Key points
- Platelet-rich plasma (PRP) is plasma from your own blood that contains high concentrations of platelets and growth factors, and it is being studied as a way to make up for the inconsistent survival of grafted fat [2, 3].
- A dermatology review described PRP as having a synergistic effect when combined with fat grafting and other treatments, but stated that treatment methods need to be standardized [2].
- A 2024 analysis pooling systematic reviews stated that the certainty of the evidence was mostly low or very low, making it difficult to reach firm conclusions about using PRP alone or in combination [1].
- Because evidence on combining PRP with fat grafting is still accumulating, it is a good idea to hear about both what you can expect and its limitations before deciding [1].
What is PRP?
Platelet-rich plasma (PRP) is plasma obtained from your own blood, and it contains high concentrations of platelets and growth factors [2]. It is usually prepared by drawing blood, spinning it in a centrifuge, and collecting the layer that is rich in platelets.
In dermatology, it is described as being used for hair restoration, skin rejuvenation, acne scars, dermal augmentation, and stretch marks, with its range of uses expanding [2]. However, the same review stated that research is needed to standardize treatment methods for each condition [2].
Why is it combined with fat grafting?
Fat grafting is being used more and more widely in cosmetic and reconstructive surgery, but the limitation of inconsistent fat survival remains a problem [3]. Research to address this has tried PRP, pre-treating fat with low oxygen (hypoxic preconditioning), hyperbaric oxygen, and tissue engineering scaffolds, and the literature notes that these laboratory findings are in the process of being carried over into clinical practice [3].
After facial fat grafting became widely accepted, attempts to apply stem cells and PRP in cosmetic practice also increased greatly, and there is a review that examined the evidence for these [4]. A dermatology review described PRP as producing a synergistic effect that improves cosmetic results when used together with lasers, microneedling, fillers, and autologous fat grafting [2].
What the pooled evidence shows
An analysis published in 2024 gathered systematic reviews on the use of PRP for facial rejuvenation and evaluated the quality of the evidence [1]. It covered 28 primary studies, 18 of which were reports without a control group, and 8 studies used PRP together with other treatments such as fat grafting [1].
Only 1 of the 13 reviews performed a meta-analysis of facial rejuvenation outcomes, and in it, satisfaction was higher among people who received PRP as an add-on than in a control group that did not receive PRP, but the certainty of the evidence was low [1]. Of the 13 reviews, 12 were rated as having low or very low confidence in their results [1].
The authors concluded that, whether PRP is used alone or with other treatments, the evidence is insufficient to draw firm conclusions about its effects on facial rejuvenation [1]. The synergistic effect described in the review above also needs to be considered with these limitations of the evidence in mind.
Combined use in scar treatment
For treating facial scars, an approach has been described that combines microfat grafting, injections of fat concentrate, subcision (a procedure that releases the tethering under a scar), and PRP supplementation [5]. Fat concentrate is a small volume of liquid rich in progenitor cells, made by centrifuging and emulsifying suctioned fat [5].
The authors considered that the factors dissolved in fat and the progenitor cells could remodel scar tissue [5]. However, this publication presents the authors' own treatment method, and its research summary does not present any study results comparing the effects of each component separately.
What is known about safety
PRP is a material obtained from your own blood, but this does not mean its safety has been sufficiently verified. In the 2024 analysis, only 2 of the 13 systematic reviews (15%) treated the occurrence of adverse reactions as a predefined outcome [1]. This means there is a lack of systematic data on adverse reactions from combined procedures.
What to check during your consultation
Whether to add PRP to fat grafting is a question to be decided by weighing the level of evidence alongside your personal goals. Because results vary from person to person, it is a good idea to align your expectations thoroughly with the specialist who examines you in person.
- Whether the purpose of adding PRP is fat survival or improving skin quality
- How the PRP is prepared and how much is used
- The difference you can expect from combining them, and the level of evidence for it
- The possible adverse reactions of fat grafting and of PRP
Frequently asked questions
- Does adding PRP help the fat take better?
- Research is under way into using PRP to address the problem of inconsistent fat survival [3]. However, an analysis pooling systematic reviews stated that the evidence is insufficient to draw firm conclusions [1]. It is still too early to regard it as a method with established effects.
- Is combining PRP with fat grafting safe?
- Only 2 of the 13 systematic reviews treated adverse reactions as a predefined outcome [1]. As a result, systematic data on safety are lacking. It is a good idea to check possible reactions and how they are managed before the procedure.
- Is the PRP procedure the same everywhere?
- It has been pointed out that more research is needed to standardize PRP treatment methods for different conditions and purposes [2]. Preparation methods and the amount used may differ from clinic to clinic, so it is a good idea to ask in advance how it will be done.
References
- Cruciani M, Masiello F, Pati I, et al. Platelet rich plasma for facial rejuvenation: an overview of systematic reviews. Blood Transfus. 2024.PubMed 38557322DOI
- Emer J. Platelet-Rich Plasma (PRP): Current Applications in Dermatology. Skin Therapy Lett. 2019.PubMed 31584784
- Shahzad F, Mehrara BJ. The Future of Fat Grafting. Aesthet Surg J. 2017.PubMed 29025213DOI
- James IB, Coleman SR, Rubin JP. Fat, Stem Cells, and Platelet-Rich Plasma. Clin Plast Surg. 2016.PubMed 27363761DOI
- Pallua N, Kim BS. Microfat and Lipoconcentrate for the Treatment of Facial Scars. Clin Plast Surg. 2020.PubMed 31739890DOI
This article is an English translation of general health information that DOY JUN Plastic Surgery compiled in Korean from the summaries (abstracts) of papers in international academic journals. Treatment methods and results vary depending on each person's condition, so please consult a specialist for an accurate diagnosis and treatment plan.