Platelet Rich Plasma (PRP) More Than Just a Skin Treatment
PRP for Skin Tightening and Scar Reduction:
Platelet rich plasma, abbreviated PRP, is obtained from the client’s own body. It is often used to stimulate skin repair and make the skin look younger. This works by using the body’s natural growth factors, which are present in high amounts in PRP and platelets. PRP skin treatment results in less wrinkling, less scar, more evenly colored skin and a return of volume in aging skin to a more youthful appearance. Results are often dramatic; reducing the cosmetic appearance of a face by 5-15 years is common. Making a neck look 10-20 years younger is common with impressive wrinkle reduction. The best results are in those with the most wrinkles, sun damage, volume loss and/or scar. A pretty, young girl with clear skin will typically not get dramatic results. Those who have some wrinkles, sun damage and/or scar have easily visible improvement, which makes the procedure especially popular in those over 40 and in anyone with acne scars or sun damage. Bags under the eyes and drooping eyelids also improve nicely. PRP can be used in any skin color, unlike most laser therapies.
How is Platelet Rich Plasma (PRP) Performed:The procedure starts with a blood draw of 30-60 cc in our office by a trained tech. A tiny amount of anticoagulant is mixed with the blood. It is processed in a special machine with a special kit, a new sterile kit being used for each client. Centrifugation concentrates the platelets in an area of blood that includes plasma and a few red blood cells. This final product is a red liquid. This is used for cosmetic, orthopedic or other injections.
The Platelet Rich Plasma (PRP) Facelift:
At this point one can do a nonsurgical “PRP facelift”. This involves facial injections using PRP. Although PRP procedures are often termed facelifts, they are only injection procedures. No scalpel is used, no general anesthetic is used and the procedures typically cost about a tenth of what a facelift costs. These procedures are often called facelifts because the results are dramatic enough that the wrinkle tightening is similar to that achieved with a facelift. Other commonly requested cosmetic PRP treatments include neck skin tightening, V-neck or cleavage skin tightening or stretch mark treatments. Special problem areas like baggy or droopy eyes and prominent mouth wrinkles can be treated without treating the whole face for a smaller fee. After skin cleaning and application of a local anesthetic cream Dr. Van Reken will inject small amounts of PRP into the skin in the areas being treated. This is done with small needles. There is more discomfort than with Botox, but less than with fillers. Injections commonly include the forehead, temples, orbits, nose, cheeks, upper white lip, lower white lip and chin—the full face. Stopping after the injection procedure alone produces good results. However, for even better results without additional down time we can add microneedling over the same treatment area. This further reduces wrinkles and is also helpful for scar. Microneedling adds about $200 to the cost and is done by trained staff.
Factors Affecting Platelet Rich Plasma (PRP) Cosmetic Result:
Factors affecting PRP cosmetic results: clinical results vary depending on individual factors including medical history, skin type, age, pretreatment skin damage, severity of wrinkles, severity of volume loss and prior skin treatments. Wrinkles, loss of facial volume and scar conditions often improve nicely in 1-2 treatments. Good results are usually present within 90 days. Temporary bruising may occur with this or any injection therapy. Bumpiness at injection sites is usually gone in a day, but may persist for up to 3 days. There are 3-4 days of down time, but many patients return to work in 2-3.
Platelet Rich Plasma (PRP) with Micro-Needling:
Microneedling can be done as a separate procedure without PRP injections. This is cheaper than when done with PRP and takes less time. As an isolated procedure microneedling is helpful for scar, skin discoloration and wrinkle reduction, but results are not as dramatic as when it is combined with PRP. Microneedling can be performed by our trained medical staff or by our trained aestheticians.
Platelet Rich Plasma (PRP) for Hair Loss:
PRP can restore hair loss in the scalp. In women one treatment produces a noticeable effect, but additional treatments make the hair even thicker. In men it is less effective, but still helps, so usually at least two treatments are required. PRP often works well with mild to moderate hair loss, but a man who is largely bald will not get a great result with PRP. PRP may be combined with a hair transplant procedure. Results are typically noticeable within a month and good within 6 months of the last treatment.
Platelet Rich Plasma (PRP) for Orthopedic Problems:
Orthopedic PRP injections are commonly done in those with joint, tendon, tendon sheath, ligament, cartilage, chronic sprain and/or arthritis issues. Common reasons for injecting PRP include arthritis in a joint, tendon damage, ligament rupture, tendinitis, nerve injuries, tennis elbow, rotator cuff shoulder problems, knee arthritis, chronic ankle sprains and many more. Results are usually good by 12 weeks.
Small areas of injury such as a tennis elbow often do well with just one injection. Chronic arthritic conditions often require 2-3 treatments for best results. Goals for a milder problem often include complete relief of symptoms. For advanced arthritis a 50-75% reduction in pain and avoiding a joint replacement surgery may be a reasonable goal. Very severe problems such as bone on bone arthritis requiring a total knee replacement can often be helped and PRP injections are now considered an alternative to total knee replacement in some patients. However, arthritis pain reduction results are not nearly as good with severe arthritis as with milder disease. PRP injections are commonly given in conjunction with surgery, such as rotator cuff surgeries or knee ligament repairs. Insurance still does not usually cover PRP orthopedic injections, but this is changing.
The injection process:
the types and sizes of needles used and skin cleansing used for other orthopedic injections, such as Kenalog injections, are similar with PRP. However, with orthopedic PRP injections no lidocaine is added to the injection material and there is an increase in pain after injection, typically moderate. Most pain is gone within 2 hours. Some patients have mild pain in the area for a day or two. A sensation of fullness in the injected area is common for a few days, such as when Dr. Van Reken injected his own knee and ankle.
Factors affecting results:
clinical results vary depending on medical history, age, prior joint or orthopedic tissue damage, prior surgery, severity of orthopedic damage on imaging studies, clinical severity of orthopedic symptoms, duration of symptoms prior to treatment, compliance with pre and post treatment instructions and individual response to treatment. Patients with orthopedic surgery recently done or to being done soon may have additional benefit and more rapid healing when PRP injections are used in with surgery.
Platelet Rich Plasma (PRP) for Female Orgasmic Dysfunction:
PRP injections near the clitoris and exterior portion of vagina greatly improves orgasmic function. Orgasms are much easier to achieve. 10% of adult women have never had an orgasm, but after PRP injections these same women are usually orgasmic. This is the only effective treatment for female orgasmic dysfunction.
Aging vagina syndrome (menopausal atrophic vaginitis):
A woman’s vaginal lubrication is regulated by estrogen. Most premenopausal women lubricate normally and enjoy sex with a loving partner. As a woman ages estrogen levels drop and estrogen sensitive genital tissues are affected. Vaginal changes include dryness, and atrophy--thinning and weakening of tissue. Many menopausal women need lubricants for sex, but it is often still painful. PRP injections in the outer portion of the vagina make the tissues thicker, better lubricated and essentially younger. Sex becomes fun again. Injections near the clitoris also make orgasms easier to achieve. This makes bother partners happier. Results are usually quite good. Vaginal CO2 laser therapy is also effective, but is more expensive over time. One can do both vaginal laser and PRP, although not the same day.
Platelet Rich Plasma (PRP) for Male Erectile Dysfunction:
Many men have some level of erectile dysfunction. This may strain relationships and make a man frustrated. Penile injections of PRP are often effective at restoring normal erectile function. A single injection session may be sufficient, but often 2-3 sessions a few months apart are done for best results. These injections should not be confused with aprostadil (brand names Caverject and Edex), which is injected immediately before sex and repeated each time one has sex. A side effect of PRP penile injections is an increase in penile size. Typical the penis will elongate about an inch and the width will increase 20-30%. Viagra, Cialis, Levitra and similar drugs may be used in conjunction with PRP injections, but are often not needed. Men with less severe erectile dysfunction may respond better to treatment, but even those with no ability to get erect are often helped.
Platelet Rich Plasma (PRP) for Leg & Foot Wounds and Ulcers:
Those with poorly healing leg or foot ulcers from varicose veins, arterial insufficiency, trauma and diabetes often benefit from PRP injections into and near the ulcers or wounds to help wound healing and stimulate new skin growth. Insurance and Medicare still do not cover the cost.
Platelet Rich Plasma (PRP) Frequently Asked Questions & Answers:Keep reading below as we answer some of the questions we get about PRP and Micro-Needling and how it can help you look younger longer with minimum downtime..
Q: I just got a facial laser treatment 3 days ago. How long until I can get a PRP facial tx?A: t depends on the type of laser. Lasers like the Medlite 1064 are gentle enough that you can do the PRP today. More aggressive treatments like the SmartSkin CO2 laser and EMatrix treatment require a wait time of 10 days or more, depending on how you look.
Q: I’m get fever blisters and shingles in my face. Can I still be treated?A: Yes, but if you have an active infection now we ‘ll delay treatment. We may prescribe an antiviral medication to help prevent such infections at the time of treatment in a case like yours. Ask us in advance. Other facial treatments, including microneedling, laser therapies, and IPL, can produce a recurrent viral infection.
Q: I’m on blood thinners, can I get PRP injections?A: Yes, but be sure to tell us ahead of time and ask the staff to discuss this with Dr. Van Reken. In some cases we me skip a single dose of anticoagulant or delay a day’s dose until after the procedure. Additional care will be used and the risk of bruising is clearly increased. An example would be someone on warfarin or Coumadin. Such patients can also be treated with Botox and fillers, but these too have an increased risk of bruising in such patients. Joint injections are also routinely done on people on anticoagulants like warfarin, Eliquis, Xarelto and Plavix.
Q: If I get multiple skin areas treated the same day will I get a discount?A: Definitely. An example would be doing a knee injection and a wrist injection the same day. We could do both with about 6 mL of PRP, so we would only have to buy and use one kit for both injections and you would only needed your blood drawn one time. This saves us money and staff time so we charge less.
Q: If PRP injections into joints are so good, why don’t all the joint specialists use them?A: Great question. First, PRP takes more time, additional training, additional equipment and the cost of a kit for processing the blood and PRP. This disposable kit has to be purchased for a single patient use to ensure your safety. Second, there is also a blood draw involved. Third, insurance does not generally cover PRP joint or tendon injections, although this is changing. For a steroid joint injection we prepare and administer the shot in less then ten minutes from a vial, using product that costs us less than a tenth of what the PRP supplies cost. Steroid shots are quick, easy, cheap and covered by insurance.
Q: PRP vs. a steriod knee shot for knee arthritis. Which is best?A: Steroid shots are a temporary fix. They improve pain and mobility for a few months, but do not really produce healing in the cartilage, ligament, meniscus or tendon. The arthritis or other pathology remains and MRI studies months after steroid shots show no healing. Six months later the shot will not be effective for pain relief. PRP injections often produce healing and lasting pain reduction for years. MRI studies of tendon problems, ligament tears, rotator cuff tears and cartilage damage often show healing and improvement in the months after PRP injections. This explains their lasting effects. If your co-pay was identical and your insurance covered both procedures which one would you choose? The decision is unltimatley yours.
Q: Are PRP knee injections an alternative to a total knee joint replacement?A: In many cases yes. The major goal of knee joint replacement is pain reduction and better ability to get around. After a series of joint PRP injections you will not have a normal knee or normal x-rays. However, let’s say you have a 75% pain reduction and can walk much better. This a reasonable alternative to a total knee replacement. In addition, many patients are not considered good candidates for total knee replacement due to advanced age, medical problems or obesity. In such patients biologic knee injections (like PRP) are currently the only option for lasting pain relief. In addition, there is much more cost, much more down time and a substantial risk of complications from a total knee replacement, including months off work for most people. This is not true with PRP.
Q: Do PRP injections hurt?A: Yes, but it depends where they are given. During scalp injections Dr. Van Reken experienced moderate stinging pain (with no premedication taken other than some anesthetic cream). This pain was down to 1 out of 10 within an hour. The injected areas may remain sore for a few days. When Dr. Van Reken’s knee and ankle injected these joints remained sore for a few hours.
We hope this info sheet helps you. Ongoing advances in medicine offer exciting new opportunities for us to help our clients with the common cosmetic, orthopedic, menopausal and ED issues which we see in many clients every day. Your questions are always welcome.
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