Platelet-rich plasma is a technology on the cusp of being an incredibly useful tool in all kinds of operating rooms. Currently used strategically in orthopedic and pain relief procedures, the blood-derived product continues to show promise the more it is researched, even if it’s promise is still shrouded in scientific ambiguities.
In the aesthetic plastic surgery world, PRP shows a potential to be a valuable tool. Unfortunately the hype, as always, needs to be checked until further evidence verifies the technology’s abilities. Board certified plastic surgeons interviewed for this story describe their own use of and thoughts regarding PRP, and what it might mean for the procedures they perform.
What is PRP?
PRP stands for platelet-rich plasma, a derivative of whole blood. The platelet aspect of blood is best known for it’s importance in clotting blood, as well as containing a collection of proteins known as growth factors. PRP is plasma with more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be ten times greater (or richer) than usual.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. The then increased concentration of platelets is ready for use.
Potential PRP Applications
Although no one knows exactly how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process. Doctors already are using it for:
- Meniscus repairs for knees
- Achilles tendon injuries, including tendonitis
- Arthritis pain in various joints, ranging from the hands to the big toe
To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:
- PRP can be carefully injected into the injured area. For example, with an Achilles injury, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
- PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.
PRP and Plastic Surgery
While PRP therapy use grows in orthopedic specialities, it’s uses across the entire medical field seems promising. Two board certified plastic surgeons in Austin already are hopeful about PRP’s ability to restore hair.
“One of the newer things that we’ve been doing with PRP or platelet rich plasma centers on hair restoration,” says board certified plastic surgeon Dr. Ashley Gordon. Her practice partner, Dr. Dustin Reid, explains how they are using PRP to fight against hair loss. “We take blood from the patient, spin the blood and we’re able to get part of the blood that is just rich in platelets,” Dr. Reid tells The Plastic Surgery Channel. “This plasma has many growth factors in it which we then inject in the scalp, and at the same time we do micro-needling to make microscopic holes for the plasma to go into. This brings that very rich plasma growth factor close to the follicles.”
The PRP injection shows promise in allowing the hair to stay in its growth phase longer, potentially providing stronger hair growth.
While PRP therapy has a promising future, there jury is still out for many. Board certified plastic surgeon Dr. Robert Whitfield believes more research is needed before the technology can be fully embraced and implemented. “It probably will take a little bit more research into what exactly PRP is doing or not doing in a given wound, a given place on the body, or the hair restoration or in a face lift or in another area,” explains Whitfield. “I wouldn’t discount it, but I don’t think we have the science behind it to see exactly what it’s doing.”
PRP’s Promise is Great; Time for Proof
As with all science, the process is typically slow from an initial hypothesis through theoretical validation. PRP exists in a space where proven results are seemingly associated, but not direct enough to fully understand the processes at work. Board certified plastic surgeon Tracy Pfeifer, MD believes there is surely promise in PRP, just that patients should be wary of the hype. Marketing PRP as a fantastic new technology is quite different from augmenting other procedures with a little PRP for potential benefit.
“The hype always accelerates past the science unfortunately, but it is showing promise in a lot of different areas like hair growth or wound healing and joints,” says Dr. Pfeifer. “So I think there is something there and we need to do more research so that we can apply it correctly.”