PRF Injections: What to Know About the Treatment

Is it hyperbole to say that Kim Kardashian getting a "vampire facial" on Keeping Up With the Kardashians was a beauty cultural reset? You might think so, but I believe that single facial introduced the world to a variety of blood-adjacent procedures. One you might have on your radar is PRF injections. Like a vampire facial, this procedure involves using your own blood to help treat a number of concerns, including under-eye bags, wrinkles, sagging cheeks, and jowls.

We spoke with two board-certified facial plastic surgeons and a dermatologist to get all the info about PRF injections. Keep scrolling to read more about how to prepare, the benefits, and the cost, below.

What Are PRF Injections?

In simple terms, PRF injections use your own blood to help rejuvenate your skin, especially in the under-eye area. We'll get into more detail later, but PRF bears some similarities to the popular PRP treatments athletes sometimes undergo for injuries. Double board-certified facial plastic surgeon Dr. Michael Somenek goes into more detail. "Platelet-rich fibrin (PRF) injections are essentially a form of undereye fillers," he says. "They're considered the next generation of platelet-rich plasma (PRP) treatments, which are usually used to aid sports injuries. PRF is an autologous blood concentrate that uses your blood to help rejuvenate your skin."

"In a PRF procedure, blood is drawn from the patient and centrifuged at slower speeds than in a PRP (platelet-rich plasma) procedure," board-certified dermatologist Dr. Brendan Camp adds. "The absence of an anticoagulant in the tube allows the formation of a spongy, gel-like product rich in platelets, stem cells, growth factors, and fibrin that can be injected into the skin to address signs of aging, hair loss, or skin healing."

Benefits of PRF Injections

• Uses your body's own cells
• Can potentially treat under-eye circles
• Can potentially decrease wrinkles
• Minimal risk of side effects
• Stimulate skin healing
• Can potentially improve hair loss

"The main benefit of PRF is that it employs your body’s own cells in a way to promote the health of your skin. As the product originates from the patient, it is very safe," Camp reiterates.

However, if you're looking to PRF injections as a replacement for fillers, especially in areas like the under-eye or cheeks, you may find yourself disappointed. "The reality is they don't really create a volume change there," says Dr. Amir Karam. "For treatment under the eyes or different places where a filler normally is needed to add volume, PRF injections are going to be ineffective. And then when there is not a substantial change in appearance to these areas, the conclusion is that the individual patient was a poor responder to the growth factors and therefore wasn't able to create volume in response. So, in my opinion, this is a very unreliable way of adding volume to correct volume loss in the face."

Karam goes on to explain that many places that offer the treatment will ask you to go in for five injections. "As you can imagine, going in five times to get your under eyes injected, the amount of bruising and trauma to that area is pretty substantial," he says. "And even in those cases, you rarely see a significant enough change. So for healing purposes and potentially giving the skin a little bit of a boost following microneedling, it probably has some value, but not as a filler substitute."

How to Prepare for PRF Injections

There are a number of things you'll want to make sure you have in order before your PRF injections. Thankfully, Somenek gave us the full rundown.

• Avoid any non-steroidal anti-inflammatory drugs (NSAIDs) for two to four weeks before your treatment. NSAIDs include Aspirin, Ibuprofen, Aleve, Motrin, or Excedrin (if your physician instructs you to take these medications, get clearance before stopping any of them). These medications can potentially interact with the PRF platelet coagulation process, rendering the treatment less effective. Note, Tylenol is not a blood thinner and is okay to take before treatment.
• Don’t forget to hydrate. Hydration is key to obtaining enough quality PRF during your treatment and getting better results. You should drink at least 64 oz of water throughout the day before your appointment. On the day of your appointment, be sure to come hydrated and moisturize the injection area beforehand.
• Avoid consuming alcoholic beverages for at least seven days prior to your treatment.
• Avoid Omega 3s, fish oil, ibuprofen, vitamin E, garlic supplements, and aspirin for two to four weeks prior to your treatment (if your physician instructs you to take any of these medications, make sure to get clearance before stopping any of them).
• Hold off on using any topical retinol and/or exfoliating acid products three days before your treatment and three days after to avoid any potential excess skin redness or irritation.

And as always, you want to make sure that the medical spa or medical facility you're going to is reputable and uses sterile techniques and sanitary instruments, since there is blood being drawn. Karam can't emphasize this enough: "Because your blood is being drawn and re-injected, using sterile techniques is extremely important, otherwise, you have the risk of forming infections, which could be very difficult to treat in the locations that they're injected in."

What to Expect During PRF Injections

If you have any aversion to blood or are squeamish about needles or getting your blood drawn, this is maybe where you're going to reconsider getting PRF injections, as the procedure involves all three of those things. Somenek explains in more detail: "A technician will draw two vials of blood that are then placed inside a centrifuge. While the blood spins, you will be seated with numbing medication to limit discomfort. After spinning, the PRF becomes separated from other blood components and withdrawn from the top of the vial. Once complete, the PRF is injected using a blunt-tipped cannula."

So where can you get this magic blood serum injected? "The final product is either injected to treatment sites like facial wrinkles, under the eye or applied using microneedling, both of which can be associated with some pain," says Somenek.

You can expect this entire procedure to last anywhere from 20-45 minutes, depending on the location you're getting injected. You might need anywhere from three to five treatments to see results.

PRP Injections vs. PRF Injections

As we mentioned earlier, PRF injections are similar to another type of injection, PRP injections. PRP injections are typically used for athletes undergoing treatment for injuries or to help them recover from injuries quicker. But there is also a fundamental, scientific, difference between the two. Karam explains:

"PRF is plasma rich fibrin. PRP is plasma-rich platelets. PRP is spun at a much higher rate in the centrifuge, therefore, most of the cells—white cells, stem cells, blood cells, etc., are kept at the bottom of the tube and the lighter cells, the platelets, are kept in the serum and the top level after spinning.

"PRF, on the other hand, is spun at a slower rate, so a lot of the white cells, stem cells, and platelets are kept in the top layers of the post-centrifuge tube, while the red cells will make their way down to the bottom. That is what is injected into the tissues, as opposed to just platelets and serum."

So why would someone want to choose PRF for the face? "The idea is that there would be potentially more growth factors and stem cell effect in the PRF treatments, as opposed to PRP," says Karam.

Potential Side Effects

As is the case with all injections, there is always a risk of redness, bruising, and pain caused by the needle used. "With any blood draw and injection there is the risk of bruising," says Camp. "Pain at the site of injection can also occur, as can redness and swelling. A headache is sometimes reported after injections into the scalp."

Getting PRF under your eyes, specifically? "Because it is a fluid-like substance being injected under the eye, you should expect some swelling and/or puffiness that can last about three to five days," adds Somenek.

The Cost

So, PRF injections are not cheap, which is where Karam's opinions about it not being a substitute for filler comes in. If you're looking at getting PRF treatments instead of fillers, it might not be the most cost-effective solution.

Like most treatments, the cost of PRF injections can vary by location, physician, and office, but you can expect to pay anywhere from $500 all the way up to $2000 per treatment. Since you need up to five treatments, you can expect to pay anywhere from $2,500 to a whopping $10,000 total.

Aftercare

As mentioned, you may experience some bruising following your treatment, but the downtime is minimal, explains Camp. "Post-treatment, it is not uncommon to have some under-eye swelling or bruising," Somenek adds. "You may experience under-eye fullness for three to five days after injection, along with a yellowish discoloration to the skin until the PRF fully dissipates. You will begin to see the results of your treatment become noticeable around the one to two month mark, as the structures and collagen under the eye continue to build. All in all, most PRF injections have no discomfort afterward."

Camp advises if you do have any discomfort, you can treat it using a cold compress and an over-the-counter pain medication like acetaminophen. And as always, sun protection should also be used afterward. 

The Final Takeaway

PRF Injections are a trendy treatment, but considering the cost and how many treatments you'd need to get done to see results, it may not be the right option for you.