PRF Injection Treatment Regimen
For aesthetic facial rejuvenation, PRF should be administered as 3-4 intradermal injection sessions spaced 3-4 weeks apart, with maintenance treatments every 6 months thereafter, using specific centrifugation protocols without anticoagulants. 1
Preparation Protocol
Standard PRF Preparation
- Centrifuge whole blood at 2000g for 8 minutes in a horizontal centrifuge without anticoagulants 2
- This differs fundamentally from PRP preparation, which requires anticoagulants 1
- Timing is critical—prepare all equipment before blood withdrawal as PRF begins spontaneous coagulation after approximately 30 minutes 2
Advanced Albumin-PRF (Alb-PRF/Bio-Filler) Preparation
For longer-lasting volumization (4-6 months resorption):
- Collect 2-4 mL of platelet-poor plasma (PPP) from the upper layer after centrifugation 2
- Heat PPP at 75°C for 10 minutes to denature albumin, then cool to room temperature 2
- Mix the heated albumin gel with liquid PRF (including buffy coat layer) using a female-female luer lock connector 2
- This creates a thicker consistency ideal for volumization versus standard liquid PRF 2
Treatment Protocols by Indication
Periorbital Rejuvenation (Under-Eye Area)
- Four sessions of intradermal PRF injections, 1 month apart 2
- Use 30-gauge needles for the delicate periorbital skin 2, 1
- For Alb-PRF formulation, use a 22G × 2-inch (~5 cm) cannula for enhanced safety around the eyes 2, 1
- Alternatively, two sessions spaced 1 month apart show effectiveness, though improvement may not be maintained for 3 months with only two sessions 2
- Results show 47.8-60.9% improvement in periorbital dark circles and 73.9-78.3% improvement in wrinkles at 3-6 months follow-up 2
Facial Wrinkles and Volume Restoration
- Four sessions with 2-3 week intervals (Cleopatra technique) for lower face rejuvenation 2
- For nasolabial folds: inject PRFM into the dermis and immediate subdermis with results showing mean reduction in wrinkle assessment scores from 3.18 to 1.65 at 3 months 2
- Bio-Filler (Alb-PRF) provides longer-lasting results (4-6 months) for volumization compared to standard liquid PRF 2
Skin Rejuvenation (General)
- Three treatments minimum with 21-day intervals, followed by maintenance every 6 months 1
- Intradermal point-by-point injection technique 2
- Results persist for at least 6 weeks with objective improvements in skin texture, elasticity, pore size, and moisture 2
Injection Technique Guidelines
Needle Selection
- 25-gauge needle or large bore cannula for Alb-PRF to avoid blockages 2
- 30-gauge needles for delicate periorbital areas 2, 1
- Lower microneedling depth to 0.25 mm when treating under-eye area 2, 1
Technical Tips for Alb-PRF
- Eliminate bubbles before heating the upper plasma layer 2
- Ensure heated albumin gel cools completely before mixing with liquid PRF 2
- Use firm luer-to-luer connection and mix slowly 2
- Push liquid through connector to eliminate dead space and bubbles before mixing 2
Pre-Treatment Preparation
Patient Instructions
- No hair products (wax, gel, spray) on treatment day for scalp applications 2
- Shampoo and detangle hair before scalp sessions 2
- Take excellent before and after photographs 2
- Mark treatment areas clearly before injection 2
Surgical Applications (Periodontal/Bone Regeneration)
- Apply chopped PRF membrane pieces (preferably face portion) in intra-bony defects 2
- Rinse defects with L-PRF exudate collected after membrane compression 2
- Create perforations in bony defects if blood supply is insufficient 2
- Cover with L-PRF membranes extending at least 3-5 mm beyond defect borders 2
Post-Treatment Care
Immediate Post-Injection
- Patients should be warned about potential bruising and swelling, which are temporary 1
- Advise good home care routine and adequate sun protection to enhance results 1
- For surgical applications: restrict to soft food, no mechanical cleaning for 1 week, rinse with 0.12% chlorhexidine twice daily for 3 weeks 2
Follow-Up Schedule
- Assess results at 3 months for facial rejuvenation 2
- Schedule maintenance treatments every 6 months 1
- Monitor for sustained improvements in wrinkles, skin texture, and volume 2
Safety Profile and Adverse Events
PRF demonstrates excellent safety as an autologous material with minimal complications 1. Studies report only minor, self-limited adverse events 2. No cases of fibrosis, irregularity, hardness, restricted movement, or lumpiness have been reported in facial applications 2. The autologous nature provides superior safety compared to chemical fillers, which many practitioners avoid due to safety concerns 2, 1.
Clinical Outcomes
PRF shows superior results compared to PRP in multiple studies, particularly for canthal smoothness and wrinkles at 3 months 1. Plasma gel (Bio-Filler) demonstrates significantly better results than standard PRP for periorbital rejuvenation 2. Patient satisfaction rates exceed 90% when PRF is combined with nanofat for facial rejuvenation 2. The treatment is cost-effective, well-tolerated, and produces significant aesthetic correction maintained for 3-6 months 2.