Platelet Gel in Facial Surgery: Is The Excitement Warranted?

The use of this technology is probably driven by the doctor, who believes in it and makes the time commitment and investment to do it. But, it is not a magic powder; it is a valueadded service. – Barry L. Eppley, MD, DMD

The placement of the volume of gel must be judicious, Dr. Clevens pointed out, so that there is no hematoma formation as a result of applying excessive volume of fluid to the wound. However, physicians can quickly learn to apply the gel, he believes. For orthopedic procedures and mammoplasty, which require larger volumes of the gel, the production of PRP may be done using a hospital-based system. In that case, the gel treatment is often reimbursable, since it is part of a more extensive surgical procedure.

A Down Side?

According to Dr. Clevens, the disadvantages of using platelet gel are minimal. The added cost-about $300 per case-is simply added to the procedure total. And because his patients demand quicker recovery times from cosmetic surgery-which is performed on a self-pay basis-this minimal added cost has not been an issue in his experience. Practitioners and patients alike are also enthusiastic about the ability to produce the concentrate from the patient’s own blood. Because platelet gel is an autologous product, there is clearly no risk of disease transmission or allergic reaction, said Dr. Clevens.

Dr. Eppley agrees that the theoretical appeal of using platelet gel to speed wound healing is great. And, from a technical standpoint, he said, producing the gel is relatively convenient, and the costs-which get passed on to the patient-are reasonable.

However, in view of the small number of clinical studies with prospective or retrospective controls demonstrating the enhancement of healing with PRP, Dr. Eppley and others believe that the jury is still out on this treatment. Scientifically, he reiterated, the evidence is not compelling. Probably what [the use of platelet gel] represents is the forerunner of better things in the future. I think the concept of extracting factors from a patient, and re-implanting them, to aid the healing process, is not going to go away. However, for the typical patient who does not have a healing problem, the benefits may not be as clear.

In the right patient-such as a person who smokes or who has compromised healing-it probably has some benefit. The use of this technology is probably driven by the doctor, who believes in it and makes the time commitment and investment to do it. But, he concluded, it is not a magic powder; it is a value-added service.