title: Current Evidence for Clinical Efficacy of Platelet Rich Plasma in Aesthetic Surgery: A Systematic Review.
abstract: Platelet rich plasma (PRP) has attracted attention in a number of surgical fields due to a wide variety of potential clinical benefits. Yet PRP has not gained wide popularity in aesthetic surgery as a result of uncertainty surrounding objective clinical evidence.
  
  
  
  We aim to describe the current applications, define preparation and activation, explore effectiveness, and propose a classification system to facilitate comparisons across studies.
  
  
  
  A comprehensive review of the literature regarding the use of platelet rich plasma in aesthetic surgery was performed. Data gathered included: PRP application, study type, subject number, centrifugation, anticoagulation, activation, PRP composition, and outcomes.
  
  
  
  Thirty-eight reports were identified. Applications included injection into aging skin (29%), scalp alopecia (26%), lipofilling (21%), fractional laser (13%), and facial surgery (11%). The majority of studies (53%) were case series without controls. Leucocytes were sparsely defined (32%). The concentration of injected and/or baseline platelets was rarely clarified (18%). The mechanism of activation was described in 27 studies (71%), while anticoagulation was uncommonly elucidated (47%). While most studies (95%) claim effectiveness, objective measures were only utilized in 17 studies (47%).
  
  
  
  Current studies produce context-dependent results with a lack of consistent reporting of PRP preparation, composition, and activation in aesthetic applications, making meaningful meta-analysis unrealistic. Thus the method of PRP preparation warrants increased attention. We recommend a set of descriptors, FIT PAAW (described below), to produce scientifically grounded conclusions, facilitating a clearer understanding of the situations in which PRP is effective.
  
  
  
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authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Russell S
authors.initials: RS
authors.lastname: Frautschi
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Hashem
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Brianna
authors.initials: B
authors.lastname: Halasa
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Cagri
authors.initials: C
authors.lastname: Cakmakoglu
authors.affiliation: Facial Surgery Section Editor for Aesthetic Surgery Journal.
authors.forename: James E
authors.initials: JE
authors.lastname: Zins
mesh_terms: D003357:Cosmetic Techniques / Q000009:adverse effects; D004954:Esthetics; D006801:Humans; D053657:Platelet-Rich Plasma; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D016896:Treatment Outcome