Its the middle of November and nearing the year end. The current weather changes occurring in the country has brought a lot of dismay. The Northern floods despite being an annual event, hit its worst in Penang this year with the last occurrence of massive floods to be 50 years ago. My heart goes to Penang and the flood victims.AlthoughI must say we learnt a lot from the previous Kelantan floods and thus people are more attune to mobilising help as fast as possible. Kudos to the volunteers on the good work. Our doctor associations are also working together to contribute help to the flood victims and the combine effort would surely be fruitful. Many forget that during the floods is one issue, but afterwards there are many other issues such as damage to property, access to clean water, and he psychological impact post disaster not to mention the rise of water borne diseases such as cholera and other diseases due to the rise of water. Stay safe people. Please remember to only drink safe filtered bottled water and wash your hands and try to keep clean all the time.
Coming to today’s blog topic, let’s talk about platelet rich plasma treatments. To make life easier, I’ve compiled 10 most asked questions on this topic mainly on aesthetic use rather than other uses.
Number 1 : What is PRP treatment?
PRP or platelet rich plasma are treatments using your own blood which is centrifuged to separate the plasma from the red blood cells and then the plasma component is then used at the target area desired. Depending on the technique and kit used the blood drawing can be anything from 10mls to 120mls based on target area of treatment and amount required. It is recognised as a treatment for orthopaedic knee problems and for facial rejuvenation but can only be done by doctors who are specially trained to do the procedure.
Number 2 : What are the benefits of PRP for my face?
PRP facial rejuvenation has shown to improve skin texture thus leads to tightening of the skin and smaller pores and improvement in pigmentation and colour. However, the results are not immediate and may take up to 3-6 weeks for you to see the effect and you may need multiple treatments at a certain interval to get the desired results.
Number 3 : Why is PRP used for rejuvenation of the skin?
The platelet component of blood contains more than 26 different types of platelet growth factors and proteins that aids healing. The theory behind the usage of PRP is that concentrating the growth factors would accelerate healing by providing the substrates for healing.
Number 4 : How is PRP applied for face rejuvenation?
PRP is applied to the face via various methods. The earliest method was the nappage technique introduced by the french where controlled superficial nicks to the skin were made using a small gauge needle like a 30G or 32G. The idea was to rejuvenate the skin on the epidermal layer. Later we discovered that even deeper injections benefit and thus the emergence of direct deeper injections into the different layers of skin, and using mesoguns and vacuum injectors. Some people use mesoroller to combine the effect with the controlled damage to stimulate more collagen growth and some combine PRP with laser treatment or PDO threads. Depending on the method of application will determine the length of social downtime.
Number 5 : Can PRP work for my hair loss problem?
Yes and no. It depends on the reason for your hair loss. PRP can be one of the adjunct for your overall hair loss problem and it works the best combined with other modalities such as nutrition, determining the underlying cause for the loss i.e. hormonal, stress, hereditary alopecia etc, LED red light therapy, shampoo change, keeping hair short and other hair losing lifestyle habits like treating trichomania or trichotillomania i.e. the obsessive compulsive disorder of pulling out hair, or over ironing, over blowing the hair. Even if it does work, the interval for repeated treatment is within 4-6 weeks with possibly requiring 5-10 treatments done continuously. However, I have seen really good results from using PRP and recently one of my colleagues posted on his discovery combining the PRP with minoxidil for better growth.
Number 6: Where else can PRP be used besides the face and the knee?
PRP treatments are still in the developmental phase but a few interesting case studies have shown benefit of using PRP to rejuvenate the vagina and enhance G spot, to improve on scars and to rejuvenate the breasts. Some even tried IV PRP for overall rejuvenation but in view that the kits may contain other preservatives and chemicals which is foreign to the body, directing directing into the vein may not be the wisest thing to do. Furthermore, most of the studies on improvement are for localised areas due to the high concentrations of platelet factors.
Number 7 : Is the procedure painful?
Any form of injections to any part of the body would incite some pain or discomfort. Depending on your sensitivity towards pain and the skill of the doctor, and whether any form of pain relief given would determine the extent of pain and experience. A well trained and skilled doctor will be able to do this procedure with tolerable and minimal pain. If you are experiencing extreme pain from the injections done or the technique used, perhaps you should start questioning the doctor’s injection skills. Not all doctors are trained the same, nor are they specialised in similar techniques. Even among aesthetic doctors, not many are really good with injections and it takes years of proper training and practice to actually have a good skill (what more doctors who are not trained in aesthetics).
Number 8: Is PRP a treatment for everyone?
Although it sounds wonderful, unfortunately No. There are many conditions that causes a person to be unsuitable for PRP or maybe have substandard results. The complete contraindications are for anyone who has any form of platelet disorder such as thrombocytopenia or abnormal platelets. People on chemotherapy, radiation therapy or with bone marrow suppression, people on warfarin and other blood thinning agents, people with clinical anaemia with low hemoglobins, people on steroids, pregnant ladies and other rare diseases. Relative contraindications would be people on aspirin and other anti-platelet therapy, patients with lipaemia (high level of fatty acids in the blood), dehydrated patient, heavy smokers, heavy consumption of alcohol and supplements that interfere with platelet functions. They may do the procedure but require to abstain for a few days and rehydrate more else the results may be substandard.
Number 9: I have done PRP before but I did not find much difference. Why?
There are 2 real factors for the success of PRP treatments. 1 is the patient, secondly is the doctor. One the patient side, minus all of the above contraindications and relative contraindications, about 20% just do not respond to PRP treatments. Usually it is related to the general health of the patient. If they are well, not under too much stress, eat healthy, exercise and sleep well, usually they will have wonderful results seen as early as 1 week. Certain supplementation such as vitamin C and glutathione enhances the PRP effect. The other most important factor is the doctor. First of all, the doctor should be able to assess if you are suitable for the procedure and which method of application is most suitable for you and how many treatments at what interval to match your expectations. Secondly, would fall back to the method and technique the doctor uses to process and apply the PRP to the patient. Depending on how experienced and well versed they are about the procedure and outcome will determine the results. My take is simple, if there is no results, ask the doctor doing the procedure for an answer. He should be able to provide an answer, if not he is not trained or qualified to do the procedure. So far I have done over a few thousand of PRP treatments for the past 6 years and only a few did not have a good outcome, but all were due to patient’s own problem such as high lipids in blood, excessive smoking and dehydration. Once these were corrected, the results improved.
Number 10 : Why is there a vast difference in the prices of PRP in the market?
This actually depends on the methods and kits used by the doctors. Some kits are very expensive and thus the price would usually be charged in the thousands. Other reasons would be the skill of the doctor. Most doctors who are just doing PRP for the sake of doing and not running a proper aesthetic practice would charge a lot cheaper because it is not their expertise. It also reflects on the skill of the doctor. Some aesthetic centres combine PRP with plant EGF and other things to enhance the results thus the price will go up. Some doctors are just so junior, they throw prices just to attract patients to their centre but they only know the procedure on surface. Some places are just beauty salons who are not medical doctors, and thus throw prices to attract people there. However, I always say, be careful if something is too cheap – there will always be a catch or some quality defect in the service or product. I may not be the cheapest, nor am I the most expensive, but you basically pay for the quality that you will receive.
I would actually recommend PRP to all patients since it is a quick rejuvenation technique that does not require much after care or abstain from sunlight like post laser therapy. For this year end we are giving our PRP treatments for a special price of RM 1500 per session only (Normal Price RM 2500). It is a 2 hour procedure with minimal downtime.
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