Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are advanced regenerative treatments that harness the body's natural healing processes to rejuvenate and restore your skin. PRP and PRF have been in clinical use for over a decade, but they have only recently gained prominence within aesthetics as their ability to produce rejuvenative effects became apparent. Derived from your own blood, PRP and PRF contain platelets, clotting factors, and other proteins that contain growth factors essential for tissue repair and regeneration.
The injection procedure starts with a simple blood draw, similar to what you’d experience for a standard blood test. The blood is then processed in a centrifuge to separate the PRP or PRF from other blood components. PRP and PRF are derived from your own blood, obtained in the office with a routine blood draw, then spun in a centrifuge to separate out the blood components.
When injected, the growth factors in PRP and PRF can stimulate a wound healing-like response in the skin and subcutaneous tissue that results in an increase in proteins, like collagen and elastin, that make the skin look younger, smoother, and healthier. Growth factors also appear to stimulate stem cell production and blood vessel formation, rejuvenating the skin on a cellular level. PRF and PRP are different from traditional filler injections because their goal is to produce rejuvenative effects on a cellular level, more so than just adding volume to the face (or other sites).
PRP has a greater concentration of platelets, but PRF contains white blood cells (so it has more growth factors) and contains fibrin, which forms a structural matrix that allows for slower release of growth factors over a longer period of time, once injected. PRF has replaced PRP for many indications, but PRP still has specific uses. PRP is still used more for hair loss, drainless facelifts, and with microneedling for acne and other indications–although this is constantly evolving. PRF is more likely to be used with albumin gel as biofiller.
Biofiller refers to substances that produce targeted, sustained bio-stimulation, which is different from traditional fillers.
As with many lay terms used in plastic surgery, the term “biofiller” can be used differently by different practices, websites, and media sources. Dr. Goldman and his team use the term biofiller to specifically refer to the injection of gel comprised of your own platelet rich fibrin combined with albumin. Albumin is the most prevalent protein in the serum component of blood. We obtain it from platelet poor plasma (PPP), which is basically the serum component of blood. When PPP is heated, the albumin congeals. (This is the same process that happens when you hard boil an egg: clear albumin becomes white and semi-solid.) To make biofiller from your blood, albumin from PPP is heated gently so that it forms a soft gel with a similar consistency to traditional injectable fillers. PRF (or PRP) can be mixed with the albumin gel and injected. The resulting gel serves as a matrix that allows the associated growth factors to be released slowly, over a period of days to weeks, to produce a sustained bio-stimulatory effect on the skin.
Biofiller represents the latest advance in injectable treatments, but it is important to remember the biofiller is different from traditional fillers. There is less of a volumizing, mass effect on the tissues and more of an improvement in skin quality, texture, elasticity. And this effect also takes place over time, over days to weeks, so it’s less immediate than most traditional fillers. To maximize the bio-stimulatory effect, biofiller is often injected as a series of 2 to 3 injections. It can also be combined with traditional fillers, topical retinoids, lasers, and even surgery.
As with all new and evolving treatments and technologies, patients should have a thorough discussion with a provider who has extensive experience with biofillers, to fully understand your options and determine if bio-stimulation is an appropriate treatment for you. Since there are multiple variations of bio-stimulator injection, some more legitimate than others, we recommend seeking out practices under plastic surgeon supervision. Ideally, consult with a practice that not only has extensive experience with traditional filler injections but also with wound healing, which is an important subspecialty within plastic surgery.
PRP is commonly used for hair restoration, drainless facelift surgery, and with microneedling, especially to treat acne scars. PRF may be used for these indications as well. Biofiller can be used like traditional fillers does work differently; it is used most commonly for lower the lower eyelids and lid-cheek groove and for superficial, etched wrinkles (the wrinkles that look like fine creases at the surface of the skin, as opposed to deep smooth folds).
For certain indications, biofiller has advantages over traditional fillers. Biofiller does not risk the puffiness that traditional fillers can produce as they attract water, especially at the lower eyelids and lid-cheek groove. So biofiller is often the treatment of choice to treat dark circles and crepey skin at the lower eyelids.
Nor does biofiller cause the Tyndall effect, the bluish discoloration that hyaluronic acid fillers can produce when placed close to the surface of the skin. Biofiller is therefore often the choice for superficial, etched wrinkles.
Occasionally, traditional filler can cause prolonged swelling and low-grade inflammation at an injection site. This does not appear to be a risk with biofiller, which is comprised of your own blood products. Thus, patients who have a history of swelling after prior filler injections, may be better candidates for biofiller than hyaluronic acid or other fillers.
The use of biofiller continues to evolve. It will likely not replace traditional fillers for injections in which the primary goal is adding volume to contour the face or minimize a deep skin fold, since traditional fillers will likely continue to give a more predictable volumizing effect.
Although there is an immediate fill effect from the albumin gel in biofiller, this reabsorbs. The biostimulatory effect will have gradual onset over several days to a few weeks as collagen, elastin, and other dermal elements increase.
PRP, PRF, and biofiller can be used as a single treatment or as a series of treatments, depending on your skin quality, desired treatment sites, and goals. In a series, treatments are usually given 4-6 weeks apart.
Our expert team of advanced practice providers has extensive experience with biostimulators, as well as fillers, medical grade skin care, and non-surgical technological treatments, like laser resurfacing. Our team can help you determine whether bio-stimulators are right for you and how they may fit in a comprehensive, individualized treatment plan for your facial rejuvenation.
