4 Platelet-Rich Plasma (PRP) Injections Techniques for the Periorbital Region
Platelet-Rich Plasma (PRP) therapy has become one of the most sought-after non-invasive treatments in aesthetic medicine, particularly for rejuvenating the delicate periorbital region. Known for its ability to address concerns such as fine lines, wrinkles, dark circles, and tear troughs, PRP promotes natural skin regeneration by stimulating collagen production and improving skin texture. Recent research has shown PRP’s efficacy in these areas, making it a highly effective treatment for facial rejuvenation (Evans et al., 2021; Majewska et al., 2024).
In this article, we will explore how PRP works, particularly for the periorbital area, and discuss blood collection, preparation methods, and PRP injection techniques. We will also examine how PRP differs from other aesthetic treatments and why it is an ideal option for those looking for natural, long-lasting skin rejuvenation.
What is PRP and How Does It Differ from Other Aesthetic Treatments?
PRP (Platelet-Rich Plasma) is a regenerative treatment that harnesses the healing power of platelets from the patient’s own blood. Platelets are rich in growth factors, which play a key role in tissue repair, collagen production, and skin regeneration. Here’s how it works:
Blood Collection and Processing: A small sample of the patient’s blood is drawn, typically around 10 to 60 milliliters. The blood is then processed using a centrifuge to concentrate the platelets into the plasma. The resulting platelet-rich plasma is then injected into the treatment area.
Natural Healing and Regeneration: When injected, PRP releases growth factors that stimulate the skin’s natural healing process. This leads to increased collagen production, improved skin elasticity, and renewed skin texture, which helps to reduce the appearance of fine lines, wrinkles, and volume loss.
How PRP Differs from Other Treatments:
PRP vs. Botox: Botox (botulinum toxin) works by temporarily paralyzing the muscles that cause wrinkles, mainly in the forehead, around the eyes, and between the brows. PRP, on the other hand, works by stimulating collagen production and improving skin texture. PRP is more about skin regeneration, while Botox focuses on muscle relaxation. PRP results are gradual and natural, whereas Botox offers instant results.
PRP vs. Dermal Fillers: Dermal fillers, such as hyaluronic acid, are used to restore lost volume and fill wrinkles by physically plumping the skin. While PRP can also help restore volume over time, it works more gradually and focuses on collagen stimulation and improving skin quality. Dermal fillers provide immediate volume, while PRP’s effects build over weeks or months, promoting long-term skin health.
PRP vs. Chemical Peels: Chemical peels use acid-based solutions to exfoliate and remove the outermost layers of the skin. This process reveals fresher, younger-looking skin underneath. PRP, however, works on a deeper level, stimulating collagen and elastin production without the need for exfoliation or peeling. While both treatments can improve skin texture, PRP also improves skin thickness, elasticity, and tone, while chemical peels mainly focus on surface-level rejuvenation.
PRP’s Natural Advantage: One of the key differentiators of PRP is that it is a completely natural treatment. Since PRP uses the patient's own blood, the risk of allergic reactions or complications is minimal. In contrast, treatments like Botox or dermal fillers use synthetic materials that may carry a small risk of side effects or complications.
PRP for the Periorbital Region: A Specialized Approach
The periorbital area—comprising the delicate skin around the eyes—is one of the most challenging areas to treat due to its thin skin, high vascularity, and proximity to important anatomical structures. PRP offers a natural solution by stimulating collagen production, improving skin texture, and restoring lost volume.
Key Benefits of PRP for the Periorbital Region:
Treating Fine Lines and Wrinkles: PRP is highly effective for addressing crow’s feet, the fine lines that appear around the outer corners of the eyes due to aging and sun damage. By promoting collagen synthesis, PRP smoothens these wrinkles, giving the skin a more youthful appearance.
Reducing Dark Circles: PRP can help with periorbital hyperpigmentation (dark circles) by improving skin texture and promoting the production of new collagen, which helps thicken the skin and reduce the appearance of dark circles.
Volume Restoration: As we age, the skin under the eyes may sag or hollow out, leading to the formation of tear troughs. PRP restores volume in these areas, providing a more youthful and refreshed appearance by stimulating the production of new tissue and collagen.
Why Choose PRP for the Periorbital Region?
PRP stands out as an ideal choice for the periorbital area for several reasons:
Natural, Safe, and Effective: Since PRP is derived from the patient’s own blood, there is virtually no risk of allergic reactions or rejection. Clinical studies show that PRP injections for the periorbital region can significantly improve the appearance of fine lines, wrinkles, and under-eye hollows. In one study, patients reported an average improvement of 25% in skin thickness and texture after a series of PRP treatments.
Minimal Downtime: Unlike surgical treatments, PRP injections are minimally invasive and require little to no downtime. Patients can often return to their daily activities shortly after the procedure, making it a convenient option for those looking to rejuvenate the periorbital area without long recovery times.
Gradual and Natural Results: PRP offers gradual, natural-looking results, which is particularly important for sensitive areas like the eyes. It doesn’t produce the sudden, sometimes artificial appearance that can occur with dermal fillers, allowing for more subtle, long-lasting rejuvenation.
When Not to Choose PRP: Limitations and Disadvantages
While PRP is effective for many patients, it may not be suitable for everyone or every situation. Here are some scenarios when PRP might not be recommended for the periorbital region:
Severe Volume Loss: For deep tear troughs or significant under-eye volume loss, dermal fillers may be more effective than PRP, as they can immediately restore volume in a way that PRP’s gradual results may not achieve.
Active Skin Conditions or Infections: Patients with conditions like active acne, eczema, or eye infections should avoid PRP treatments, as these can exacerbate the condition or interfere with the skin's natural healing process.
Blood Thinning Medications: Patients on blood thinners or anticoagulants may experience excessive bruising or difficulty in clotting, which can affect the results of PRP therapy.
The Importance of Proper Blood Collection and Centrifugation for PRP
For optimal results in the periorbital region, PRP must be prepared correctly. The blood collection and centrifugation process directly impacts the effectiveness of the treatment:
Blood Collection: Typically, 10 to 60 milliliters of blood is drawn. The blood is drawn through standard venipuncture using a 21- or 22-gauge needle.
Centrifugation: After blood collection, the blood is processed in a centrifuge to separate the platelet-rich plasma from the red blood cells. The platelets are concentrated in the plasma layer and are then collected for injection. Double centrifugation is often recommended for periorbital treatments to ensure the highest concentration of platelets, enhancing collagen production and skin rejuvenation.
Why Proper Preparation Matters: If the blood is not properly processed or the centrifugation protocol is not followed correctly, the concentration of platelets may be insufficient, leading to suboptimal results. Ensuring the right protocols are followed maximizes the efficacy of the PRP treatment, delivering the best possible outcome for the periorbital area.
4 PRP Injection Techniques for the Periorbital Region: Precision for Optimal Results
PRP injections for the periorbital region require advanced techniques and a deep understanding of the delicate anatomy around the eyes. The skin in this area is thin and highly vascular, so precision in technique is critical to achieving natural, safe, and effective results. Below are the most commonly used PRP injection techniques, each serving a different purpose based on the target area, depth, and desired result.
1. Fan Pattern Technique (For Crow’s Feet and Fine Lines)
This technique is primarily used to treat crow’s feet and fine lines around the outer corners of the eyes caused by aging, sun exposure, and repeated facial expressions.
How It Works: PRP is injected in a fan-like pattern across the crow's feet area. This method ensures even distribution of PRP, stimulating collagen production and smoothing fine lines.
Injection Depth: Shallow intradermal injections, targeting the superficial dermis where fine lines form.
Injection Sites: Focus on the lateral canthus, the outer corner of the eyes where crow’s feet appear.
Technique Tip: Hold the needle at a slight angle to reduce discomfort and ensure smooth deposition of PRP. Start with superficial layers and increase the depth slightly if necessary.
2. Linear Threading Technique (For Tear Troughs and Under-Eye Hollowing)
Used for treating tear troughs (under-eye hollows) and dark circles, which are common concerns in the periorbital area.
How It Works: The needle is inserted along the length of the tear trough, and PRP is injected in a continuous linear fashion. This restores volume and improves skin texture, reducing the appearance of hollows and dark circles.
Injection Depth: Shallow to moderate intradermal injections, avoiding deeper tissue layers to prevent affecting underlying blood vessels.
Injection Sites: Focus on the mid and lower tear troughs, where hollows and dark circles are most noticeable.
Technique Tip: For deeper volume loss, consider using a microcannula to reduce trauma and minimize bruising, especially in sensitive areas like the tear trough.
3. Grid or Cross-Hatching Technique (For General Periorbital Rejuvenation)
For overall skin rejuvenation across the periorbital region, improving skin tone, texture, and addressing fine lines and mild laxity.
How It Works: PRP is injected in a grid or cross-hatching pattern, covering the entire periorbital area. This technique ensures even distribution of PRP across both the upper and lower eyelids.
Injection Depth: Superficial to moderate intradermal layers, depending on the skin’s condition and area being treated.
Injection Sites: Across the upper and lower eyelids and around the eyes, where fine lines and loss of skin elasticity are present.
Technique Tip: The cross-hatching pattern ensures that PRP is spread evenly across the treatment area, improving collagen production and skin quality.
4. Alternative Delivery Method: Microcannula for Sensitive Areas
Microcannula is an alternative delivery method for injecting PRP, especially useful for treating tear troughs and other sensitive areas in the periorbital region.
How It Works: Unlike sharp needles, a microcannula has a blunt tip that reduces the risk of tissue trauma, vascular injury, and bruising. The cannula is inserted through a small entry point, allowing PRP to be deposited smoothly along the targeted area.
Applications: Microcannula can be used with techniques like linear threading or grid/cross-hatching, making it versatile for treating hollow under-eyes or rejuvenating delicate skin.
Advantages:
Reduces the risk of bruising and swelling.
Allows for more even PRP distribution in a single insertion.
Enhances patient comfort, particularly in sensitive areas.
When to Use: Recommended for patients with thin or sensitive skin and for areas prone to bruising, like the tear troughs.
Technique Tips for Success
Use a Light Hand: The periorbital area is very sensitive, so applying too much pressure during injection can cause discomfort or damage to the tissue. A light, steady hand is essential.
Bevel-Up Technique: Always use the bevel-up technique to reduce trauma and ensure smooth PRP deposition.
Layered Approach: Start with more superficial injections for fine lines and gradually deepen the needle for areas requiring volume restoration or skin rejuvenation.
Avoid Over-Filling: Subtlety is key when treating the periorbital region. Over-filling can lead to unnatural results, especially in the under-eye area. Gradually layer PRP to achieve natural, refreshed skin.
Conclusion
PRP therapy offers a natural, non-invasive solution to rejuvenate the periorbital region. By targeting specific concerns like wrinkles, dark circles, and volume loss, PRP provides a safe, effective way to restore a youthful appearance to the delicate skin around the eyes. With the right preparation, injection techniques, and patient selection, medical professionals can achieve exceptional results. Whether using techniques like fan pattern, linear threading, grid/cross-hatching, or microcannula, the key is precision and subtlety to ensure natural, refreshed results.
PRP is an excellent option for patients seeking subtle, gradual improvements in the periorbital area without the need for surgery. Understanding the limitations and knowing when to choose alternative treatments, such as dermal fillers, is key to achieving the best outcomes for each patient.
Reference:
Evans AG, Ivanic MG, Botros MA, Pope RW, Halle BR, Glassman GE, Genova R, Al Kassis S. Rejuvenating the periorbital area using platelet-rich plasma: a systematic review and meta-analysis. Arch Dermatol Res. 2021 Nov;313(9):711-727. doi: 10.1007/s00403-020-02173-z. Epub 2021 Jan 12. PMID: 33433716.
Majewska, Lidia, Kijowski, Jacek, Dorosz, Karolina, Developing a Reproducible Procedure for Optimal Utilization of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) in Aesthetic Treatments: Efficacy Evaluation Using Ultrasound Imaging—A Single-Center Prospective Open-Label Randomized Study, Dermatologic Therapy, 2024, 8649287, 12 pages, 2024. https://doi.org/10.1155/2024/8649287
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