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Rejuvenating the periorbital area using platelet-rich plasma: a systematic review and meta-analysis

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Abstract

Intradermal injection of autologous platelet-rich plasma (PRP) is a non-surgical cosmetic therapy to rejuvenate the periorbital area pathologies of wrinkles, periorbital hyperpigmentation (POH), and photoaging. The past decade has seen the adoption of this novel therapy around the world. This is the first systematic review and meta-analysis evaluating PRP treatment of periorbital pathologies. This is a PRISMA compliant review that includes a comprehensive search of the databases Cochrane Library, Ovid Medline, Ovid Embase, and clinicaltrials.gov. The search was performed in June 2019 to obtain all peer-reviewed articles published in English that describe the application of PRP to periorbital pathologies. A meta-analysis of patient satisfaction was performed for randomized controlled trials. Nineteen studies treating 455 patients (95% female, age range 28–60) were included. Studies were categorized based on reported outcomes: wrinkles (11 studies), POH (7 studies), and photoaging (6 studies). Patients were treated a mean of 3 times (range 1–8) in mean intervals of 23 days (range 14–56 days). Follow-up averaged 3 months (range 1–6 months). Meta-analysis of 3 randomized controlled clinical trials (RCTs) shows that patients treated with PRP have increased satisfaction above controls of saline, platelet-poor plasma, mesotherapy, and as an adjunct to laser therapy (overall effect p = 0.001, heterogeneity I2 = 64%). PRP treatment of periorbital area pathologies results in histologic improvements of photoaging, subjective satisfaction score increases, and blind evaluator assessments of rejuvenated skin appearance. Future studies are needed to address limitations of the current literature and should include long-term follow-up, delineation of the POH etiology that is treated, RCTs with low risk of bias, and be absent conflicts of interest or industry sponsors.

Trial registration: Prospero Systematic Review Registration ID: CRD42019135968

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  1. Adam G. Evans

    Present address: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA

Authors and Affiliations

  1. Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN, 37208, USA

    Adam G. Evans, Mirjana G. Ivanic & Mina A. Botros

  2. Department of Plastic Surgery, Vanderbilt University Medical Center, D-4207 Medical Center North, 1211 Medical Center Drive, Nashville, TN, 37212, USA

    Mirjana G. Ivanic, Gabriella E. Glassman & Salam Al Kassis

  3. Vanderbilt University School of Medicine, 1161 21st Ave South, Nashville, TN, 37232, USA

    Rand W. Pope & Briana R. Halle

  4. University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN, 38163, USA

    Rafaella Genova

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Contributions

The project was conceptualized and designed by AE and SAK. The search strategy was designed by AE, MI. The search was performed by MI and BH. Article selection was done by AE and MI. Data extraction was performed by AE, MI. Tables were made by AE, MI, RP. Meta-analysis was performed by AE, MB. Figures were made by AE, MI, and MB. The first draft was written by MI. Revisions to writing were performed AE, RP, GG, RG, SAK.

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Correspondence to Adam G. Evans.

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The author Mirjana Ivanic had dual affiliation at the time of this research at both Meharry Medical College and Vanderbilt University Medical Center.

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Supplementary file1 Online Resource 1. Full Search Strategy. The search terms and sequence that was applied to the databases Cochrane Library, Ovid Medline, Ovid Embase, and clinicaltrials.gov. (DOCX 17 KB)

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Evans, A.G., Ivanic, M.G., Botros, M.A. et al. Rejuvenating the periorbital area using platelet-rich plasma: a systematic review and meta-analysis. Arch Dermatol Res 313, 711–727 (2021). https://doi.org/10.1007/s00403-020-02173-z

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