PRP Alone and with Fat Grafts
Platelet products have been used in Plastic Surgery by Dr. Steven Dominguez since the 1980’s when the Platelet Rich Fibrin Matrix was placed on chronic non-healing wounds, burns, torn ligaments, CSF fluid leaks[i], alopecia, and open wounds with a poor blood supply. The identification, isolation, and activation of the GFs are now used to increase the fat graft uptake, improve aged skin, decrease hyperpigmention (sun spots and melasma), increase scalp hair density, and transiently reduce wrinkles.
Platelets, the fundamental component of primary hemostasis are also an important reservoir of wound healing Growth Factors (GFs)in the body.
Platelet GF are specific proteins stored in the α-granules that when released play an important role in many processes such as coagulation, immune response, angiogenesis and the healing of damaged tissues.
Platelet GFs stimulate chemotaxis, proliferation, and differentiation of adipose stem cells (ASCs) and committed cells during the process of tissue repair and healing. Committed cells are cells that have differentiated, such as fibroblasts, dermis, blood vessel, dormant hair buds, and fat cells.
PRP Growth Factors
The GFs and cytokines released from platelets include platelet-derived growth factors (PDGFs), transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), insulin-like growth factors (IGFs), and fibronectin.
PRP and ADSVF fat transfer
PRP is known to increase the density of the dermis, increase blood vessel and flow to the area, stimulate fibroblast proliferation, decrease melanin production, and activate stem cells. The result is a spongier dermis, and when combined with AMSCGF, an increase in fat graft survival in chronic wounds.
The PRP GF onset of action is immediate with maximal effect at 30 days, which thereafter last 6-12 months.
PRP GFs are injected by Dr. Steven Dominguez alone or combined with AMSCGF into the face, breast, scars, P and O spots, and chronic wound beds.
PRP and Alopecia Treatment
PRP GFs are used in the treatment of alopecia.
Cervelli[ii] reported that PRP GFs induced activation of antiapoptotic regulators, such as the Bcl-2 protein and Akt signalling, prolongs the survival of dermal papilla cells during the hair cycle. In addition, the upregulation of FGF-7/b-catenin signalling pathways with PRP treatment is suggested to stimulate hair growth by inducing follicular stem cell differentiation as well as prolonging the anagen phase of the hair growth cycle.
Kang[iii] et al. reported the clinical efficacy of injection of CD34+ cell-containing PRP preparation for pattern hair loss. In this study, at three months after the first treatment, the patients presented clinical improvement in themean number of hairs, 20.5 ± 17.0%, mean hair thickness, 31.3 ± 30.1%, and mean two-point score, 84.4 ± 51.7%, compared with baseline values. At 6 months, the patients presented clinical improvement in mean hair count, 29.2 ± 17.8%, mean hair thickness, 46.4 ± 37.5%, and mean two-point score, 121.3 ± 66.8%, compared with baseline.
[i] Papay FA; Maggiano H; Dominguez S; Hassenbusch SJ; Levine HL; Lavertu P: Rigid Endoscopic Repair of Paranasal Sinus Cerebrospinal Fluid Fistulas. Laryngoscope 99:ll95-l20l, l989
[ii] Cervelli V, et al. The Effect of Autologous Activated Platelet Rich Plasma (AA-PRP) Injection on Pattern Hair Loss: Clinical and Histomorphometric Evaluation. BioMed Research International. Vol 2014, Article ID 760709, 9 pages. http://dx.doi.org/10.1155/2014/760709
[iii] J.-S. Kang, Z. Zheng, M. J. Choi, S.-H. Lee, D.-Y. Kim, and SB Cho, "The effect of CD34+ cell containing autologous platelet-rich plasma injection on hair pattern loss: a preliminary study." Journal of the European Academy of Dermatology and Venereology vol. 28, no. 1, pp. 72–79, 2014.
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