What is platelet-rich fibrin?

If you cut yourself, and your blood is exposed to oxygen, the two main proteins found in blood, fibrinogen and thrombin, convert to a fibrin matrix. A clot forms, the bleeding stops, and your body moves to the next stages of healing. During these initial stages the body uses platelets to induce the healing and clotting cascade. Platelets not only assist in clotting but they also release an array of growth factors that inform the body that it’s been damaged and signal more cells to invade the area. These cells specifically the white blood cells are there to protect you from incoming pathogens that may try to infect the area. This begins the inflammatory process which typically lasts anywhere from one to seven days. Then comes the regenerative phase during which incoming stem cells fibroblasts and in our case other skin cells assist in the repair and regenerative process. These cells lay down new collagen and elastin.

When it comes to regeneration, regenerative cells are found in much lower concentrations when compared to other cell types. By centrifuging blood and separating cells based on density, it is possible to concentrate regenerative cells to 10 times their normal concentration. This platelet concentrate can be applied directly to the defect site to aid in healing and regeneration.

The goal for therapy with PRF is not to replace previously utilized materials such as neurotoxin or dermal filler but instead to offer an additional and safer modality with the ability to “regenerate” tissues naturally. Many patients feel that therapies with PRF offer a more natural look when compared to other more traditional therapies. PRF can help our patients look natural and exactly like themselves just 10 20 years younger.

As we age, we experience a reduction in collagen synthesis, as well as associated increase in tissue degradation, which can lead to a net loss of facial volume, skin folds, and wrinkles. By reintroducing blood-derived growth factors back into an area where tissue changes have occurred, not only can we jump-start healing, but we can restore facial volume and revive tissues.

What is platelet-rich plasma?

Platelet rich plasma is the first-generation platelet rich fibrin. Both PRP and PRF are centrifuge blood concentrates, however, PRP involves an anticoagulant mixed with your blood to prevent clotting. Before healing can occur clotting must occur, as the clot traps very important cells and growth factors that aid healing. By adding anticoagulants into the PRP formulation this clotting was actively being prevented.

Today we use special blood collection tubes that are made to be more hydrophobic water repelling allowing us to delay clotting long enough to centrifuge the blood and get the cells we need, but still encourage clotting once the material is implanted in the body, all without the aid of an anticoagulant. Thus, the new generation PRF was born. PRF has only improved upon the effectiveness of PRP.

The concept of microneedling is also known as collagen induction therapy. Our device, the DermaPen is an electrical medical device that delivers a vibrating, stamp-like motion to the skin, effectively creating a series of micro channel. The micro needles can be adjusted in height to achieve penetration depths ranging from 0.25 to 2.5 millimeters, depending on the task at hand.

Microneedling can be used to introduce growth factors and regenerative molecules into the important layers of the skin. Some clinics microneedle vitamin C to improve the production of collagen, or hyaluronic acid to help rehydrate the skin. Our practice uses the power of PRF to improve skin quality, tone, and texture – a “vampire facial.”

Microneedling with PRF is an extremely safe skin resurfacing therapy and results in minimal damage to the skin. The patient downtime is usually only 24 to 48 hours, which is considerably shorter than other comparable methods of facial rejuvenation such as laser or chemical peels.

Microneedling boasts several advantages

  • Shorter healing times when compared to other modalities typically 24 to 48 hours
  • Can be utilized on all skin types
  • Well tolerated by patients
  • Minimal risk of post inflammatory hyperpigmentation or bruising
  • Encourages the production of collagen
  • No chemicals or additives


What can I expect after a microneedling procedure?

Typically, the skin will appear red similar to a mild sunburn for 24 to 48 hours. Almost immediately after the procedure, your skin will feel tighter with greatest improvements usually observed within three days. Depending on your skin color and condition, you may completely heal within 24 hours post-therapy, especially if an appropriate post treatment skin care regimen is followed.

How long do the effects of microneedling last?

Within 24 hours, patients will begin to notice an immediate glow of the skin. Collagen production will reach its peak about two to four weeks post therapy and these effects can last for up to six months. Three microneedling treatments spaced apart one month each is recommended for most patients to maximize results, with a maintenance treatment every six months thereafter.

How long does the procedure take to perform?

The procedure generally takes about 45 minutes total. It takes 15 minutes to draw and centrifuge the blood to make your PRF. Typically, your face will be numbed with topical anesthetic for 15 to 30 minutes for maximum comfort. It takes approximately 10 to 15 minutes to microneedle the entire face and neck.

Can microneedling be used on other body parts?

Absolutely! Microneedling with PRF for the treatment of body scars or stretch marks is possible.

In more troublesome areas PRF can be injected with very small needles because of its liquid consistency. This is particularly beneficial when patients have specific areas that are more wrinkled and/or damaged. Injectable liquid PRF is often performed in combination with microneedling and the combination approach of both modalities can significantly improve fine lines and wrinkles in these troublesome areas, or any area that the patient would like to specifically address.

The three areas most requested by patients are:

  • Fine lines and wrinkles around the eyes (crow’s feet)
  • Glabellar lines between the eyebrows (11’s)
  • Nasolabial folds (lines that extend from the corner of the nose to the corner of the mouth)
  • Marionette lines(lines that extend from the corner of the mouth to the chin)

In such cases it is advantageous to deliver more growth factors to local areas. With small papule injections it becomes possible to deliver up to five times more volume into these areas prior to microneedling.



Is the use of needles more painful than microneedling alone?

The procedure can be pain free due to topical anesthetic applied to numb the area beforehand. The needles used to deliver the liquid PRF are the same needles used to deliver neurotoxin.

How many treatments are required to rejuvenate the skin?

Like with other treatment modalities that aim to rejuvenate the skin instead of fill it and tent the skin upward, at least three treatments are recommended for most patients. Some patients, depending on their skin texture, tone, and laxity, will require more treatments for best results.

When using a traditional dermal filler, the area is immediately filled with hyaluronic acid, which is then resorbed over time. When using PRF, the body goes through a regeneration process in which it begins to repair itself and produce its own collagen. Therefore maximum results with PRF are typically seen two to three months post-therapy, as the body continues to make collagen after the therapy.

Using PRF can lead to more natural and longer-lasting results, but the results are not as immediate as with traditional filler.

Bio-Filler® is a trademarked science that belongs to CARE Esthetics and its network of providers. Bio-Filler® is an all-natural biologic facial filler alternative to traditional hyaluronic acid dermal fillers. Bio-Filler® overcomes one of the only limitations observed with both PRP and PRF – their relatively short half-life, that is the time it takes to breakdown and be absorbed back into the body.

PRF aims to restore and regenerate tissues, but it has a hard time acting as a true filler because has a relatively fast resorption time, typically 10 to 14 days. This means that within two weeks of treatment those growth factors are released regeneration starts and collagen is produced over the next six months.

While PRF is effective in improving skin tone and texture, deep folds generally require a more permanent and volume stable material. Sometimes liquid PRF was combined with synthetic fillers such as Juvederm or Restylane to achieve the look that the patient was expecting. Even today, liquid PRF can be combined with a traditional hyaluronic acid dermal filler to achieve desired results.

In 2019, methods were discovered to extend the working properties of PRF by heating plasma albumin. The working properties of PRF were found to be drastically extended from a standard two-week period to up to six months!



How is the Bio-Filler® made?

To process Bio-Filler®, PRF is heat created to drastically extend its working properties and then mixed with untreated PRF. The entire preparation takes about 25 minutes and the results can help patients achieve a natural youthful look.

Where can Bio-Filler® be injected?

Bio-Filler® can be injected anywhere your provider would usually place a traditional hyaluronic acid dermal filler – tear troughs, temples, cheeks, chin, and lips.

Does Bio-Filler® still regenerate tissues?

Yes, Bio-Filler® still regenerates tissues. The same technology used in Bio-Filler® is used for more complex disorders such as diabetic ulcers and knee and spinal injections. Research on the Bio-Filler® technology has been more widespread in medicine, as it has only relatively recently been introduced to facial esthetics. The Bio-Filler® protocol has resulted in positive outcomes and been proven to induce collagen synthesis when implanted within the superficial and deep layers of the skin. This technology has the ability to form a stable clot following heating, which provides superior volume enhancement when compared to standard liquid PRF.

What are other advantages of Bio-Filler®?

  • 100% natural and chemical-free 
  • Safe to individuals with allergies and autoimmune diseases 
  • Natural rejuvenation