NEW EVOLUTION OF AESTHETIC BIOTECHNOLOGYSPECIALIST IN NONABLATIVE SKIN REJUVENATION

AND AUTOLOGOUS CELLULAR REGENERATION

Indah Yulianto.,Yulianto D., Endra Yustin., Ari Kusumawardhani.DERMATO VENEREOLOGY DEPARTMENT

MEDICAL FACULTY OF SEBELAS MARET UNIVERSITY / DR. MOEWARDI GENERAL HOSPITAL

SURAKARTA 

Skin treatment action levelsMultidisciplinary Program For the

Rejuvenation for the faceFILLERS

Wrinkles & Volumes

correction

BIO Stimulatio

nPRP

Architectural skin reconstruction/reorga

nization

Dermo coemeticis

Peels

Renewal of the corneal layer

Germinative layer stimulation

Dermis stimulation

Beauty is a balance between form and volume

Beauty produces in us an aesthetic feeling, an admiration

by pleasing the eye

Beauty does not captivate through detail but through the whole,which is greater than the sum of the individual parts

Beauty does not only have to do with the face, the voice, the body or a

charming appearance.

What is BEAUTY ?

Platelet-Rich Plasma (PRP)PRP has been breakthrough in the

stimulation and acceleration of soft tissue healing, rejuevenation

It represents a relatively new biotechnology that is part of the growing interest in tissue engineering and cellular therapy today

The clinically useful product is a concentration of platelets in small volume plasma and is therefore a “platelet-rich-plasma”

It come drop by drop from our blood

Anatomy and Fungtion from platelets

PRP – harvesting :

The patient’s blood is drawn

Autologous Whole Blood

Platelet poor plasma and

Buffy coat

Erythrocyt

Platelets Poor Plasma

Platelets Rich Plasma

Rpm/minutes

Rpm/minutes

Steps in the preparation of platelet-rich

plasma.

Platelet-rich plasma (in the syringe) and platelet-poor plasma (in the centrifugation tube). The latter can be used to cover the surgical area.

HypothesisIf platelets concentrate could be

brought to level greater than eight times baseline the physiological effects may be profoundly positive.

(Dr Astley E Smith.,Global Autografting Institute)

PRP AND HC PRP

PRP hcPRP

15 PRP protocols : PRP 2 x – 8 x 1 Protocol : hc PRP 9X – 45X

Centrifuge Single spin Double or Triple centrifugeSingle or double pooling

Platelet activation :NothingCaCl2CaCl2 or Bovine Thrombin

Platelets activation :Ca Cl2 and Autologous Thrombin from patients serum

Fibrin Clot Fibrin Clothc PRP enhanced fibrin clotSuper Autologous Graft (EF 23+, EC 23+, EB 23+,) EF + enhanced Fibrin, EC : Enhanced Collagen; EB : Enhanced Bone)

RESEARCH &

DEVELOPMENT

Cell separation

Autologous cell culture

Autologous stem cells culture

Cell differential

Tissue regeneration

Healing remodelling

DENTAL MEDICINE

Dental extractionDental implantation

DERMATOLOGYINTERNAL MEDICINEGERONTOLOGY Cutaneousreconstruction and transplantation

Ulcer and Chronic wound therapy (after radio therapy )

Re-implantation of Autologous cells, extemporaneous or cultivated in-vitro

Surgery

Cardio-vascular surgery

Abdominal surgery

Maxillo facial surgery

Orthopaedic surgery

Dermatology, Cosmetic and Plastic surgery

Treatment of severe burns

FIELDS APPLICATION of Platelets Rich Plasma

Factor Name Principal Source

Effects

PDGF aa PDGF bb PDGF ab

Platelet derived growth factors

Activated thrombocytes

Mitogenes of mesenchymal stem cells promote the synthesis of the extracellular matrix

TGF- alpha TGF- beta

Transforming Growth Factors

Activated thrombocytes

Stimulation of DNA synthesis, proliferation of various types of cells. Favours the synthesis of collagen

IGF- I IGF- II

Insulin-like Growth Factors

Activated thrombocytes

Stimulates the proliferation and differentiation of osteoblasts

EGF Epidermal Growth Factor

Activated thrombocytes

Stimulates proliferation and differentiation of epidermis cells, co-stimulating angiogenesis

Some Growth Factors Acting on “Healing Cascade”

VEGF Vascular Endothelial Growth Factor

Leucosytes & Endothelial cells

Stimulate angiogenesis & chemo- attraction of osteoblasts

In addition the activated thrombocytes have onto their surface a multitude of signalisation molecules eg. CD9, CD-W17, CD31, CD41, CD42a-d, CD51, CD-W60, CD61, CD62P, CD63

Advantages of a-Plasma

Tissue regeneration & rejuvenation: neo-collagenesis(TGFα& β), neo-vascularisation(EGF & VEGF), & extracellularmatrix formation (PDGFαα& ββ& αβ) –NB: growth factors in genetically pre-determined ratio!

Bio-glue (fibrin glue): haemostasis & tissue adhesion in skin flaps, bone grafts, trauma intra-surgery and post-surgery

Safety: non-allergenic & free from concerns over transmissible diseases e.g. HIV, Hepatitis B & C, CJD, etc.

Autologous: no risk of rejection reaction Wound healing time: increased Physiological ‘anti-biotic’: anti-bodies & WBC’s& proteolyticenzymes Plasma includes: hormones, biotransformedvitamins & other

nutrients Tissue engineering: in-vitro autologous tissue culture-medium. Ease of use: dermal & hypodermal injections Convenience: Plasma harvesting performed in doctor’s rooms (no

external laboratory required)

Contra -IndicationsPlatelet Dysfunction SyndromeCritical ThrombocytopeniaHypofibrinogenaemiaHaemodynamicInstabilityAuto-immune diseaseMalignancySepsisAcute & Chronic InfectionsChronic Liver PathologyAnti-coagulation therapy Pregnancy (for cosmetic indications)

BEFORE 1 Month After

BEFORE AFTER – 3 months

A – 64 years – old woman, injection by autologous PRP

1 month after.

Acne Scar : Subcision + hc PRP : 1 month after

After – scratching by rat – 3 weeks ago

before

4 days after injections

Acne Scar : Dermaroller 1.5 mm + PRP

Before 1 week after(right side)

BeforeBefore1 week after1 week afterSubsicion

with Nocorneedle

Acne Scar + Subsicion + PRP Acne Scar + Subsicion + PRP

3 weeks after

Alopecia – 36 years old

Alopecia and MarkingAlopecia and Marking 3 weeks after Injeksi PRP

In Bulbus