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What’s The Procedure That’s Raising Physicians’ Eyebrows?

Discussion in 'General Discussion' started by Mahmoud Abudeif, Jun 4, 2019.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Silver Member

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    The lengths that some people will go to avoid the inevitability of aging include a procedure with a ghastly name. Doctors, it’s time to familiarize yourself with the Vampire Facial, also known as platelet-rich plasma injection (PRP). PRP is a procedure that certain specialists among you may know, but the rest have only come to appreciate after a recent spate of media coverage.

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    PRP is approved for applications in orthopedics, sports medicine, and wound care, where it can speed up the healing process. Experts at the Hospital for Special Surgery, the #1 orthopedic hospital in the United States, explained that PRP involves drawing a patient’s blood, spinning it in a centrifuge to separate the platelets and plasma, then reinjecting the suspension into the area targeted for treatment. The procedure is safe when proper sterilization protocols are followed. In a literature review of studies on PRP applications in orthopedics, researchers found that the procedure may be effective for certain injuries, such as knee osteoarthritis, but not for others.

    However, it gained national notoriety after two patients at a health spa in Albuquerque, NM, contracted HIV—likely from contaminated needles involved in the beauty treatment more commonly known as the “vampire facial.”

    PRP for aesthetic purposes rose to cultural prominence likely in large part because of Kim Kardashian-West. In 2013, she posted this photo to Instagram after undergoing the procedure. The procedure was then part of an episode of the show, Kourtney and Kim Take Miami. Kardashian later said that she would never undergo the procedure again due to the overwhelming pain. At the time, she was pregnant and had to forgo a local anesthetic.

    PRP itself is not an FDA-approved procedure, but rather is available off-label. The FDA, however, has approved some of the devices used in the procedure, asserting that the procedure should be administered by a healthcare professional for the treatment of “exuding cutaneous wounds, such as leg ulcers, pressure ulcers, and diabetic ulcers and mechanically or surgically-debrided wounds.” Nothing is discussed of the aesthetic treatment in the FDA approvals. Additionally, not all US states require a physician to administer the vampire facial, either.

    In the Albuquerque clinic, patients received these so-called vampire facials in the form of micro pen injections to the face. The intent behind the procedure, according to the American Society of Plastic Surgeons (ASPS), is to improve skin quality, including texture, tone, and the appearance of wrinkles.

    In an April 2018 news release, the ASPS said that PRP has early, promising results for cosmetic facial procedures; however, more research is required to determine the best preparation and injection techniques. In recent studies, researchers have highlighted the cosmetic benefits of PRP.

    Researchers of a 2018 comprehensive literature review published in Aesthetic Plastic Surgery highlighted how well-tolerated PRP tends to be, since it’s derived from the patient's own blood.

    “The lack of identifiable complications and convenience of treatment provides a positive outlook for future use and investigations,” concluded the authors of another 2018 study published in Facial Plastic Surgery Clinics of North America.

    In still another study published in the International Journal of Dermatology, investigators compared PRP in combination with other minimally-invasive procedure with the minimally-invasive procedures by themselves, and concluded that PRP had an enhancing effect.

    It seems that any uncertainty surrounding the efficacy of PRP in aesthetic procedures is in how it’s prepared. In 2017, a meta-analysis published in the Aesthetic Surgery Journal in which the authors called meaningful meta-analysis “unrealistic” for these reasons. They concluded: “The method of PRP preparation warrants increased attention. We recommend a set of descriptors…to produce scientifically grounded conclusions, facilitating a clearer understanding of the situations in which PRP is effective.”

    The issue at the Albuquerque Clinic doesn’t appear to be PRP itself, but how it was administered. CNN reported that the New Mexico Department of Health shuttered the spa in September 2017 for blood-borne infection control issues. The New Mexico Department of Health has extended free blood-borne illness testing for all patients of the spa who visited between May and September 2018.

    The so-called vampire facial is the creation of Charles Runels, MD, who holds the trademarks for The Vampire Facial® and Vampire Facelift®. Dr. Runels issued a statement when news first broke of the safety violations at the Albuquerque clinic, saying that those responsible at the clinic were imposters. Dr. Runels maintains a list of certified vampire facial providers on his website.

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