Plastic and Aesthetic Surgery

Biography

Biography: Aaron L Shapiro,

Abstract

Recently Platelet Rich Plasma (PRP) and Platelet Rich Plasma with a Fibrin Matrix (PRFM) have been utilized as stand-alone treatments for rhytids, volume loss and hair loss. Combination therapy with other modalities has yielded superior results in fat transfer, micro-needling treatments and hair transplantation. Platelets have proven to be potent sources of growth factors and contain vascular endothelial growth factors, platelet derived growth factors, epidermal growth factors and fibroblast growth factors among others. These factors are crucial to stimulate endothelial budding, revascularization and new tissue formation. Fibrin is also an essential element, not only in the presentation and release of growth factors but also in providing a matrix upon which the platelets can remain and extend their action. Adding the fibrin matrix ensures the growth factors will remain in place and continue their action over many days. We will review the science of PRP and PRFM including available studies on its efficacy. We have used PRFM with fat transfer to enhance both immediate and long-term results. A histologic case study is presented showing neovascularization and the effectiveness of mixing fat with PRP. PRP has also been utilized in our practice as a volumizer and we review these results and studies on its efficacy. It has been shown to improve the nasolabial fold area, tear trough area and acne scarring. There is widespread use of PRP in combination with micro needling and we will review the improved results that can be attained. Enhancement of hair growth and hair transplantation is another exciting application that is just beginning to gain recognition. We will share our study on serial injections of PRP to the scalp in male and female alopecia as well as for male pattern baldness. We also review the current literature on this exciting new and controversial application.