines, microneedle treatments, and hair preservation and restoration. The under eye is an area of particular interest to me since the majority of patients seeking aesthetic clinics identify it as a priority, and, in many cases, it is a driver to clinics. Outside of surgery, most aesthetic providers use hyaluronic acid fillers to address the area, which are less than ideal with a high rate of patient and Figure 2 (A) Before and (B) after PRF for dark circles in combination with filler. Images courtesy of Anil Rajani, MD Figure 3 (A) Before and (B) after treatment for brown spots and the tear trough. Images courtesy of Anil Rajani, MD

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