The Complete Guide to Platelet-Rich Fibrin (PRF)

What is platelet-rich fibrin?

Platelet-rich fibrin (PRF) represents the next evolution in autologous regenerative therapies, building upon the established foundation of platelet-rich plasma (PRP). Developed by Dr Joseph Choukroun, PRF is produced from the patients own blood without the addition of anticoagulants or chemical activators, resulting in a natural fibrin matrix that slowly releases growth factors over an extended period.

Clinics offer PRF therapy as part of our regenerative aesthetics programme. This provides patients with a natural approach to skin rejuvenation and tissue regeneration.

PRF vs PRP: Understanding the Differences

While both are derived from the patients blood, PRF and PRP differ significantly in their preparation and biological properties:

• Anticoagulants: PRP uses anticoagulant tubes (citrate or EDTA) to prevent clotting; PRF uses plain tubes without anticoagulants
• Centrifugation: PRF uses slower centrifuge speeds and shorter times, resulting in a different cellular composition
• Fibrin matrix: PRF forms a natural three-dimensional fibrin scaffold that traps platelets, leukocytes, and growth factors. PRP is a liquid concentrate
• Growth factor release: PRP releases growth factors rapidly (burst release); PRF releases them slowly over 7-14 days from the fibrin matrix
• White blood cells: PRF retains significantly more leukocytes, which contribute to the immune and regenerative response
• Cost: PRF is typically less expensive to prepare as it does not require specialised anticoagulant tubes or activation agents

Types of PRF

• L-PRF (Leukocyte-PRF)the original solid form, used primarily in dentistry and surgery
• i-PRF (Injectable PRF)liquid form produced with very low centrifuge speeds, suitable for injection in aesthetic applications
• A-PRF (Advanced PRF)modified centrifugation protocol that concentrates more growth factors and leukocytes
• PRF membranescompressed PRF clots used as bioactive membranes in wound healing

How PRF works in aesthetic medicine

The biological activity of PRF in skin rejuvenation involves several mechanisms:

• Sustained growth factor releasethe fibrin matrix acts as a slow-release reservoir, delivering PDGF, TGF-β, VEGF, EGF, and IGF-1 over 7-14 days
• Fibroblast stimulationgrowth factors activate fibroblasts to produce new collagen, elastin, and hyaluronic acid
• AngiogenesisVEGF promotes new blood vessel formation, improving tissue oxygenation
• Stem cell recruitmentgrowth factor signalling attracts circulating stem cells to the treated area
• Anti-inflammatory modulationleukocytes within the PRF matrix help modulate the local immune response

Aesthetic Applications of PRF

Skin Rejuvenation

• Injectable PRF (i-PRF) is administered through superficial microinjections across the face, neck, or decolletage
• Improves skin texture, elasticity, and luminosity
• Particularly effective for fine lines and crepey skin
• Can be used in the periorbital area where other injectables carry higher risks

PRF with Microneedling

• i-PRF applied topically during or after microneedling, penetrating through micro-channels
• Enhanced collagen stimulation compared to microneedling alone
• Accelerated post-treatment healing
• Effective for acne scarring, stretch marks, and general skin rejuvenation

Hair Restoration

• Scalp injections of i-PRF stimulate hair follicles and promote hair growth
• The sustained growth factor release may offer advantages over PRP for hair restoration
• Typically combined with microneedling of the scalp
• Course of 4-6 treatments recommended

PRF Bio-Filler

• PRF combined with hyaluronic acid or albumin to create a bioactive filler
• Provides both volume and regenerative benefits
• Shorter longevity than synthetic fillers but with tissue-improving properties
• Growing area of clinical interest and research

The PRF Procedure

1. Blood draw20-40ml of blood drawn from the arm using specialised non-anticoagulant tubes
2. Centrifugationimmediate processing in a calibrated centrifuge at specific speeds and times (typically 700rpm for 3-5 minutes for i-PRF)
3. Collectionthe liquid PRF layer is carefully collected using a syringe. Time is critical, the fibrin polymerisation process begins immediately, so the PRF must be used within 15-20 minutes
4. Applicationinjected into the skin using fine needles or applied topically during microneedling
5. Recoverymild redness and swelling for 24-48 hours. No significant downtime

Treatment Protocol

• Initial course: 3-4 sessions spaced 3-4 weeks apart
• Maintenance: Single sessions every 4-6 months
• Hair restoration: 4-6 sessions monthly, then quarterly maintenance
• Combination protocols: PRF can be alternated with other treatments such as polynucleotides, skin boosters, or chemical peels

Safety and Considerations

PRF has an excellent safety profile due to its autologous nature:

• No allergy riskderived entirely from the patients own blood
• No additivesno anticoagulants, bovine thrombin, or calcium chloride used in preparation
• Common side effectsmild redness, swelling, bruising at injection sites (self-limiting)
• Contraindicationsblood disorders, platelet dysfunction, active infection, anticoagulant therapy, pregnancy, active cancer, autoimmune conditions

“PRF is a major change in regenerative aesthetics. By eliminating chemical additives and harnessing the bodys natural fibrin matrix, we achieve a more physiological and sustained regenerative response.”, Journal of Clinical Medicine

Frequently asked questions

Summary

Platelet-rich fibrin is an exciting advancement in regenerative aesthetics. This offers a natural, additive-free approach to skin rejuvenation, scar improvement, and hair restoration. Its unique fibrin matrix provides sustained growth factor delivery that may offer advantages over traditional PRP in certain applications. We are committed to offering the latest evidence-based regenerative treatments and will advise you on whether PRF, PRP, or an alternative approach is best suited to your individual needs.