Since the 1950s and the discovery of growth factors, as well as the rapid development of aesthetic medicine, the number of studies and their publication has been constantly increasing. Physicians are constantly on the lookout for safe and effective treatments. Thanks to the accumulated knowledge regarding the prasmolifting procedure, they now have at their disposal the most complete, multifunctional and active procedure for skin rejuvenation and anti-aging.
What is platelet-rich plasma
Platelet-Rich Plasma – is the autogenous concentration of human platelets in a small volume of plasma. It is a multidisciplinary procedure, on which there is a large body of literature in the field of cosmetic surgery, as well as oral implantology, ophthalmology, orthopedics and sports medicine.
Plasma, which is 55% blood fluid, is mostly water (90% by volume), and also contains dilute proteins, glucose, mineral ions, hormones, carbon dioxide (plasma is the transport medium for waste products), platelets, and the blood cells themselves. It represents the concentration of platelets, as well as the seven major protein growth factors that platelets actively produce for wound healing. These growth factors include three isomers of platelet-derived growth factor. All of these growth factors exist in platelets, but platelets need to be activated. Once activated, they release alpha granules that store these growth factors.
In addition to this, activated platelets have a large number of signaling molecules on their surface: CD9, CD-W17, CD41, CD42a-d, CD51, CD-W60, CD61, CD62P, CD63. Because these concentrated platelets are contained in a small volume of plasma, platelet-rich plasma – it is more than just a platelet concentrate; it also contains three blood proteins that act as cell adhesion molecules for osteoconduction and as a matrix for bone, connective tissue, and epithelial movement. Such cell adhesion molecules are fibrins, fibronectins and vitronectins.
Origin, structure and distribution of platelets
Platelets – These are cytosolic fragments of megakaryocytes (a type of white blood cell) that form in the bone marrow, are round or oval in shape, and are approximately 2 microns in diameter. They have a three-layered shell with a glycoprotein receptor on it and partially associated with a double layer of phospholipids and cholesterol.
Platelets do not have a nucleus but they contain organelles and structures such as mitochondria, microtubules and granules (α, δ and λ). There are approximately 50 – 80 alpha granules per platelet, each bound by an elementary membrane and formed during megakaryocyte maturation. Granules in diameter are approximately 200 – 500 nm and contain more than 30 biologically active proteins, many of which play a major role in hemostasis and/or tissue healing.
Preparation of platelet-rich plasma
What is Plasmolifting?
The processes of tissue regeneration are natural, but with age they slow down and do not work at full strength. However, they can be helped. For the first time, plasma with a high platelet count was used for this back in the 70s. the last century. It was then that in the laboratory it was proved that such plasma has a positive effect on the condition of the skin, hair follicles, bones and joints.
Platelets actively secrete growth factors — substances that stimulate cell division. In addition, platelets tend to accumulate around problem areas in tissues, so that the action of growth factors becomes directed.
Plasmolifting uses the patient's own blood. The drug is made from 45-60 ml of venous blood, from which platelet-rich plasma is extracted by centrifugation. Injections of the resulting drug into problem areas can reduce wrinkles, restore skin elasticity and radiance, correct flaws (pigmentation spots, decreased tone and dull skin color, acne and post-acne), restore hairline. The procedure is painless, performed without anesthesia and lasts only about 1 hour.
Important to know! Plasmolifting and autohemotherapy should not be confused. Autohemotherapy involves the intramuscular injection of the patient's own whole blood taken from a vein. It is intended to raise nonspecific immunity, is used in the treatment of a number of diseases. Plasmolifting — cosmetic procedure, injections are made intradermally.
To achieve a lasting effect, course treatment is prescribed, on average, 3–4 procedures are required at intervals of 7–10 days, specific terms are determined individually.
Procedure specifics.
A small volume of blood (ideally 20 ml) is taken from the patient's vein and placed in the correct size tube for centrifugation. The concentration of platelets (growth factors) will depend on:
- total amount of blood used;
- platelet recovery efficiency;
- final volume of plasma containing platelets.
For these reasons, for acceleration homogenization, which is important for liquid self-activation, it is better to work with wide and short tubes. It is important to choose a factor concentration less than 4 so that the final concentration is not too high, which would be harmful due to the high risk of self-activation (premature). Self-activation in such cases is the result of an increase in the concentration and accumulation of platelets that follows their physical proximity.
The results obtained by systems using double centrifugation are similar to the results of single centrifugation, however, injections are more painful and prone to inflammation due to the ratio of platelets, leukocytes and plasma, as well as due to more processes. Moreover, even if the required concentration is higher, the risk of self-activation will increase.
PRP contains a large amount of cellular microparticles, including annexin V+ microparticles, which are lost to a certain extent during double centrifugation of PRP.
It is well known that the wound healing process is complex and is generally divided into three stages: inflammatory, repair and remodeling. Fragmentation of platelets during processing should be avoided, as this results in the completion of the tertiary structure of some secretory proteins during the activation process. As a result, such fragmentation during processing can result in the release of high levels of proteins with reduced biological activity.
The integrity of the platelet membrane can be maintained by using low gravitational forces during the centrifugation process. Growth factors produced by activated platelets initiate and modulate wound healing in both soft and hard tissues.
There are a large number of PRP kits, but some of them contain thrombin – obtained from ruminants or humans – and therefore the end product cannot be considered autogenous. Others use a chemical buffer solution to separate plasma and red blood cells and result in no pure PRP. Separation must be physical, not chemical.
Based on Prime magazine.
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