Platelet-Rich Plasma treatments are the latest injectable-based procedures to be used as a catch-all for a seemingly endless slew of aesthetic problems. The combined elements of celebrity endorsement, efficacy doubts, and an increasingly experimental industry have made PRP a hot topic this past year. This "bloody" procedure has seen an ongoing rise of off-label usage ranging from breast lifts to hair restoration and the experimentation will likely persist as we move into 2019.
The PRP Rundown
PRP treatments typically involve a three-step process in which blood is extracted from the patient, spun in a centrifuge, and then the platelet-rich plasma is extracted from that blood and re-injected into the patient's problem area(s). The science behind it states that platelet-rich plasma can help aid in tissue regrowth and repair. This is why it was originally conceived as a viable treatment option for musculoskeletal issues involving damaged ligaments, joints, tendons, and muscles.
Platelets are essentially portions of the blood where growth factors (GF's) are in abundance. GFs are responsible for most of the generation, healing, and general growth that occurs within the body. When blood is spun in the centrifuge, the platelet concentration is increased to anywhere from 5-10 times higher than regular levels. So when that plasma is injected into specific tissues, the GFs get to work and speed up natural regeneration and healing processes.
Debates Over Efficacy
The efficacy of PRP treatments has been contested since its original incarnation and continues to be debated as more off-label and experimental use grows. Most opponents of PRP injections are concerned with the ability of providers to ensure that the platelet-rich plasma is being precisely delivered to the correct tissues and that it's actually being absorbed and utilized by those tissues rather than simply wasted. Other concerns are more generalized and focus on the use of PRP in ways that have not been officially approved or scientifically tested as effective treatment methods.
These are valid concerns with any types of treatments and are especially reasonable when you consider the "miracle" marketing associated with PRP procedures. Still, this "cure-all" does have stable scientific foundations and the outcomes for many of its users have shown to be primarily positive. When you set aside the hype and look at the beneficial effects PRP is reportedly having, it becomes fairly easy to ignore the naysayers and jump on the platelet bandwagon.
Celebrity & Hype
Widespread public acknowledgment PRP treatments began primarily in the sports world as injured celebrity athletes sought out new remedies to heal their torn muscles, ligaments, tendons, and other musculoskeletal-related ailments. Some notable proponents of PRP during its lesser-known years were Tiger Woods, Kobe Bryant, and Alex Rodriguez. This was back when the treatment was still being used within the realm of its primary purpose.
Later, when celebs like Kim Kardashian and Angelina Jolie began using it for facial skin repair and breast lifts, the hype surrounding PRP quickly blew up. It was also at this time that critics started taking a stance against off-label PRP usage, regardless of the efficacy. In the past couple of years, the immediate hype has slightly worn off and more serious approaches have been taken to utilize PRP in new and exciting ways.
Experimentalism and Non-Surgical Trends
There's a continuous push in almost any medical field toward more liberally-minded experimentalism. This is especially true in the world of aesthetic medicine and even more so in the specific sub-genre of injectables. Botox for the scrotum, dermal fillers as rhinoplasty alternatives, and PRP for breast lifts are among the examples of experimental, off-label uses of injectables that have worked their way into the more established aesthetic services industry.
As the general consumer market for aesthetic medicine becomes younger, the desire for more customized, experimental, and non-surgical treatment options continues to grow. Botox managed to capture the attention of these Millennial patients and now PRP is further appealing to their demand for less expensive procedures with less invasiveness and more temporary results that consumers can essentially "try on". And, hype aside, both of these injectables are backed by very promising science and have managed to provide fairly remarkable results.
Ways PRP is Being Used:
Sports-related injuries spawned the early growth of PRP as a viable treatment option. In these situations, PRP is often used in conjunction with other more traditional types of physical therapy and surgical interjection. For example, Tiger Woods reportedly used PRP along with other treatment options to foster more rapid healing of his torn ASL. This use of platelet-rich plasma injections is undoubtedly the most thoroughly researched and perhaps least contested within the medical community.
Made famous by celebs like Bar Refaeli, Kim Kardashian, and Angelina Jolie, PRP for facial rejuvenation (aka the Vampire Facial or Vampire Facelift) has probably been the most criticized use of this injectable. It's usually done in conjunction with microneedling procedures and, despite the initial backlash, has managed to achieve mostly positive results. The underlying concept of using GF-rich blood to boost collagen production in the facial skin is fairly logical and likely does provide measurable benefits. While the outcomes appear to be a bit less noticeable than with other variations of PRP use, the vampire facial definitely has plenty of potential to treat skin damage caused by acne, aging, and discoloration.
Breast reconstruction using PRP is another form of this treatment that combines a previously utilized procedure (fat transfers) with the platelet-rich plasma injections. In 2013, a study was commissioned that compared the lasting impact of breast reconstruction done with fat grafting alone versus grafts combined with PRP. The results showed that patients saw a 30% increase on average in the maintenance rate (lasting effects) of breast reconstruction done with PRP. Clearly, in this instance, the growth factors involved with platelets have improved the overall outcomes of the original procedure and we will likely see much more testing done in this area in the next few years.
Using natural female growth factors through PRP procedures, physicians have found a viable treatment option for helping women experiencing sexual dysfunction and urinary incontinence. Essentially, PRP is injected into specific areas of the vaginal region leading to increased lubrication, sensitivity, and sexual gratification. This treatment has colloquially become know as the "O-Shot" and has proven effective at regenerating and repairing tissue damage caused by aging and other genetic factors. This is also a perfect example of the seemingly endless implementations of platelet growth medicine.
One of the more rapidly growing and intriguing uses of PRP involves restoring the regenerative properties of hair cells on the scalp. The outcomes are generally more subtle than other more traditional forms of hair restoration. However, the results are relatively long lasting, provide a natural appearance, and receive a mostly positive response from patients.
In the end, there is obviously a lot to learn about this "magical cure-all" and all of its various implementations. Regardless of how you feel about PRP, the treatment and its extensive ongoing experimentation are likely bound to increase in the coming years. Be prepared to see more incarnations of PRP as we move into 2019 and stay confident that the stronger uses will prosper as the more flimsy will hopefully be weeded out.
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