Facial Fat grafting improvement with PRP

Why PRP & fat ?

Platelet Rich Plasma has been proposed as a promising treatment option in the field of skin care (Abuaf et al. 2016, Cho et al. 2010, Cho et al. 2012, Kim et al. 2011). For a few years, it is successfully used in numerous dermal applications, including alopecia, scar revision (keloid or traumatic scars), acne scars, stretch marks, skin rejuvenation (overall improvement in skin texture and firmness) and dermal augmentation. 

Autologous fat grafting is used extensively in reconstructive and aesthetic plastic surgery for the correction of soft-tissue volume defects. (Luck et al., 2017 ). However, a major limitation of this approach is the variability in the survival of the graft, with resorption rates ranging from 10-90% (Modarressi ,2013). This is thought to be in part due to inadequate vascularization of the transplanted fat tissue resulting in necrosis of the transplanted adipocytes (Smith et al., 2019 ; Modarressi 2013) hypothesized that since PRP is rich in growth factors and other factors involved in neovascularization adding it to fat preparation would provide an appropriate source of nutrients at the early stage of transplantation and contribute to improved survival of the graft.

In addition, PRP may release anti-inflammatory cytokines that prevent degradation of the graft (Seyhan et al., 2015) and PRP factors may enhance the differentiation of preadipocytes to the mature form (Cervelli et al., 2012 ; Kakudo et al ., 2008).

In vivo, adding RegenPRP to fat grafts prior to injection significantly increased adipocyte viability and tissue vascularity in a mouse model (Atashi et al., 2019). These studies show that PRP can improve the outcome of autologous fat transplantation.

Moreover, addition of PRP to fat graft makes the graft safer and simpler to inject, particularly in the peri-orbital region and nose, avoiding granuloma and irregularities.

-Long lasting result when compared to synthetic resorbable products;

-No risk of granuloma or allergic reactions which can be provoked by injection of permanent products;

-A natural consistency ;

-An improvement of cutaneous and subcutaneous trophicity.

9.00 - Theoretical part

I) PRP biology in tissue healing, skin rejuvenation and alopecia:

-Role of plasma and platelet in skin rejuvenation and atrophic scars

-Definition, role of platelet and plasma in dermal applications

-Importance of having a high quality PRP, instruction for use (reproductibility of the procedure, ensure Red Blood Cell depletion, good practice of use and traceability).

-Combination of PRP and Autologous Thrombin as a new treatment option in aesthetics

-How to extract thrombin and how to mix it, in good proportion, with A-PRP

-Autologous alternative to classic treatment option for peri-orbital area (discoloration of the julgo-palpebral fissure…)

Involvement of A-PRP in alopecia

-Evidence of A-PRP efficacy on acute and chronic AA

Involvment of A-PRP during hair transplant procedures

Dermal and alopecia applications

Area to treat: peri-orbital area, superficial wrinkles, tear trough, decolete, neck

Alopecia applications

II) Involvement of A-PRP in fibroblast and Adipose Derived Mesenchymal Stem Cells proliferation (ADSC):

impact of A-PRP in fat grafting

III) Clinical assessments and Literature Search concerning A-PRP in dermal applications and fat grafting

Clinical background, current knowledge, state of the art

Pathophysiology of skin aging and acne scars

Current therapeutic options

Clinical relevance of A-PRP for the treatment of skin defects such as atrophic acne scar treatment and fat grafting improvement

Examples of Clinical Cases

References

13.00 - Practical part

Hands-on training under the surveillance of leading specialist. Fat grafting and different injections techniques.

-Dermal and aesthetics injections technics:

Injections of A-PRP in deep dermis (point by point)

- Superficial injections of A-PRP in the face (micro-needling)

-Peri-orbital injections ofthe combination of PRP and Autologous Thrombin

- Face fat-grafting with PRP