Platelet Rich Fibrin for Tear Trough Rejuvenation

Background: Platelet therapy is quickly becoming an integral aspect of cosmetic treatments.
Most notably, Platelet Rich Plasma (PRP) has been used topically or as an injection to
stimulate collagen production and enhance the efficacy of cosmetic procedures such as fat
transfer, hair loss, laser treatments, and microneedling. Harvested PRP has platelets,
fibrin, and white blood cells, which contribute to wound healing, neocollagenesis, and
elastogenesis. Platelet Rich Fibrin (PRF) is the next generation of PRP and contains very
high concentrations white blood cells, fibrin and a small amount of mesenchymal stem cells
found circulating in our bloodstreams. Due to a lack of anticoagulant in the tube, PRF
becomes a gel after 15-20 minutes of being isolated. This is useful in reconstructive and
aesthetic medicine, which allows it to be used for cosmetic volume restoration in addition to
topical indications.

Hyaluronic acid fillers have become increasingly popular in aesthetic medicine over the past
two decades. Hyaluronic acid fillers are synthesized in a variety of different ways and last
anywhere from 6 to 24 months, depending on the volume and location of the face or body they
are injected. Fillers under the eyes in the "tear trough" area are popular treatments to
allow patients to appear more refreshed and rested. Although this is an "off label"
application of injectable fillers, it is extremely popular and is performed safely in many
aesthetic clinics worldwide. Given that PRF can be used to restore volume, it will be
determined if PRF in combination with hyaluronic acid filler will enhance resultant volume
and skin quality in the treated areas.

Objective: The purpose of this study is to investigate the efficacy and longevity of Platelet
Rich Fibrin (PRF) in combination with hyaluronic acid filler for cosmetic volume restoration
of the tear troughs. This study will also evaluate visible improvement in skin texture that
may be attributable to the added PRF.

Hypothesis: The addition of Platelet Rich Fibrin (PRF) to hyaluronic acid fillers contribute
to volume restoration of the tear trough and also improve the texture and quality of the skin
in the treated area. The patient will perceive a more natural and improved result on the
PRF-treated side.

Inclusion Criteria:

- Males/females aged 20-80 who are experiencing moderate volume loss of the tear troughs
and/or under eye bags. Eligible subjects will be in generally good health and able to
provide a blood sample for treatment.

Exclusion Criteria:

- Those who fall outside of the age range 20-80 years of age, with chronic health
problems including but not limited to thyroid disorders, cancer, blood disease, etc.
Those who do not demonstrate volume loss of the tear troughs to the degree that
warrants intervention. Conversely, those who are better suited for surgical
intervention as opposed to non-surgical injections will not be eligible.