What is Platelet-Rich Plasma (PRP) Treatment?

PRP is produced from a person’s own blood. It is a concentration of one type of cell, known as platelets, which circulate through the blood and are critical for blood clotting. Platelets and the liquid plasma portion of the blood contain many factors that are essential for the cell recruitment, multiplication and specialization that are required for healing.

After a blood sample is obtained from a patient, the blood is put into a centrifuge, which is a tool that separates the blood into its many components. Platelet-rich plasma can then be collected and treated before it is delivered to an injured area of bone or soft tissue, such as a tendon or ligament.

PRP is given to patients through an injection, and ultrasound guidance can assist in the precise placement of PRP. After the injection, a patient must avoid exercise for a short period of time before beginning a rehabilitation exercise program.

What are the purposes of PRP injections?

Wounds: Doctors  use PRP injections to encourage healing of chronic , non infected wounds.

Acute injuries: Doctors have used PRP injections to treat acute sports injuries, such as pulled hamstring muscles or knee sprains.

Tendon injuries: Tendons are tough, thick bands of tissue that connect muscle to bone. They are usually slow to heal after injury. Doctors have used PRP injections to treat chronic tendon problems, such as tennis elbow, Achilles tendonitis at the ankle, and jumper’s knee, or pain in the patellar tendon in the knee.

Postsurgical repair: Sometimes doctors use PRP injections after surgery to repair a torn tendon (such as a rotator cuff tendon in the shoulder) or ligaments (such as the anterior cruciate ligament, or ACL).

Osteoarthritis: Doctors have injected PRP into the knees of people with osteoarthritis. A 2015 study found that PRP injections were more effective than hyaluronic acid injections (a traditional therapy) for treating osteoarthritis. However, the trial was a small group of 160 people, so larger trials are needed for this to be conclusive.

You are eligible for PRP therapy if:

you are not completely bald and have low-density hair
you do not smoke heavily or drink alcohol frequently
you do not indulge in drugs usage
you do not take blood thinners
you do not suffer from medical conditions such as chronic skin or liver disease, cancer, metabolic disorders, blood disorders such as platelet dysfunction syndrome, thrombocytopenia, hypofibrinogenemia, hemodynamic instability

Here’s what to expect from a typical PRP injection process:

A healthcare professional will draw a sample of your blood. The amount of the sample depends on where the PRP will be injected. For example, the amount of blood taken for injection into the scalp for one study was 20 milliliters. This is slightly larger than one teaspoon.

The blood is placed into a centrifuge. This is a machine that spins around very quickly, causing the blood components to separate. The separation process takes about 15 minutes.

A technologist takes the separated plasma and prepares it for injection into the affected area.

Doctors will often use imaging, such as ultrasound, to pinpoint specific areas for injection, such as the tendon. Your doctor will then inject the PRP into the affected area.

Are there any risks or side effects of (PRP)?

Because PRP involves injecting a substance into the skin, there are potential side effects. PRP is autologous, which means it contains substances that come directly from your own body. This reduces the risks for an allergic reaction that can occur from injecting other medications, such as cortisone or hyaluronic acid. However, there are risks from the injection itself, including:

infection
nerve injuries
pain at the injection site
tissue damage
You should discuss these potential risks with your doctor, as well as the steps your doctor will take to minimize these risks.

What is Fat Grafting?

A fat grafting procedure transfers fat from areas in which you have excess fat, such as the outer thighs, and injects it into areas that may be lacking in volume, such as your face, hands, breasts or buttocks. This safe, long-lasting, well-tolerated procedure produces natural-looking results. Every year, thousands of people undergo successful fat grafting and are pleased with the results.

When to Consider Fat Grafting

If you have facial areas that appear creased and sunken
If you desire more permanent correction than is provided by temporary fillers
If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate your hands and face
For use in breast reconstruction, to fill in contour irregularities or hide obvious signs of breast implants

How do you prepare for Fat Grafting?

Stop smoking at least six weeks before the procedure to avoid poor wound healing and scarring.
Avoid taking aspirin, nonsteroidal anti-inflammatory medications (NSAIDs: Advil, Motrin, Aleve) and vitamins/homeopathic regimens that can increase bleeding.
Regardless of the type of procedure to be performed, hydration is very important before and after for safe recovery.

How is Fat Grafting performed?

Harvesting: You and your surgeon will select a site for fat removal and will inject it with a local anesthetic. Your surgeon will then create a small incision in the area for fat removal and, using a sterile technique, insert a cannula connected to a syringe to carefully extract fat (liposuction).

Purification and transfer: Once enough fat is obtained from the donor area, your surgeon will process it to prepare the fat cells for transfer to small syringes that will be used for fat injection. Purification may require the use of a centrifuge to spin the fat or a filtration process to remove impurities.

Placement: The area designated to receive the graft will then be prepared. Your surgeon will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, a line of fatty tissue parcels is carefully deposited in natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat. Some surgeons recommend massaging the grafted areas to create a satisfactory contour. Others prefer to rely on the placement technique to create the appropriate contour. The surgeon may also place a dressing or bandage over the grafted area.

How will I look and feel immediately following Fat Grafting?

The swelling and bruising during the first week are significant, and you will not be ready to see others socially or professionally.
In the second week the bruising resolves, but you will still have swelling.
There is great improvement in most cases between the seventh and tenth days, but you may still not be ready to go out in public. Most people who have very little time off from work take one week off, including two flanking weekends. Those who can afford two weeks off or more are even better positioned to return to work.
By the third week you will begin to look more like yourself. Careful application of makeup can be helpful in camouflaging any residual signs of swelling or bruising.
Once the swelling recedes, you will be able to appreciate the changes, but subtle swelling may persist for weeks.

What are the potential risks of Fat Grafting?

 

Unpredictable fat graft survival
Adverse reaction to anesthesia
Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
Infection
Changes in sensation
Scarring
Allergic reactions
Damage to underlying structures
Unsatisfactory results that may necessitate additional procedures
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your fat transfer.

Stromal Vascular Fraction (SVF) Injections

It is a minimally invasive surgical procedure that involves not only restoring lost volume in the face and hands, but also sculpting the facial structure to enhance your cheek bones and/or jaw lines, both of which may have diminished with time.

The patient’s own fat is taken from the abdomen, thighs or other areas and one part of this fat tissue is used for the face rejuvenating injections while an another is used to isolate the stromal vascular fraction cells, which include a range of growth factors and stem cells, from the adipose (fat) tissue. Once the cells have undergone the process of isolation, they are injected into the face and/or hands in the same areas that the fat injections have been administered as per your sculpting needs and desires. The SVF cells, via tiny injections may also be placed in areas that did not receive fat, such as the neck and chest for an overall rejuvenation of the skin.

By separating the SVF cells from the fat, a concentration of the regenerative cells can be added to the already injected fat. The benefits of this additional step include a much greater retention of the fat that has been placed as well as longer lasting results. The regenerative effects also improve the tightness, tone and texture of the skin leaving you with a luminous, more supple appearance in 3 to 5 weeks.

How are SVF injections performed?

During the fat grafting procedure, fat is harvested from the donor area by inserting a cannula and suctioning out the fat, similar to liposuction. This is done under local anesthesia to minimize any potential discomfort. The harvested fat is then purified so that only the fat cells are grafted. Once the fat is ready to be placed, it is injected into the targeted area through a cannula until the desired appearance is achieved. Lastly, the SVF cell concentration is injected using a fine needle.

Here’s what to expect after SVF procedure

Patients may experience mild swelling and bruising after the fat grafting procedure, which can be minimized by icing the area. Fat grafts usually last longer than fillers and other volumizing treatments, and are considered safe for most patients since no foreign material is being injected into the body.

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