The Effect of Platelet-Rich Fibrin on Nasal Skin Thickness in Rhinoplasty

Abstract

The study hypothesized the potential positive effects of platelet-rich fibrin (PRF) in postoperative rhinoplasty patients, such as better wound healing, less dead space, and less edema. The authors assessed PRF for nasal dorsum camouflage and studied its potential effects on nasal dorsal skin in rhinoplasty. Thirty-eight patients who underwent open approach primary rhinoplasty were categorized into two groups: nasal dorsal PRF group and control group. PRF membrane was used for nasal dorsum camouflage and laid over the bony dorsum and cartilage framework of the supratip area. Skin and subcutaneous soft tissue thickness were measured by linear superficial tissue ultrasound at the pre- and postoperative first week and the third month in both groups. Mean skin thickness over the supratip area was significantly higher in the control group in the first-week control. There were no significant differences in both first-week and third-month controls' nasal dorsum mean skin thickness measurements between the two groups. Regarding PRF complications, we encountered no complications in either group, including scarring, hematoma, infection, skin discoloration, and acne. The authors present the application of PRF membrane over the bony dorsum and cartilage framework of the supratip area. They observed its positive effect on postoperative edema, especially in the early postoperative period. Long-term investigations have to be performed to evaluate its potential effect on the rhinoplasty procedure. This was a level of evidence 3 study.

Use of the Autologous Membrane in Structured Rhinoplasty: An Alternative to Camouflaging and Filling

“…Associating the findings of the literature that state a real effect on connective tissue formation despite PRF’s resorption 15 with those of maintaining the camouflage results after 3 months, the membrane’s detection on ultrasound, 31 the reduction in cartilage’s resorption with PRF, and the consistence of our clinical results for up to 12 months, we consider the use of the L-PRF membrane in rhinoplasty an alternative option. Also, growth factors present in L-PRF have already improved and accelerated healing.…”

“…Choukroun et al 15 evaluated the histologic effects of the use of PRF on the maturation of bone allografts in implant dentistry and observed that, despite the reabsorption of PRF, there was the presence of neoformed bone and connective tissue, indicating a real biologic effect. Gode et al 31 also described the use of L-PRF in primary rhinoplasties and evaluated camouflage and edema. They did not observe membrane resorption after 3 months of surgery using ultrasound to measure the thickness of the subcutaneous and soft tissues.…”

The use of piezoelectric instrumentation and platlet rich fibrin matrix in septorhinoplasty: Report of two cases

“…Gode et al investigated effects od PRF on postoperative edema and wound healing with ultrasonography as an objective evaluation method and they found positive effects od PRF on postoperative edema, especially in the early postoperative period. Patients who have thicker skin have bigger tendecy of forming ,,dead space" which can later be filled with scar tissue, which consequently leads to persiestent edema and bad cosmetic outcome [7]. It is author's opinion that PRF membrane should be used mandatory in this kind of cases.…”

“…There are many studies which have shown positive effects of platelet-rich fibrin (PRF) in postoperative rhinoplasty patients. [6,7]. PRF is developed and published by Choukroun in 2001 and first it was mostly used in oral and orthopedic surgery for bone regeneration and in plastic surgery for chronic wound healing.…”

“…After centrifugation final product is separated i three parts and PRF is created in the middle as a complex fibrine matrix which can be pulled out and put on bony and cartagiloneous vault of the nose [8,9]. Gode et al applied PRF membrane on bony dorsum and supratip area and observed positive outcome on skin thickness and postoperative edema, especially in early postoperative period [7].…”