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Review
. 2022 Sep 5:30:e20220020.
doi: 10.1590/1678-7757-2022-0020. eCollection 2022.

Autologous platelet concentrates for facial rejuvenation

Marília Afonso Rabelo Buzalaf  1 , Flávia Mauad Levy  1
Affiliations
Review

Autologous platelet concentrates for facial rejuvenation

Marília Afonso Rabelo Buzalaf et al. J Appl Oral Sci. .

Abstract

Background: Autologous platelet concentrates (APCs) are promising therapeutic agents in facial rejuvenation since they are a great source of cytokines, growth factors and other biologically active substances. Obtained from the patient's blood, they have the advantages of reducing immunological reactions, making the procedure safer, well tolerated, with minimal adverse effects and lower cost. Currently, they are used for facial rejuvenation both in combination with microneedling and in mesotherapy techniques, as well as to treat facial acne scars, melasma and wounds after laser ablative treatments. This review summarizes current knowledge on the use of APCs, ranging from basic concepts related to their composition and mechanisms of action to up-to-date information on their clinical efficacy.

Methodology: MEDLINE (PubMed) was searched from inception through 2021 for English language publications on APCs for facial rejuvenation.

Results: A total of 100 files were found. Based on the available literature, APCs for skin rejuvenation are safe and well tolerated. The most studied product is the first-generation material, platelet-rich plasma (PRP).

Conclusions: The results are in general favorable, but the quality of the studies is low. The second and third generation products, platelet-rich fibrin (PRF) and injectable platelet-rich fibrin (i-PRF), respectively, are easier to be obtained and, at least in vitro , seem to induce greater collagen production than PRP, especially under lower relative centrifugation forces, but to date only a few clinical trials evaluating these products exist. More high-quality trials with appropriate follow-up are necessary to provide adequate evidence that may help to improve the treatment regimens with APCs. Many aspects should be considered when designing clinical trials to evaluate APCs, such as the patients' characteristics that best predict a favorable response, the optimal number of sessions and the interval between them, the characteristics of the studies and the development of better instruments to evaluate skin aging.

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Conflict of interest statement

Conflict of interest

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Differences between the distinct generations of autologous platelet concentrates
*APCs – autologous platelet concentrates; PRP – platelet-rich plasma ; PRF – platelet-rich fibrin ; i-PRF – injectable platelet-rich fibrin ; RCF – relative centrifugation force.
Figure 2
Figure 2. Mechanisms of action of autologous platelet concentrates in facial rejuvenation. After platelets activation, their α granules fuse with the cell membrane, in a process called degranulation. Their growth factors are then secreted, bind to transmembrane receptors on target cells (mesenchymal stem cells, osteoblasts, fibroblasts, endothelial and epidermal cells), activating an intracellular signaling protein that causes the expression of a protein, which, in turn, triggers effects such as cell proliferation, angiogenesis, synthesis of collagen and extracellular matrix components, and reduced apoptosis. With skin aging, fragmented collagen fibrils accumulate, which impairs the growth of new collagen fibers and disrupts the extracellular matrix. Activated platelet aggregates increase the expression of matrix metalloproteases (MMP-1 and -3), stimulating the removal of fragments of collagen fibrils. In addition, they contain several growth factors that stimulate fibroblasts to synthesize new, more organized collagen fibers, besides increasing the synthesis of hyaluronic acid, which binds to water, increasing the skin volume and hydration
Figure 3
Figure 3. Laboratorial studies evaluating autologous platelet aggregates
*PRF = Platelet-rich fibrin; PRP = Platelet-rich plasma; RCF = Relative centrifugation force
Figure 4
Figure 4. Clinical trials on the use of autologous platelet aggregates for facial rejuvenation
See this image and copyright information in PMC

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