Can platelet‑rich plasma (PRP) be used for lip augmentation in an otherwise healthy adult without bleeding disorders, anticoagulant or antiplatelet medication use, pregnancy, or active skin infection, and what is the recommended protocol and expected outcomes compared with hyaluronic‑acid fillers?

Platelet-Rich Plasma for Lip Augmentation

Platelet-rich plasma (PRP) should be used for lip rejuvenation and texture improvement rather than volumization, as it does not provide lasting 3D augmentation beyond 3 months, whereas hyaluronic acid fillers remain the primary choice for significant lip volume enhancement lasting 6-18 months. 1

Primary Indication: Rejuvenation vs. Volumization

PRP is fundamentally a rejuvenation treatment, not a volumizing agent. 1 The key distinction is critical for setting appropriate patient expectations:

• Autologous Platelet Concentrates (APCs/PRP) provide rejuvenation effects including improvement in lip color, moisture, dermal structure, and texture through biostimulation of natural collagen production and tissue regeneration 1
• The 3D volumizing effect does not last beyond 3 months with platelet concentrates, though rejuvenation effects persist longer 1
• Hyaluronic acid fillers create harmonious volumizing with lasting 3D effects for 6-18 months and should be the primary option when significant volume enhancement is the aesthetic goal 1

A prospective study of 10 patients receiving injectable platelet-rich fibrin confirmed no significant change in lip volume at 3-month follow-up (p = 0.11), despite significant improvements in patient-reported satisfaction with skin and lips 2

Clinical Protocol for PRP Lip Administration

Use the same technical approach as hyaluronic acid fillers to ensure vascular safety:

• Needle gauge: 27-30 gauge needles or 25 gauge cannula 1
• Injection technique: Retrograde fashion into each quadrant of the lip 1
• Critical depth: Above the orbicularis oris muscle to avoid vascular complications, as vessels can be encountered within 1mm of the injection site 3
• Volume per quadrant: 0.2-0.5 mL to avoid compression of neurovascular structures 1, 3
• Total volume: Approximately 2 mL total (0.5 mL per quadrant across four quadrants) 2

Expected Outcomes and Timeline

Patients should expect qualitative improvements in lip appearance rather than measurable volume increase:

• Rejuvenation effects: Improvement in lip color, moisture, texture, and dermal structure 1, 4
• Patient satisfaction: Statistically significant improvement in satisfaction with skin (p = 0.04) and lips (p = 0.02) at 3 months 2
• Lip lines: Numerical improvement in satisfaction with perioral lines 2
• Natural appearance: PRP offers advantages of natural-looking results with biostimulation effects 1
• Duration: Rejuvenation effects persist beyond the initial 3-month period when volumizing effects dissipate 1

Safety Profile and Adverse Events

PRP has an excellent safety profile with only minor, self-limited adverse effects:

• Common effects: Bruising (resolving in 7-9 days), swelling, and tenderness are the most frequent treatment-related effects 3
• Pain: Mild pain or discomfort during injection may occur 1
• Resolution: Most adverse events are mild to moderate and self-limited, resolving within days to weeks 1
• Warn patients preoperatively about these common occurrences to set realistic expectations 1, 3

Critical Pitfall to Avoid

The most common error is using PRP when significant volumization is the patient's primary goal. 1 This leads to patient dissatisfaction when the 3D volumizing effect disappears after 3 months. Avoid using APCs/PRP when significant volumization is the goal - instead, recommend hyaluronic acid fillers for volume enhancement and reserve PRP for patients seeking rejuvenation, improved texture, and natural biostimulation effects 1

Combination Approaches

Combination of HA fillers with PRP is being studied but requires further research to determine optimal safety and efficacy protocols 1 One study in scleroderma patients demonstrated maintained benefits at 24 months when combining hyaluronic acid with platelet-rich plasma, though this was in a disease-specific context 5

Patient Selection Algorithm

Choose treatment based on the patient's primary aesthetic goal:

• For significant volume enhancement: Hyaluronic acid fillers (6-18 months duration) 1
• For subtle rejuvenation with natural appearance: PRP/APCs with understanding that volumizing effects last only 3 months 1
• For texture, color, and moisture improvement: PRP is appropriate 1, 4
• For combination benefits: Consider sequential or combined approaches, though evidence is still emerging 1