Systematic Review of Platelet-Rich Plasma and Platelet-Rich Fibrin in Facial Rejuvenation

BACKGROUND: Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are promising treatments for facial rejuvenation, leveraging growth factors to stimulate natural tissue repair and regeneration. Despite their growing popularity, their effectiveness remains controversial, with studies yielding mixed results. This systematic review evaluates the current evidence on PRP/PRF therapies and their effect on the following 6 key parameters of facial aging: wrinkles, texture, dyschromia, elasticity, skin thickness, and hydration. METHODS: A comprehensive literature search was performed in PubMed, Embase, and Cochrane databases for controlled trials, prospective cohort studies, and case series published after 2010. Eligible studies included more than 5 patients, evaluated PRP or PRF as monotherapy, and addressed at least 1 of the 6 listed parameters of facial aging. Articles were screened by 2 independent investigators and scored for quality of evidence using the Oxford Centre for Evidence-Based Medicine hierarchy. RESULTS: Twenty articles, comprising 514 patients, met inclusion criteria. Sixteen studies compared PRP/PRF to a control or baseline, while 4 compared them to alternative treatments. Wrinkles and fine lines (n = 16) were the most frequently studied parameters, followed by dyschromia (n = 12), texture (n = 11), elasticity (n = 6), skin thickness (n = 5), and hydration (n = 4). Significant improvements following PRP/PRF treatment were reported in 80% of studies on skin thickness, 75% on elasticity, 40% on wrinkles, 33% on texture, 17% on dyschromia, and 0% on hydration. Skin dyschromia had the highest proportion of studies reporting mixed findings (41.7%), whereas skin hydration had the highest proportion of studies reporting no improvement (67%). Additionally, all studies evaluating patient satisfaction reported significant improvements from pretreatment to posttreatment. No serious adverse events were reported in any of the included studies. CONCLUSIONS: This systematic review identified skin thickness and elasticity as the facial aging parameters with the strongest evidence of improvement following PRP/PRF treatment, while skin hydration showed the weakest.