Regenerative Medicine

Facial rejuvenation with your own cells

What is Regenerative Medicine?

Facial rejuvenation with your own cells and Platelet-Rich plasma ( PRP) and /or Autologous Cellular Rejuvenation (ACR).

Most people, of both genders, choose to age gracefully. However, in the era of anti-aging medicine, the tendency is to turn back the clock and undergo some form of rejuvenation to reduce facial wrinkles, lines and blemishes.

Aging of the skin, dermal components and cells, means that the skin texture and appearance deteriorate. Aging affects the hands and soft tissue of the face. This is characterized by sagging, jowls, thinning of the skin, puffiness, age spots (lentigines) and wrinkling (forehead, cheeks, neck and décolleté). Skin texture changes and dryness is a problem.

Sun exposure worsens the process by solar-aging and UV irradiation. This means that vertical and horizontal facial and body wrinkles deteriorate with time.

The New Role in Biological Dermal Rejuvenation!

For decades, rejuvenation of the face by surgical face-lift has been popular. Today, more non-invasive treatments are available to improve the skin complexion of the aging face. Botulinum and dermal fillers have also become popular. Currently, popular methods to rejuvenate, tighten and resurface the face include radiofrequency, non-ablative photothermolysis, IPL’s and light-emitting diode (LED) phototherapy. Also popular is combination therapy consisting of IPL, laser and Cosmeceutical, including vitamin A derivatives. However whatever option is used, the aging process cannot be prevented and skin improvement by these treatments is gradual, subtle, modest and variable.

This new approach, is appealing to clients seeking a more natural method to facial rejuvenation, is regeneration with your own cells and more specifically, autologous platelet-rich plasma (PRP). This is also referred to as autologous cellular regeneration (ACR) an aesthetic practice, which is a safe and tolerable procedure.

Platelet-Rich Plasma (PRP) has been utilized in aesthetic medicine (UK, Japan, and Asia, Europe) to rejuvenate and slow down the aging process and face (2006). This refers to mesenchymal and epithelial rejuvenation by application of the persons own enriched autologous plasma. Recently, ACR-PRP has been pioneered for facial rejuvenation in select patients with chronological aging, and solar damage. Regeneration or anti-aging by biological stimulation of resident stem cells by growth factors.

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How Does it Work?

REGENERATIVE MEDICINE is the production and injection of autologous platelet rich plasma.

It is well known that platelets have many functions. Platelets contain important growth factors that, when secreted, are responsible for:

Tissue regeneration and rejuvenation
increasing collagen production
recruiting other cells to the site of injury
initiating vascular in – growth
inducing cell differentiation
bone – mineralization
extra cellular matrix formation
Non – Allergenic
It is a ‘body own’ physiological product vs. animal derived or human donor products.
Elimination of donor transmissible infections
Biological Glue: for tissue adhesion especially in skin flaps, bone grafts and trauma.

These are vital steps in collagen regeneration and wound healing.

THE PROCESS IS -

SAFE and Physiologically Active
Preparation is Simple and Quick, and completed on the Physicians premises in the appointment time. No products are sent off premises.
Can be used in multiple areas for dermal rejuvenation

Prior to treatment a blood sample of 10 – 20 mls is extracted from the patient. This blood is immediately placed in the centrifuge for 5 – 8 minutes. When centrifugation is complete your Plasma will be separated into three layers: (1) platelet – poor plasma, ( 2) red blood cells , and (3) the ‘buffy coat’ ( i.e. platelets and white blood cells) from your red blood cells. The rich platelets are extracted from the base of the plasma gel. The platelets are injected into the deep dermis or fat layer of the skin. Platelets gradually increase collagen which can increase skin thickness and overall health of the skin.

HOW LONG IS THE PROCEDURE FROM START TO FINISH?

Approx 45mins to 1 hour per two test tubes.

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Which areas can be treated ?

Around the eyes – Peri Orbital Rim

Cheeks and Mid face

Cheeks

Thinning skin on the neck

Jaw Line and Sub Malar

Back of hands

Décolletage

Other Body Areas

SKIN ANALYSIS IS IMPERATIVE BEFORE STARTING THE REJUVENATION PROCESS

Ask your aesthetic therapist to perform a skin analysis and to grade the aging process. Scoring is done by using the Fitzpatrick scale, analysis include assessment of the skin tone, colour and texture. Damage can be quantified by photography, scanning and ultrasound. Treatment options are then based on this analysis. Case studies reported in Europe, England, Asia, Japan and South Africa have demonstrated consistent rejuvenation of facial aging, including wrinkling in persons with modest grades of photo- or chronological aging. Patient selection is important and skin diseases have to be excluded. Improvement of skin texture and tone can be expected, these features are noticeable within 3 weeks, and the process can be enhanced by addition of appropriate Cosmeceutical. Benefits include non-allergenic properties and ease of administration.

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What is the process of ACR-PRP ?

Your therapist will assess the degree of skin aging, perform a skin analysis, and recommend a sensible treatment with reasonable outcome.
Options of facial rejuvenation are explained to you, including efficacy and safety. Cost analysis is discussed and the number of sessions possibly required.
Persons between the ages of 30 and 80 years are eligible.
Almost all skin tones show that the process is safe and effective because your own enriched plasma is used, but not all grades of wrinkling can be improved.
A photograph of the skin is taken to assist the follow-up and grading of the improvement.
Sixteen millilitres (16ml) of blood is obtained from the arm by venapuncture.
The blood is collected in special sterile tubes and centrifuged in the practitioner’s rooms to separate the plasma. The plasma is drawn up into a syringe and activated with calcium-chloride; this stimulates natural growth factor release from the platelets in the plasma. About 8ml of PRP is obtained which is used for facial rejuvenation and injection.
By a mesotherapy technique, the PRP is injected, by multiple tiny punctures under the skin (including the dermis), under topical local anaesthesia. The forehead, peri-orbital region, cheeks, chins and dorsum of the hands, are the targets of aging and wrinkles, for rejuvenation. The process is relatively painless providing sufficient topical anaesthesia is applied. A mesotherapy gun is also suitable to deliver the PRP into the skin and the dermis.
PRP facial rejuvenation (or also termed ACR) can be a one off treatment, but further microinjections can be re-performed at 6-12 weekly intervals for recalcitrant lines and wrinkles if the client desires this.
Currently Regenlab PRP renders the most efficient enriched ACR, compared to other products.
This entire process and injection time is simple and takes approximately 45 minutes – 1 hour in total. The process is on the same day and on the same medical practice.

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Any Side Effects ?

SIDE EFFECTS OF ACR- PRP FACIAL REJUVENATION

Minimal: Expect minimal swelling, bruising and redness for 12-24 hours. Some clients experience headache.
Modest: Some patients may feel faint. A bruise at the venapuncture site may be visible for 2-3 days.
Severe: A low morbidity procedure. Almost no down time. No need for hospitalization. Anaphylaxis does not occur. In rare cases, skin cellulitis may occur which can be treated with antibiotics and cold compresses. Occasionally hospitalization is needed in these cases. Secondary skin infection is a rare complication.

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Who is a Good Candidate ?

EXCLUSION CRITERIA FOR ACR- PRP FACIAL REJUVENATION

Persons with skin disease (SLE, porphyria, allergies), cancer, chemotherapy, severe metabolic and systemic disorders, and abnormal platelet function (i.e. blood disorders). Anti-coagulation therapy and underlying sepsis excludes the use of PRP and are not good candidates for this procedure.

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Results & Expectations

Results are visible at 3 weeks and improve gradually over ensuing months with improvement in texture and tone.
Cosmeceutical and Light therapies can enhance the results.
Advanced wrinkling cannot be reversed and a minimal improvement is predictable in persons with alcohol and tobacco abuse.
Severe scarring may not respond.
Further plasma treatment is also popular and safe. PRP - ACR is effective and well tolerated, but patient selection is important if predictable results are to be expected.

Before & after one treatment for Full Face ‘bio active facial rejuvenation’ Courtesy of Dr Alessio Redaelli, Milano

Three months after one treatment. Courtesy of Dr Alessio Redaelli, Milano

Before & After Naso-Labial & Marionette folds

Three months after single treatment with PRP. Courtesy of RegenLab

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About Dermal Fillers

Evolution of the Facial Filler

The ideal filler should be non allergenic, durable, easily injected, user friendly, cost effective and malleable enough to provide a natural look and feel. In addition it should degrade naturally, require no reconstitution or refrigeration, have a long shelf life, evoke minimal pain on injection, be non animal or human derived, require minimal downtime and exhibit few side effects.

Commonly Used Fillers

Dermal fillers in particular have been created to restore volume in a process known as soft tissue augmentation. Commonly used fillers include autologous fat, collagen, hyaluronic, lactic acid, and with increasing frequency a pure and synthetic calcium and phosphate ions microsphere solution.

The Calcium and Phosphate Ion Microspheres Dermal Filler has been studied and used extensively in implants and drug delivery systems for years, with application in otolaryngology, dentistry, orthopedics, urology and neauosurgery and non surgical Facial Augmentation.

The Calcium and Phosphate Ion Microspheres Dermal Filler is considered longer lasting than collagen and hyaluronic acid, with correction duration of up to 18 months. The microspheres typically are degraded via normal metabolism and do not calcify when implanted into tissue.

Allergan has recently released a new dermal filler, filler type JU and JU+. This filler is excellent for areas where contouring and shapes do matter such as lips, as it tends to swell less than other fillers and last for around 9-10 months. It creates natural and soft lips and can be easily used to define or to enlarge the lips volume. There is usually less swelling with this type of filler comparing to other available fillers.

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