Mr Basim Matti FRCS London Dr Peter Everts PhD Eindhoven, Holland

1. Mr BasimMatti FRCS London Dr Peter Everts PhD Eindhoven, Holland

2. Mr Matti 31 Patients Data Set as of 1st November 2011

3. PRP PRP is an autologous blood product with a high concentration of platelets. The platelets produce a cocktail of Cytokines and Growth Factors, which trigger and accelerate the regeneration of tissues.

4. PRP It is concentration of human platelets in a small volume of plasma measured > than 1,000,000 platelets /mm³ = 4-6x the normal Normal value of platelet concentration in whole blood 150,000-400,000mm³

5. Aim Of PRP Therapy • Regeneration of collagen and Elastine fibres • Prevention of collagen degradations • Rejuvenation of the skin

7. Wound healing principles

9. Platelet physiology

10. Platelet activation

11. Growth Factors

12. Platelet Rich Plasma Concentration of Growth Factors • PDGR – 130 times Platelet derived Growth Factor • TGF beta – 80 times Transforming Growth Factor-beta. • VEGF – 11 times Vascular Endothelial Growth Factor • IGF 1 Insulin like Growth Factor, HGF Hepatocyte GF, Basic Fibroplasten GF

13. How Growth Factor Works

14. Areas for injection Injection sites into dermal layer and dermal junction

15. Seishin Institute Japan. • >12,000 patients undergone PRP Therapy • “NEW PRP Skin Regeneration Therapy, • three to five times richer in platelets than conventional PRP therapy • inject platelet-rich plasma containing white blood cells. “ • http://www.saiseiiryou.com Hyaluronic Acid PRP Source: Seishin Institute Japan

16. Cytomedix Angel System Enclosed Point of Care System

17. Automatic collection of PRP

18. Peripheral blood Platelet level 276.000mm³ Dense Platelet concentration 2.750.000mm ³ using Angel™ System

19. Other Test Tube systems

20. Our PRP Technique • 52ml blood draw • 8mls citrate ACD-A • Angel processing 18 minutes • PRP yield 2mls highly concentrated • average 12.2 x baseline platelets • Add 4mls platelet poor plasma • = 6mls PRP injected with platelet concentration >850.000mm³ • >3-4 x baseline platelet concentration

21. Video: Procedure 56secs www.youtube/avancemedical/final_edit_5th_November

22. Our Experience: Cohort n31

23. Pre 8 wks Post

24. Source: Sclafani A.P. (2010) Platelet Rich Fibrin Matrix for improvement of deep naso-labial folds . Journal of Cosmetic Dermatology , Vol.9: 66-71

25. Sclafani A.P. (2011) Safety, Efficacy and Utility of Platelet Rich Fibrin Matrix ARCH Facial Plastic Surgery Published on line Feb 2011 doi:10.1001/archfacial.2011.3 Sclafani A.P. (2009) Applications of Platelet Rich Safety, Fibrin Matrix in Facial Plastic Surgery Facial Plastic Surgery Vol 25 No. 4

26. Patient Questionnaire Key questions: • Improvement in tone of skin • Improvement in texture of skin • Reduction in lines • Improved ‘glow’ or radiance of the skin • Volumetric improvement ????

27. PATIENT SURVEY • Respondents 21 patients • 19% (4 patients) see no difference • 81% (17 patients) see and feel a difference in skin tone and texture. • 42.86% (9 patients) state they see a marked improvement in skin tone, texture and reduction of lines. • 38.1% (8 patients) extremely satisfied with the results.

28. Age Distribution

29. Further Research • Number & intervals of treatments • Longevity of treatment • Combination therapies • Micro needling • Mesotherapy • Ultrasound • Cost of treatment • Is it worth it?

30. THANK YOU barbados meating

31. Thank you