How does the “vampire facelift” (aka PRP) work?

 
The “vampire facelift” (aka Selphyl, platelet-rich plasma injections) is an increasingly popular wrinkle-reducing treatment that involves taking your blood, separating it with a centrifuge, then reinjecting it into your face.

It’s not a “real” facelift (i.e. it doesn’t involve cutting you open). It sounds really weird and mucky, but it’s actually fascinating how it works! Platelet-rich plasma (PRP) has been used in surgery for 20 years, and more recently it’s been used to promote healing in sports injuries and cosmetic surgery as well.

What’s in blood?

Human blood contains a lot of things. The part we usually think of are the red blood cells, which give the blood its red colour, and transport oxygen around your body. There are also white blood cells which are important in the body’s immune system, and platelets, which help with clotting. These are the main three components  floating in a watery goop called plasma, which contains lots of things like electrolytes, nutrients, proteins and waste materials.

Using a centrifuge, you can separate all the components of blood by spinning it really quickly so the.denser bits sink to the bottom. This is what blood looks like after you give it a whirl in a centrifuge:

To separate out platelet-rich plasma, a couple of centrifugation steps are usually needed. The final PRP has around 3-5 times the concentration of platelets than normal blood.

Why are platelets so important?

As well as clotting blood, platelets also contain growth factors and proteins which are important in the repair and regeneration of tissue. Therefore PRP can potentially accelerate the healing process, and presumably encourage the growth of cells in the injected areas.

Platelets quickly release the growth factors and healing proteins contained in them after being activated (e.g. using thrombin, collagen or calcium chloride). Within 10 minutes, approximately 70% is released, and almost all of them are released within the first hour. The platelets continue producing small amounts of the growth factors until it dies (after around a week).

What are the side effects?

Compared to dermal fillers, there’s a smaller chance of migration or lumping. The most exciting thing about PRP is that it has the potential to fill in areas under the skin with natural tissue rather than foreign material, which means there’s less chance of bad reactions. Like other autologous methods (where only the patient’s own tissue is inserted into the body) there’s no chance of rejection. Additionally, as the PRP encourages the growth of the same cells that are already in the area, rather than merely filling in the grooves with something else, results should be more “natural” than with other procedures.

It’s also a relatively quick procedure – it only takes around half an hour to take the blood and prepare the PRP for injection. Although there are claims of no swelling or bruising, quite a few people have reported problems.

Does it work?

At the moment there isn’t much proper published clinical evidence since it’s a relatively new procedure. A few studies where it was shown to be effective in certain situations, such as in improving the appearance of deep nasolabial folds. At the same time, there are doubts that PRP can work properly in the shallower areas that are targeted in the “vampire facelift”. There’s a lot of anecdotal evidence that it improves skin smoothness and plumpness though, so proceed at your own risk!

References

R E Marx, Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 2004, 62, 489.

T E Foster, B L Puskas, B R Mandelbaum, M B Gerhardt and S A Rodeo, Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med 2009, 37, 2259.

A P Sclafani, Platelet-rich fibrin matrix for improvement of deep nasolabial folds. J Cosmet Dermatol 2010, 9, 66.