PLATELET-RICH PLASMA
PRP, or platelet-rich plasma, is a cutting-edge regenerative therapy that is highly effective in a variety of curative and aesthetic clinical areas, from skin rejuvenation to hair regrowth (which is even successfully achieved in 80 percent of cases) and the improvement and preservation of joint cartilage.
It consists of a blood draw within which red blood cells, white blood cells and platelets circulate. The blood drawn and placed in sterile tubes is put into a centrifuge, which is able to separate the part of the plasma that is concentrated with platelets and separates them from the rest of the blood cells.
Once the centrifugation step is completed, micro-pipettes are used to aspirate this plasma and place it in a sterile container ready to be activated and prepared for treatment. Classical activation consists of the addition to the platelet-rich plasma of a substance that is calcium gluconate, which serves to keep the material obtained from clotting; the more modern method, on the other hand, does not involve any type of use of external substances and is performed immediately at the end of the processing: in fact, it has been seen that fresh PRP, injected immediately after its processing, has a much higher regenerative potential than that mixed with calcium gluconate. At this point with a syringe this activated plasma is suctioned and with a very small needle injections go there into the area we need to treat.
SKIN REJUVENATION – “VAMPIRE FACE LIFT”
In skin regenerative therapy, PRP awakens cells that have remained dormant from the skin aging process, reactivating them and increasing cellular turn-over; thus, we can observe skin rejuvenation and a rapid reparative response in case of tissue trauma. In the US, the method is also referred to as “vampire face lift.” The surgical method of bio-revitalization with the autologous regenerative product also allows the activation of stem cells already present deep in the skin. Injection of the platelet concentrate is essential for a marked level of improvement of acne scars present especially at of the temporal and malar area.
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PRP III consists of a more aggressive infiltrative method: compared to classic injections all over the face, many small channeled passages are created with small needles that subsequently allow the PRP to be applied all over the face: similar to a mask effect, this method allows absorption even in the most superficial layers of the skin.
The treatment can be combined with the newer and innovative method of lipofilling/fat transplantation to increase the quality and viability of the cells. Numerous stem cells are present in the transplanted adipose tissue. Their total preservation without manipulation, their processing without centrifugation, their total cleansing from waste products (oil and blood), allows the full potential of these cells to be utilized.
(HANDS, FEET,LOW NECKLINE, KNEES, NECK)
HAIR REPAIR & REGENERATION
Platelet growth factors are also used before and after hair transplant surgery, precisely to recreate and greatly help the engraftment of the implanted bulbs.
Regenerative therapy with platelet growth factors has clear responsive effects in about 80% of cases. It is a standardized therapy about which there are multiple data and statistics in the medical literature. In recent years, remarkable clinical effects have been shown (especially in the 20% who did not demonstrate satisfactory clinical results with classic platelet growth factor grafting) by micronized adipose tissue grafting with complete preservation of the vascular-stromal niche (SVF) (see later).
ACNE & SCARS
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A second entry is characterized at the intra-epidermal level, i.e., growth factors are deposited between the various epidermal sheets; this allows to improve the trophy, elasticity of the middle layers of the skin and to be able to act inside the scar, so as to make it softer, increase blood flow and decrease fibroblasts, cells deputed to the formation and maintenance of fibrosis.
The last level of medical treatment composed of tissue regeneration and active superficial biostimulation is Needling + Peeling: the needling consists of a roller with many small, very thin needles that allow for mechanical stimulation of the cells of the deep layer in a semi-invasive manner but at the same time to convey the regenerative material of growth factors
Chemical Peeling is a treatment to eliminate dead layers of the skin’s surface: Peeling, a class 1 medical device based on trichloroacetic acid (TCA) at medium/high concentration, is ideal for the treatment of problems such as skin elastosis of the face, scarring atrophy, melasma and post-inflammatory hyperpigmentation, photo aging, atrophic dermis in middle-aged/elderly patients, recent (red or white) and dated stretch marks
Taking advantage of the right ratio of TCA (at 35 percent) to the other active components, the peel provides a tightening, smoothing effect, as well as an immediate improvement of skin complexion and texture with significant reduction of fine lines. In addition, the presence of Cogic Acid guarantees, in addition to the peeling, a de-pigmenting effect, especially on dark spots of melanin origin.
ORTHOPAEDICS & TRAUMATOLOGY REGENERATIVE SURGERY
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The first effect is that of a marked improvement in the biological and histological conditions of the knee or shoulder cartilage and joint tissues, just as in muscle tissues PRP relieves pain and reduces healing time; however, if we treat a muscle injury, our goal is to improve healing; if, on the other hand, we treat degenerative arthritic syndromes, such as those affecting knee cartilage, the first goal is to limit the pain symptoms; this also happens thanks to the consistency of PRP, i.e. viscous autologous liquid that is injected into the joint.
In recent years, impressive clinical effects have been shown (especially in patients in whom PRP did not demonstrate satisfactory clinical results) through the grafting of micronized adipose tissue with complete preservation of the vascular-stromal niche (SVF): with a fat harvest, its special processing (which absolutely prohibits centrifugation) and injection of the same into the joint cavity, a very strong cartilage regenerative effect is witnessed. Researchers to date are still investigating whether the regenerative effect is due to cellular differentiation of these cells derived from adipose tissue, or whether the vascular-stromal niche (SVF) releases particular factors that are able to stop inflammation and redistribute cellular architectural harmony that provides for repair of damaged tissue (see next chapter: Human Adipose Stem Cells with adipose micro fractured clusters and preserved Stroma-Vascular Fraction).