Combination techniques in the treatment of atrophic acne scars
Masterclass Juvelook & Lenisna training led by dr Paul Charlson
AUTHOR:
Dr Magdalena Kędzia
An anaesthesiologist and certified aesthetic medicine doctor
Platelet Rich Fibrin (PRF – Platelet Rich Fibrin) is an autologous tissue biostimulator that arouses great interest and hopes in aesthetic medicine. Treatments with the use of PRF are successfully used in dentistry, orthopedics and sports medicine. Fibrin, similar to platelet-rich plasma, is obtained from the patient’s blood, but thanks to the different procedure of obtaining, it brings a wider, fuller and more promising spectrum of regenerative possibilities.
Platelet Rich Fibrine is a suspension with a high concentration of platelets and other elements stimulating regenerative processes. Due to their three-dimensional structure, platelets are stimulated for longer to release key regenerative growth factors: PD-EGF, PDGF, VEGF, bFGF, TGFb, as well as cytokines that cause mesenchymal cells to migrate to the injection site. Platelets and leukocyte cytokines are important components of this biomaterial, and the fibrin matrix supporting them is helpful in creating factors responsible for the real therapeutic potential of PRF.
The effect of injecting the PRF to the site of damage is a long-lasting stimulation of platelets to release growth factors, directing the migration of mesenchymal stem cells to the site of damage and strong chemotaxis due to the action of leukocytes. This process strongly intensifies the biological regeneration of tissues, causes the activation of “sleeping” mesenchymal stem cells, that proliferate into individual missing cell lines, initiating tissue regeneration.
Rich-cell fibrin is an autologous preparation that works very well in the treatment of scars, both traumatic and burns. The therapeutic cycle depends on the degree of tissue damage, and above all on the patient’s age. For children, 2-3 treatments at monthly intervals are sometimes enough to achieve a good regenerative effect.
Sometimes the damage is deep, and the regenerative mechanisms are incorrect – with keloid formation, e.g. after a burn. In this case, we focused on a long therapy, often supported by compression therapy (in the case of my patient it was a personalized pressure mask, and the entire treatment process took us one and a half years).
The therapy concerned not only the face but also the hand and forearm. Initially, we had to deal with keloids on the cheeks and above the upper lip, difficult-to-heal tissue defects on both temples, and scars and post-inflammatory discolorations on the hands. In one and a half years, we met 10 times, first every month, and after extinguishing excessive scarring every 3 months. I think it was worth believing in the power of fibrin.
How does cellular fibrin really work? ? This is a process the effects of which we have to wait for – both in treatment and Anti-Aging therapy. It can be assumed that in the initial stage there is a process of multiplication of new epidermal cells, fibroblasts, pericytes necessary in the process of creating new tissues. New collagen is created, especially blood vessels. These new blood vessels will, in the following stages, lead to better oxygenation, nourishment of the new skin and restoration of the correct healing conditions and the growth of new tissue.
It is worth mentioning the unique property of PRF – its “intelligence”. There is no risk of hypercorrection or overstimulation with this method, the repair of tissue has the property of self-limiting, does not build pathological tissue, but only (and until) recreates the correct conditions for growth and healing.
The PRF therapy plays an increasingly important role in many branches of medicine, gives hope and – although it is under research – is most likely the future of regenerative and anti-aging medicine.
