What is the recommended technique for facial injection of autologous platelet‑rich plasma (growth‑factor concentrate) in a healthy adult without active skin infection, bleeding disorders, anticoagulant therapy, pregnancy, or hypersensitivity?

Facial Injection Technique for Autologous Platelet-Rich Plasma (Growth Factor Concentrate)

For facial rejuvenation with autologous platelet concentrates, use precise intradermal injection technique with a 30-gauge, 4mm needle to create visible papules with blanching, delivering 0.05-0.1 mL per injection site spaced 5mm apart, targeting specific problem areas before any microneedling procedures. 1

Pre-Procedure Preparation

• Apply compounded topical anesthesia (pharmacy-based, not over-the-counter) for at least 30 minutes prior to the procedure and ensure complete removal before beginning 1
• Ensure the skin is well lubricated with the platelet concentrate to avoid a dry tugging sensation during injection 1
• Map out problem areas such as fine lines, wrinkles, crow's feet, glabellar lines, and deep nasolabial folds for targeted treatment 1
• Take excellent before and after photographs for documentation 1

Injection Technique Specifics

The intradermal injection method is the safest approach because it delivers growth factors superficially without risk of deep vascular placement, which lies well below the dermis in the hypodermis. 1

Needle Selection and Positioning

• Use small gauge needles: 30-gauge, 4mm length for optimal precision 1
• Ensure the bevel of the needle is facing upward to create an optimal papule 1
• Insert at a shallow angle for precise intradermal placement 1

Injection Protocol

• Inject 0.05-0.1 mL per injection site 1
• Space injections 5mm apart across the treatment area 1
• Formation of a visible papule with blanching confirms correct intradermal layer placement 1
• Inject problem areas before microneedling when the platelet concentrate is in its most liquid form 1

Treatment Schedule

Three to four treatment sessions are required for adequate facial rejuvenation, with a minimum 21-day interval between sessions. 1

• Treatment phase: 3-4 sessions spaced at least 21 days apart 1
• Maintenance phase: One treatment every 6-12 months thereafter 1
• Evaluate results after completing the initial treatment series 1

Critical Timing Considerations for PRF

If using platelet-rich fibrin (PRF) instead of PRP, the formulation will clot within 20-40 minutes if left in the syringe, and exposure to oxygen by opening the tube cap will cause much faster clotting. 1

• Prepare everything before withdrawing blood when using PRF due to limited working time 1
• Use PRF immediately after preparation to avoid premature clotting 1

Post-Procedure Instructions

• Advise patients to avoid sunlight for 24 hours post-procedure 1
• Instruct patients to avoid heavily scented facial creams and products for 24 hours 1
• Counsel patients on proper home care routine and adequate sun protection 1
• Advise against smoking and other damaging habits that impair healing 1

Common Pitfalls to Avoid

Do not inject superficially in a haphazard manner—precise intradermal placement with papule formation is essential for safety and efficacy. 1

• Do not use needles longer than 4mm for facial intradermal injections, as this increases risk of deeper placement 1
• Do not inject over tattoos or permanent makeup 1
• Do not proceed if the bevel is facing downward, as this prevents proper papule formation 1
• Do not inject when skin is dry—maintain adequate lubrication with the platelet concentrate throughout the procedure 1

Alternative Delivery Method: Microneedling

For patients preferring microneedling over direct injection, a spring-loaded microneedling device with adjustable needle depth (0.25-2.5mm) can be used to create microchannels that are then filled with platelet concentrate. 1 This method has minimal downtime (24-48 hours) and lower risk of hyperpigmentation compared to lasers, making it suitable for all skin types including sensitive and ethnic skin (Fitzpatrick types >III). 1