REVIVAL PRP® for Skin Rejuvenation
WHAT IS REVIVAL PRP®?
REVIVAL PRP® is an Advanced Separator Gel-based, easy to use, sterile system that is used to prepare PRP in a safe and effective manner to accelerate the body’s own natural healing process.
PRP is used in various medical applications including tissue enhancement, treatment of tissue and cell regeneration, rejuvenation, reconstruction and for general healing and repair in various fields of medicine. PRP is indicated for the acceleration of bone and tissue healing in the following areas:
THE SKIN AGING PROCESS
The skin is a thin layer of tissue forming the natural outer covering of the body of a person or animal.
It is the body’s largest organ and protects against heat, radiation, physical damage, infection, chemical poisoning and/or fluid loss
With time, the skin regenerative capacity decreases, leading to changes in its function and appearance. Skin disorders can be caused by many conditions, including: blood vessel diseases, diabetes, heart disease, liver disease, nutritional deficiencies, obesity or reactions to medicines.
Aging of human skin results from a combination of intrinsic and extrinsic factors:
- Intrinsic aging: A gradual decline in function over time
- Extrinsic aging: Cumulative damage caused by environmental factors (i.e. smoking, exposure to chemicals and ultraviolet B (UVB) radiation
In skin continually exposed to sunlight without proper protection, UVB induces collagen degeneration and altered deposition of elastic tissue
This results in the impairment of the structural integrity of the dermal extracellular matrix, causing the skin to wrinkle.
- Provide more permanent results
- Longer recovery times
- Temporary results
- Shorter recovery times
Laser Resurfacing: A skin resurfacing procedure that uses a laser to improve the appearance of the skin or treat minor facial flaws by removing layers of skin.
Radio-frequency Skin Tightening: Uses RF energy to heat tissue and stimulate subdermal collagen production in order to reduce the appearance of fine lines and loose skin. This technique induces tissue remodeling and production of new collagen and elastin.
Mesotherapy: Mesotherapy treatments involve injecting Hyaluronic Acid and/or vitamins directly into the middle layer of the skin (mesoderm). This nourishes and rejuvenates the skin by promoting the production of collagen and elastin and stimulates the skin’s metabolism.
Microneedling: Also known as collagen induction therapy, involves using fine needles to create hundreds of tiny, invisible puncture wounds in the top layer of skin.
Filler injections: When injected under the skin, a filler raises or puffs up that specific area. Fillers are used to smooth wrinkles or pitted scars in the skin, usually on the face. They are also used to make the lips fuller.
There are many kinds of injectable fillers, including:
- Hyaluronic acid (Restylane, Juvederm, Captique)
- Bovine collagen (Zyplast, Zyderm)
- Autologous fat cells
- Biodegradable polymer (Sculptra)
- Calcium hydroxylapatite (Radiesse)
- Microscopic plastic beads and bovine collagen (Artefill)
WHAT IS PRP?
Platelet Rich Plasma (PRP) is a concentration of platelets derived from the patient’s own blood that is above the baseline level and contains several growth factors which stimulate healing.
Platelets are the key components of PRP. They are small anuclear fragments of cytoplasm produced by megakaryocytes in the bone marrow. Platelets affect primary haemostasis, the innate immune response and inflammation, host defences against microorganisms, wound healing and malignancy.
The most basic method to prepare PRP is through centrifugation. The patient’s blood is drawn and centrifuged at varying speeds until it is separated into 3 layers: Platelet Poor Plasma (PPP), Buffy Coat/Platelet Rich Plasma (PRP) and red blood cells.
An effective PRP preparation should have a platelet concentration of 1.5-3 million platelets/µL. It is important to have both an appropriate concentration and the presence of intact platelets with functionality unchanged, so that growth factors are not delivered prior to application. It is also important that a PRP preparation should not contain any Red Blood Cells (RBCs) as this may affect the healing efficacy of the PRP.
The platelets undergo degranulation to release Growth Factors (GFs) with healing properties. The plasma contains cytokines, thrombin, and other GFs with inherent biological and adhesive properties.
Platelet content is also affected by the donor’s gender, with females having a higher concentration than males. GF content however, is not influenced by age or gender. GFs are released after exogenous or endogenous activation. PRP is commonly activated by calcium chloride, thrombin, chitosan and/or batroxobin. Calcium chloride and thrombin are the most common methods of PRP activation.
PRP improves the elasticity and texture of the skin, restoring a more youthful appearance. It can be used to treat:
Also known as the “Vampire Facial”, a PRP procedure takes the regenerative elements from your own blood, concentrates them and re-injects them into the desired area. The results are outstanding and multiple clinical trials support its use in skin rejuvenation
APPLICATIONS OF PRP IN DIFFERENT THERAPEUTIC AREAS
PRP has many different applications over a wide range of therapeutic areas such as Sports and Orthopedics, Dental, Cosmetic Surgery, Esthetics and Dermatology, General Surgery , Chronic Wounds, Ophthalmology, Veterinary
PRP combined with ultra-pulsed fractional CO2 laser had a synergistic effect on PRP therapy for facial rejuvination (Hui et al, 2007). Combined application:
- Effectively reduces facial wrinkles
- Significantly improves skin texture and elasticity
- Relieves coarse pores, pigmentation, and erythema caused by laser therapy.
Other clinical studies have demonstrated that PRP induces the proliferation of new fibroblasts within the first few hours. PRP treatment resulted in notable increased rates of fibroblast migration and also induces the synthesis of collagen fibres that are of higher density and quality.
Early results are promising that PRP placed in the preparation site of a dental implant will promote and accelerate osteointegration. This may be beneficial in the maxilla, in areas of previous failures, in type IV bone, in osteoporotic women, etc.
Platelet Rich Plasma (PRP) is often used to treat a variety of chronic tendon, acute ligament and muscle injuries as well as other conditions such as arthritis and osteoporosis pain.
Athletes of all competition levels are early adopters of novel treatment methods. They are driven to find less invasive methods of injury management and faster means of returning to their sports.
Ligament, muscle and tendon tears are often slow to heal due to inadequate blood supply to these areas. Although PRP can be injected on any muscle or tendon, the following areas are the most common sites:
- Shoulder (rotator cuff)
- Elbow (Lateral or medial Epicondylitis; aka tennis or golfer’s elbow)
- Knee (patellar tendon; aka Jumper’s knee)
- Ankle (Achilles Tendon)
PRP can also be used during surgery to augment healing for ACL reconstruction and rotator cuff repair.
Connective tissues such as ligaments and tendons heal by filling in with scar tissue, which in turn, doesn’t support the pressure of large loads effectively and increases the risk of re-injury. Chronic tendon injuries are related to degeneration of the tendon tissue. Traditional forms of therapy do not necessarily improve the tendon’s ability to create new tissue and heal in the same way PRP does.
Platelets release bioactive proteins and growth factors which enhance tissue regeneration and healing. New tendon cells called tenocytes start to develop in the treated area. Cartilage cells called chondrocytes form when PRP is injected into damaged cartilage. There is also an increase in the number of growth factors in the treated area as well as a build-up of Type 1 collagen fibers, which constitute the base structure of tendon tissue. PRP has been demonstrated to shorten recovery time, decrease pain and improve performance in the injured area
- Many high-profile athletes are also taking advantage of the benefits that PRP offers:
- Kobe Bryant of the LA Lakers received more than three treatments on his knee in the past few years and was able to make a full comeback after serious injury
- Alex Rodrigues of the New York Yankees received multiple PRP treatments for both his left shoulder and right knee
- Peyton Manning (quarterback of the Denver Broncos) had several treatments to help repair ligaments, tissues and alleviate pain in his neck
- Tiger Woods received PRP treatments for his Achilles tendon and both knees after a knee surgery to repair injury.
(News coverage of PRP usage in athletes)
(Pittsburgh Steelers athletes use PRP as an innovative injury treatment)
Some common orthopedic indications for which PRP is used are listed below:
- Tendinopathies (refers to a degenerative condition of tendons characterized by the chronic loss of collagen, stability, strength and tissue integrity possibly caused by natural aging, injury, repetitive stress, and/or neural, vascular and hormonal inputs)
- Ligament Sprains
- Muscle Strains
- Joints (i.e. osteoarthritis; a chronic degenerative disease of hyaline cartilage)
PRP can be effective for many cases of osteoarthritis as repairing the damage has posed a great challenge due to its regenerative limitations. Platelets and other elements within the blood help tendons and ligaments heal by stimulating a repair and growth response that accelerates the process of developing new tissue. However, the tendons and ligaments do not receive a rich blood supply containing these factors which is why they often take a significant amount of time to heal. PRP stimulates healing of cartilage and reduces pain and disability by delivering these factors directly to the site of injury. Areas of treatment can include knee, hip, shoulder and ankle.
With age, the cartilage lining the joints can shrink and wear thin causing friction between the bones. Bone spurs and inflammation can gradually enlarge the joint leading to the pain and dysfunction of arthritis.
Damages to the cartilage have been treated by cortisone and HA injections, micro fracture, debridement and grafting procedures. The results obtained by these techniques are so far unsatisfactory and in most cases, result in the formation of fibrous connective tissue with minimal mechanical strength at the affected area.
Not only does PRP stimulate cellular activity and the process of regeneration and repair, it also improves bone and cartilage recovery, as well as reduce inflammation and pain which could potentially inhibit the deteriorating effects of age and slow the progression of arthritis.
The primary goal of PRP is to resolve pain through healing, therefore, it could prove to have lasting results. Initial improvement may be seen within a few weeks and gradually increase as healing progresses. Research studies and clinical practice have demonstrated PRP injections to be very effective at relieving pain and returning patients to their normal lives.
Ultrasound and MRI imaging have both shown definitive tissue repair after PRP therapy thereby confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses to an irreversible condition.
Platelet rich plasma contains the bioactive proteins which act as the catalyst for accelerating the wound healing process. With the increased level of growth factors present in PRP, the tissue maturation phase is accelerated and the overall healing process is significantly improved in terms of post-operative pain, swelling, infection and establishment of tissue texture, colour and contour. PRP’s cohesive nature and its hemostatic properties also allow for minimal bleeding.
Growth factors found in PRP permit accelerated tissue regeneration. It can be used to treat corneal lesions and dystrophy, superficial punctuate keratitis, severe dry eye-related ocular surface disorders, ocular GvHD, recurrent erosion syndrome, neurotrophic keratopathy, keratopathy with loss of epithelial-stromal tissue resulting from chemical or physical traumas, sicca syndrome and/or Sjögren’s syndrome.
It also provides nutritional factors necessary to maintain cellular feasibility in the epithelial repair process while reducing the risk of contamination and infection.
Can Platelet-rich Plasma be Used for Skin Rejuvenation?
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Kim and colleagues in 2011, investigated the effects of activated platelet-rich plasma (aPRP) and activated platelet-poor plasma (aPPP) on 2 essential processes for rejuvenation of aged skin: the remodelling of the extracellular matrix, and the activation of dermal fibroblasts. The effects of aPRP and aPPP on cell proliferation and matrix protein synthesis were measured by incorporation assays and quantification of collagen synthesis, two key indicators that regeneration effect is taking process. They found that aPRP and aPPP both stimulated cell proliferation, and matrix protein synthesis. Additionally, aPRP and aPPP increased the expression of type I collagen, MMP-1 protein, and human dermal fibroblasts proliferation, concluding that aPRP and aPPP promote tissue remodelling in aged skin and may be used for skin rejuvenation in cosmetic dermatology.
PRP Combined with Fractional Laser Therapy for Skin Rejuvenation
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Shin and colleagues in 2012, conducted a study to determine the additional effects of PRP combined with laser therapy in skin rejuvenation compared to laser therapy alone. The patients in the study received three sessions of fractional laser; and half of them were treated with topical application of PRP combined with fractional laser. Evaluations were done by dermatologists at the beginning and at the end of the treatment in a blinded clinical assessment, also skin biopsies were taken to measure the levels of skin roughness, elasticity, hydration, and redness; and finally, the patient satisfaction was measured with a subjective scale. The researchers found that PRP combined with laser increased patient satisfaction and skin elasticity while decreased the skin redness. PRP also increased the amount of collagen, and the number of fibroblasts in the treated area, essential for skin rejuvenation. Based on this finding, they concluded that PRP with laser treatment is a good combination therapy for skin rejuvenation, explained by the capacity of PRP to increase dermal elasticity, by increasing the fibroblast proliferation and collagen production.
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PRP for Facial Rejuvenation
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FREQUENTLY ASKED QUESTIONS
PRP can address many cosmetic concerns, particularly in those skin areas where other non-surgical options can not deliver the desired natural results. PRP can:
- Significantly improve the texture of your skin
- Reduce the size and depth of wrinkles and fine lines
- Treat acne scars, stretch marks
- Add volume to the face, hands, neck, and décolleté (upper chest)
- Be safely used around and below the eyes, and around the mouth
Patients should always be evaluated by a healthcare professional to ensure that they are in good overall health and can receive PRP therapy. The practitioner will also ensure that the patient understands what a facial rejuvenation procedure will realistically deliver.
REVIVAL PRP® may be used alone, or as part of a comprehensive skin renewal strategy to maximize the regenerative effect. These other treatments include but are not limited to:
- Laser therapy
- Chemical peels
- Botulinum toxin (Botox)
- Dermal fillers
PRP is contraindicated in patients who are anaemic and/or have a low count of platelets. Other potential contraindications include:
- Abnormal or unstable blood pressure
- Low circulating blood volume
- Cardiac blood flow restriction (e.g. unstable angina)
- Local or generalized infections
- Blood thinning or clot dissolving therapies
Do not use nonsteroidal anti-inflammatory drugs (NSAIDs) 48 hours before and after the therapy.
No, REVIVAL PRP® is formulated with an Advanced Separator Gel that acts as a physical separation barrier which traps cells that induce inflammation such as the granulocytes below the separator gel. This results in accessible plasma which is rich in platelets and growth factors but almost completely depleted of non-desirable inflammatory cells.
Clinicians do not want red or white cells that cause bruising and inflammation which delays the healing process of the skin. For this reason, the REVIVAL PRP® separator system is ideal for esthetic procedures.