Platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and exosomes represent the forefront of regenerative injectables, offering cell-based and cell-free options for tissue repair, wound healing, and aesthetic rejuvenation. These therapies leverage autologous or bioactive molecules to stimulate healing, modulate inflammation, and promote collagen synthesis. At Cosmetic Injectables Center Medspa, all regenerative injectable procedures are performed by certified expert injectors under the direct medical supervision of Dr. Sherly Soleiman, MD, a board-certified physician and national leader in medical aesthetics.
PRP: Platelet-Rich Plasma
PRP is an autologous blood concentrate, rich in growth factors and cytokines, used to stimulate tissue repair and regeneration. Its applications span orthopedics, dermatology, wound healing, and medical aesthetics.
Mechanism and Preparation
PRP is prepared by centrifuging a patient’s blood to concentrate platelets and growth factors. Modern protocols standardize preparation, yielding reproducible cytokine profiles for consistent clinical outcomes (2013 systematic review). PRP acts as a reservoir of growth factors, supporting cell proliferation and tissue regeneration (2014 review).
Clinical Evidence
- Knee Osteoarthritis: PRP injections provide superior pain relief and functional improvement compared to viscosupplementation, with benefits lasting up to 12 months (2025 meta-analysis).
- Rotator Cuff Tendinopathy: PRP improves pain and function in shoulder injuries (2025 meta-analysis).
- Tendinopathy: PRP supports tendon healing with a favorable safety profile (2025 meta-analysis).
- Wound Healing: Combining PRP with mesenchymal stem cells (MSCs) accelerates wound closure and tissue regeneration, especially in diabetic wounds (2025 meta-analysis).
Histological Insights
PRP has demonstrated regenerative changes at the cellular level, including restored architecture in testicular tissue and promotion of spermatogenesis (2025 study).
Regulatory Context
PRP is classified as a 361 HCT/P product by the FDA, must not contain added drugs, and is used off-label in compliance with minimal manipulation rules (FDA guidelines). All PRP procedures at Cosmetic Injectables Center Medspa adhere to these standards.
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PRF: Platelet-Rich Fibrin
PRF is a second-generation autologous concentrate forming a fibrin matrix that gradually releases growth factors, providing a natural scaffold for tissue repair.
Mechanism and Preparation
PRF is produced by centrifuging blood without anticoagulants, resulting in a fibrin clot that entraps platelets and leukocytes. This matrix supports sustained growth factor release and cellular migration, making PRF valuable for bone and soft tissue regeneration (2023 review).
Clinical Evidence
- Alveolar Ridge Preservation: PRF reduces bone resorption and preserves volume after tooth extraction (2025 systematic review).
- Periodontal Regeneration: PRF combined with bone grafts improves defect fill and clinical attachment in intrabony defects (2025 meta-analysis).
- Orthopedics: Injectable PRF (i-PRF) promotes bone and soft tissue healing with superior histological integration compared to PRP (2025 review).
Histological Insights
i-PRF combined with exosomes reduces inflammation and improves collagen organization in tendon repair models (2025 study).
Regulatory Context
PRF is subject to the same FDA oversight as PRP, requiring compliance with minimal manipulation and autologous use (FDA guidelines).
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Exosomes
Exosomes are extracellular vesicles containing proteins, lipids, and nucleic acids, acting as messengers to modulate inflammation, promote angiogenesis, and stimulate tissue repair. Unlike PRP and PRF, exosomes are cell-free and can be derived from various sources, including stem cells and plants.
Mechanism and Preparation
Exosomes transfer bioactive molecules between cells, influencing cellular behavior and tissue regeneration. Their cell-free nature reduces the risk of immune rejection and allows for targeted delivery of therapeutic signals (2024 review).
Clinical Evidence
- Knee Osteoarthritis: MSC-derived exosomes improve joint function and reduce cartilage degradation in preclinical models (2025 meta-analysis).
- Osteoarthritis: Extracellular vesicles modulate inflammation and promote cartilage repair (2024 review).
- Spinal Cord Injury: Bone marrow MSC exosomes enhance motor recovery and survival in animal models (2025 meta-analysis).
- Diabetic Neuropathy: Exosomes from stem cells support nerve regeneration and pain reduction (2025 meta-analysis).
Histological Insights
- Plant-Based Exosomes: Increase epithelial thickness, reduce inflammation, and boost collagen in wound healing (2025 study).
- PRP-Derived Exosomes: Accelerate diabetic wound healing with enhanced angiogenesis and collagen remodeling (2025 study).
Regulatory Context
No exosome products are FDA-approved for regenerative or orthopedic use outside clinical trials. Use in clinical practice must comply with FDA guidance and is considered investigational (FDA compliance).
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Comparison Table: PRP vs PRF vs Exosomes
| Feature | PRP | PRF | Exosomes |
|---|---|---|---|
| Source | Autologous blood | Autologous blood | Stem cells, blood, or plant-derived |
| Preparation | Centrifugation with anticoagulant | Centrifugation without anticoagulant | Ultracentrifugation/filtration |
| Matrix | Liquid | Fibrin clot/matrix | Cell-free vesicles |
| Growth Factor Release | Rapid | Sustained (slow release) | Controlled via vesicle content |
| Clinical Use | Orthopedics, dermatology, aesthetics | Dental, orthopedics, wound healing | Experimental, wound/nerve/cartilage |
| FDA Status | 361 HCT/P, off-label | 361 HCT/P, off-label | Investigational, not FDA-approved |
| Immune Risk | Minimal (autologous) | Minimal (autologous) | Low (cell-free, but source-dependent) |
| Internal Links | PRP, PRF & PRFM, Microneedling | PRP, PRF & PRFM, EZGel | Exosomes |
Indications and Procedure Options
Medical Aesthetics and Regenerative Medicine
- Skin Rejuvenation: PRP and PRF are used for facial rejuvenation, microneedling, and scar revision.
- Hair Restoration: PRP is commonly injected into the scalp to support hair growth.
- Wound Healing: PRP, PRF, and exosomes are being studied for chronic wound management.
- Orthopedic and Dental Applications: PRP and PRF are established in joint, tendon, and bone healing; exosomes are under investigation.
Procedure Options at Cosmetic Injectables Center Medspa
All procedures are performed by certified expert injectors under Dr. Soleiman’s direct supervision, with a focus on patient safety, transparency, and natural results.
Safety, Regulation, and Patient Considerations
- FDA Oversight: PRP and PRF are regulated as 361 HCT/P products and must be prepared from the patient’s own blood. Exosome therapies are investigational and not FDA-approved for clinical use outside trials (FDA guidance).
- Informed Consent: All patients receive a comprehensive Good Faith Exam and full disclosure of risks, benefits, and alternatives.
- Individual Results: Outcomes vary based on indication, patient health, and procedure technique.