Improving Wrinkles and Skin Quality Under the Eyes with Platelet-Rich Plasma (PRP)

A woman says she has horrible crêpiness and wrinkling under her eyes. She wants to know the best treatment aside from fractional CO2 laser, which she has already repeatedly tried.

Dr. Amiya Prasad is a board-certified cosmetic surgeon practicing in Manhattan and Long Island for over 20 years. He also had fellowship training in oculofacial plastic surgery. Eyelid surgery and eye rejuvenation is a focus of his practice.

The majority of treatments for the under eye area have to do with some type of thermal energy, but unfortunately, there is a limit to what thermal energy can accomplish. In the 90s, doctors were using the original, very aggressive CO2 laser and it created a lot of good, tight results, but it also created undesirable results when used excessively. The pendulum swung towards less aggressive lasers such as the erbium laser which Dr. Prasad has used for many years. He also observed that people who came for consultations also did chemical peels and/or another type of laser repeatedly which made eyelid skin even thinner.

During aging, the skin loses collagen, blood supply and it becomes irregular. For the past several years, Dr. Prasad’s practice has been in the forefront of certain regenerative medicine and technology where he helped people using platelet-rich plasma (PRP). This uses the body’s own healing factors which are injected under the skin. Generally, when someone has this much crêpiness like this woman, with strategic placement, it has been able to significantly improve skin quality without using lasers.

This is not a onetime treatment. In the modern world, people want quick or immediate results. However, in treating skin, it can’t be beautiful overnight. There are certain limitations especially when someone has reached a certain age, has a certain amount of sun exposure, and if they have been smoking. They have to eliminate a lot of those potential toxic reasons for the crepiness.

Dr. Prasad has also done PRP with Acellular matrix for hair loss. He doesn’t necessarily place in under the eyelid with the same concentrations. With PRP, he builds tissue rather than heating. Sometimes, if someone’s skin is a little bit thicker, he’ll combine the effect of PRP with laser at the same time.

Dr. Prasad suggests that patients learn more about this modality and see what they can do from a more holistic approach. Clearly there’s only so much one can do to build the collagen. He agrees with the person and would not recommend lasers because they will not get significant improvement with more laser treatment.

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