PRP
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.
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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, this activated plasma is aspirated with a syringe and with a very small needle; injections are made in the area to be treated.
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 cell turn-over; thus, we can observe skin rejuvenation and a rapid reparative response in cases 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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(HANDS, FEET, KNEELS, NECK)
In skin regenerative therapy, PRP awakens cells that have remained dormant from the skin aging process, reactivating them and increasing cell turnover; thus, we can observe skin rejuvenation and a rapid reparative response in case of tissue trauma even in those areas where aesthetic medicine therapies have little success (hands, feet, cleavage, and neck). The surgical method of bio revitalization with the autologous regenerative product (the patient’s own material) also allows the activation of stem cells already present deep in the skin. The injection of the platelet concentrate is essential for a marked improvement in the tissue layer from which all the epidermal sheets (more or less young) that go to make up the skin arise.
The treatment can be combined with the newer and innovative method of lipofilling/fat transplantation) to increase the quality of final result.
ACNE & SCARS
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Platelet-derived growth factors (PRPs) remodel the various scar layers by awakening the cells of the dermo-epidermal basement membrane (cells deputed to cellular turn-over, that is, the cells that from the deepest layers of the skin, regenerate the various epidermal leaflets down to the stratum corneum, the most superficial layer and in direct contact with air and consisting of dead cells); therefore, the first entry occurs in the deep plane so as to bring more blood and oxygen supply to the cells that change the skin over the various months.
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 bio stimulation 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 issues such as skin elastosis of the face, scar atrophy, melasma and post-inflammatory hyperpigmentation, photo aging, atrophic dermis in middle/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 in 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
The grafting of platelet factors at the joint level stimulates cells responsible for tendon and cartilage regeneration.
To date, therefore, we possess a state-of-the-art treatment that allows us to preserve and treat the deterioration of joint tissues, certainly due both to ‘advancing age but also from excessive joint use.
The first effect is that of a marked improvement in the biological and histological condition of 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 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).