الفهرس 
INTRODUCTION AND RATIONALEOnly 14 pages are availabe for public view
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Abstract
Platelet rich plasma (PRP) has been used over the last several years as an effective treatment in various surgical and medical fields. In odontology (Anitua, 2001), PRP has been proven successful in gingival regeneration. In orothopedics it is used in acceleration of improvements in bone fracture healing and in articular cartilage repair. (Garciac and Albandea GNA.2007). In traumatology it is used in muscle strain injuries (Henderson, 2003) and interesting results have also been reported in the treatment of osteodegenerative diseases and in the management of patients with complex injuries (Kakudo, 2008). PRP is used in ulcer reconstruction (Mehta, 2008) and it has proven to be very effective in diabetic patients (Rutkowski, 2008). The use of PRP has long been known in aesthetic medicine as well (Anderson and Baker, 2003), although very few of the studies were specifically directed to benefits in face and neck revitalization.
Platelet rich plasma is an autologous product derived from whole blood through the process of gradient density centrifugation; it concentrates a large number of platelets in a small volume of plasma (Marx, 2004). Autologous PRP has been shown to be safe and effective in promoting the natural processes of wound healing, soft tissue reconstruction, and bone reconstruction and augmentation. The potential value of PRP lies in its ability to incorporate high concentrations of platelet-derived growth factors, as well as fibrin, into the graft mixture (Rick et al., 2007). PRP mimics the last step of the coagulation cascade, leading to the formation of a fibrin clot (Liu et al., 2002). PRP functions as a fibrin tissue adhesive with hemostatic and tissue sealing properties, but it differs from fibrin glue and other platelet-poor tissue adhesives because its platelets provide a unique ability to promote wound healing and enhance osteogenesis. Recently published studies have demonstrated beneficial results with PRP used in a broad range of clinical healing applications. Moreover, PRP can be exogenously applied to soft tissues to promote wound healing and tissue sealing, in patients undergoing certain surgical procedures (Yazawa et al., 2003).
Over 4.5 million nonsurgical procedures were performed in the US in 2008 for skin rejuvenation (Cosmetic surgery national data bank, 2009). Volume deficiency in tissues as age increases is what makes people seek and get injectable dermal filler treatments, looking for a younger and rejuvenated look (lemperle et al., 2001).
Skin rejuvenation is any cosmetic or medical procedure used to attempt the reverse the visible signs of ageing. Skin rejuvenation processes have the ability to diminish wrinkles and lines as well as firm loose and sagging areas of the skin giving a younger appearance. There are some surgical and medical procedures that can enable this (Cavalini, 2004).
With time certain changes occur to the skin that affect its appearance. With age, one of the changes occurring in the skin is decreased sebum production, leading to loss of its natural luminosity because of dryness, and decreased shedding rate of keratin giving the skin a dull appearance. They cause uneven looking patches on the skin, creating a rough dull patches on the skin. Loss of the skin’s natural hydration also occurs with age, which means lack of its ability to retain water, which evaporates. Lipids in the ceramide lipids barrier, produced in smaller quantities, so no longer forms a homogenous barrier and so skin barrier no longer performs its function as effectively (Elias et al., 2008). This allows external aggressors and irritants (pollution, allergen particles, etc to penetrate deeper into the skin. Skin thus becomes more vulnerable and reactive, and is more rapidly strongly irritated (Candi et al., 2005).
These effects lead to loss of